This category is for other interesting topics that may be of interest to neurodiagnostic technologists/scientists.

Course Goal: The present course is aimed at providing Neurodiagnostics students with the essential knowledge and key concepts for understanding how the nervous system generates, encodes, and processes information. The current understanding of the complex aspects of such activity and the major challenges associated with brain disease biomarkers and monitoring tools development will be discussed as well.

Course outline:

Students will be introduced to functional neuroanatomy, electrophysiology, as well as elements of neurochemistry and molecular neuropharmacology allowing to understand how signaling pathways drive brain function in health, and in a lesser extent, in neurotropic infections, malignancy, and metabolic disease. 

Learning outcomes:

At the end of this course student should be able to:

  • Describe the structure and cellular content of the human nervous system, and the major detrimental changes supporting common diseases
  • Describe how the nervous system structures interact to coordinate the functions of visceral organs and skeletal muscles, to respond to both internal and external stimuli
  • Describe the generation and transmission of action potential and brain circuitry generating the electroencephalogram (EEG), the sleep-wake cycle, and biological rhythms
  • Discuss challenges associated with brain disease biomarkers and monitoring tools development.

Neurodiagnostic (NDT) procedures differ but there are many similarities in all the instruments used in NDT.  This course establishes a foundation for the neurodiagnostic technology to use instruments in a skilled way.  This course