NCS Neuroimaging and Stimulation Flashcards
true or false: following neurologic injury, you are only able to see local strucutral changes on imaging
false - there are local and wide spread changes you can see
what is the best imaging for neurological injury
a. MRI
b. PET scan
c. CT
d. DTI
e. multimodal imaging
e. multimodal imaging
the brain changes resulting from experience are associated with
a. gray matter changes
b. white matter changes
c. both gray and white matter changes
c. gray and white matter changes
the brain changes resulting from experience are associated with structural changes in the brain. if a person does not continue to use that skill, what brain structure changes do we expect to see
a. gray matter reduction
b. white matter reduction
c. both gray and white matter reduction
b. white matter reduction
which of the following imaging techniques is not sensitive enough to see microscopic structural changes in the brain
a. MRI
b. DTI
c. cortical morphometry
d. myelin weighted imaging
a. MRI
which of the following imaging techniques is not sensitive enough to see microscopic structural changes in the brain
a. CT
b. DTI
c. cortical morphometry
d. myelin weighted imaging
a. CT
true or false: DTI is an imaging technique used to assess structural damage of white matter pathways
true
true or false: DTI is an imaging technique used to assess functional damage of white matter pathways
false - structural
true or false: balance training has been correlated with white matter neuroplastic changes
true
which of the following patients has the best prognosis:
a. young patient with widespread white matter injury
b. old patient with widespread white matter injury
c. old patient with little white matter injury
d. young patient with little white matter injury
d. young patient with little white matter injury
which of the following is an MRI approach to assessing brain function
a. arterial spin labeling (ASL)
b. EEG
c. SPECT
d. TMS
e. functional near infrared spectroscopy (fNIRS)
a. arterial spin labeling (ASL)
which of the following imaging approaches uses blood oxygen level dependent levels to assess neural activity
a. EEG
b. fMRI
c. TMS
d. fNIRS
e. SPECT
b. fMRI
true or false: fMRI has good time resolution to assess brain function
false - assesses by second, not at the ms that the brain operates at
true or false: fMRI is an appropriate imaging technique to assess brain function for a patients hand dexterity in a seated position
false - cannot be technically complex as pt needs to be supine
true or false: fMRI is a direct measure of neural activity
false - indirect as looks at BOLD (blood)
which of the following is true: fMRI has
a. good spatial resolution and good temporal resolution
b. good spatial resolution and bad temporal resolution
c. bad spatial resolution and good temporal resolution
d. bad spatial resolution and bad temporal resolution
b. good spatial resolution and bad temporal resolution
According to Sagi et al., 2012, what is the shortest amount of time to create an acute brain change with performing balance training?
a. 45min
b. 1 hour
c. 2 hours
d. 4 hours
c. 2 hours
true or false: EEG is a direct measure of neural activity
True
Which of the following is not a positive of EEG imaging?
A. Direct measure of neural activity
B. Good temporal resolution
C. Good spatial resolution
D. Can assess electrical activity at rest or during activity
C. Good spatial resolution - incorrect, EEG has limited spatial resolution
Which of the following is not a con of EEG imaging?
A. Susceptible to noise
B. Requires training to interpret/perform
C. Poor spatial resolution
D. Non invasive
D. Non invasive
true or false: EEG is placed directly onto the scalp
true
true or false: TMS is placed directly onto the scalp
true
which of the following imaging techniques can give you a causative relationship between action/sensation and brain activation
a. fMRI
b. EEG
c. DTI
d. TMS
d. TMS
the others can only demonstrate correlations
which of the following imaging techniques is not feasible in the clinic
a. fMRI
b. EEG
c. TMS
a. fMRI
which two imaging techniques are typically paired together as a multimodal approach to assess brain network/activation changes after injury
a. TMS and fMRI
b. TMS and EEG
c. EEG and DTI
d. DTI and fMRI
b. TMS and EEG
true or false: TMS is used solely a neuromodulatory technique to excite or inhibit particular brain areas
false - TMS can be neuromodulatory or investigatory to measure response
You have been seeing Johnny for persistent post-concussion symptoms. You want to assess Johnny’s brain function during UE activity in the clinic. You happen to have several imaging options at your disposal due to your affiliations with a teaching hospital. Which is the most clinically practical imaging tool to select and why?
a. fMRI
b. TMS
c. EEG
d. TMS and EEG
c. EEG
NOT fMRI: fMRI does provide a lot of useful information, including spatial resolution, it is quite impractical in regards to cost and efficiency.
NOT TMS: Evidence of using TMS in concussion assessment is limited. Also, TMS cannot be used for assessment while performing a motor task as its output measure is a motor evoked response.
YES EEG: is sensitive to the dynamic properties of the brain and can be used to assess brain function during a motor task, such as handwriting.
NOT TMS and EEG: Using both TMS and EEG in conjunction would minimize the inherent limitations of each approach, as well as provide both structural and functional information regarding Johnny’s concussion. However, it is not the most clinically practical due to increased cost, training required, and decreased portability.
what is the most common imaging technique to assess CVA in chronic stages?
a. EEG
b. MRI
c. DTI
d. combination/multimodal imaging
d. combination/multimodal imaging
true or false: CVA only affects white matter integrity
false - CVA affects both white matter and grey matter but greater white matter
transcallosal inhibition results in significant impairment following which neurologic injury
a. PD
b. MS
c. ALS
d. CVA
d. CVA
true or false: in CVA, high frequency excitation TMS to the affected hemisphere results in both improved motor and sensory function
true
true or false: in CVA, low frequency inhibition TMS to the unaffected hemisphere results in both improved motor and sensory function
false - only motor function
true or false - TMS alone is enough to create neuroplastic changes
false - need TMS and therapy
true or false - TMS can help all individuals with chronic CVA
false - unclear of who will benefit
some people benefit, some people dont
true or false: Tau protein deposition, reduced axonal integrity, increased incidence of cognitive deficits and earlier onset of dementia, presence of early depression are acute effects of recurrent mTBI
false - these are chronic effects
what is the cause of migraine photophobia and phonophobia in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy
a. abnormal ion flux
what is the cause of slowed reaction and info processing in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy
c. axonal injury and altered neurotransmission
what is the cause of persistent impairment in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy
d. abnormal protein and proteolysis leading to atrophy
which of the following is associated with chronic phase changes in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein synthesis
d. abnormal protein synthesis
following concussion, how many days do we expect 90% of cases to resolve
a. 2-3 days
b. 4-7 days
c. 7-10 days
d. 14-20 days
c. 7-10 days
which imaging is typically used in concussion but is not diagnostic
a. MRI
b. CT
c. DTI
b. CT to r/o more serious
true or false: according to the current consensus recommendations, following concussion, a person should rest for the first 24-48 hours
true
true or false: ApoE-4 is the metabolic biomarker for concussion
false - there is none established
which is the most common imaging technique to assess structural damage in concussion
a. MRI
b. EEG
c. TMS
d. DTI
d. DTI
which is the most common imaging technique to assess functional damage in concussion
a. MRI
b. EEG
c. TMS
D. DTI
b. EEG
true or false - a patients EEG following concussion would demonstrate delayed and reduced activation response to auditory stimuli
true
what combination/mixed modal imaging would be appropriate to assess brain dysfunction/injury following concussion?
a. DTI and MRI
b. DTI and EEG
c. MRI and TMS
d. MRI and EEG
b. DTI and EEG
what combination/mixed modal imaging would be appropriate to assess brain dysfunction/injury following concussion?
a. DTI and MRI
b. DTI and TMS
c. MRI and TMS
d. MRI and EEG
b. DTI and TMS
true or false - normal populations would demonstrate brain changes on imaging in response to immobilization
true
what brain changes do you expect to see in normal populations in response to immobilization
a. decreased white matter area of the affected arm
b. increased white matter area of the affected arm
c. decreased cortical thickness of the affected arm
d. increased cortical thickness of the affected arm
c. decreased cortical thickness of the affected arm
what brain changes do you expect to see in normal populations in response to immobilization
a. decreased white matter area of the unaffected arm
b. increased white matter area of the unaffected arm
c. decreased cortical thickness of the unaffected arm
d. increased cortical thickness of the unaffected arm
d. increased cortical thickness of the unaffected arm
which of the following interventions prevents the cortical loss of immobilization?
a. action observation
b. motor imagery
a. action observation
true or false: immobilization results in peripheral local changes such as muscle atrophy as well as brain changes
true
according to the SAFE (shoulder abduction, finger extension) PREP algorithm, a patient who scores 8 or more will
a. require TMS for recovery
b. have limited recovery
c. have complete recovery
d. cannot determine without MRI results
c. have complete recovery
according to the SAFE (shoulder abduction, finger extension) PREP algorithm, a patient who scores <8 with absent MEP will
a. require TMS for recovery
b. have limited recovery
c. have complete recovery
d. cannot determine without MRI results
d. cannot determine without MRI results
according to the SAFE PREP algorithm, your patient has notable prognosis which means you expect
a. the patient will have normal function in 12 weeks
b. the patient will be able to use their hand for most ADLs in 12 weeks
c. the patient will be able to move their arm without functional use in 12 weeks
d. the patient will have minimal movement/improvement in 12 weeks
b. the patient will be able to use their hand for most ADLs in 12 wekks
according to the SAFE PREP algorithm, your patient has limited prognosis which means you expect
a. the patient will have normal function in 12 weeks
b. the patient will be able to use their hand for most ADLs in 12 weeks
c. the patient will be able to move their arm without functional use in 12 weeks
d. the patient will have minimal movement/improvement in 12 weeks
c. the patient will be able to move their arm without functional use in 12 weeks
given that rTMS improved motor learning in some but not all individuals post stroke, which of the following assumptions may be true
a. in order to be a responder, you may need a certain neural tissue or cognitive reserve
b. in order to be a responder, you need to have a MCA CVA
c. there is no way to know who will be a responder and who will not
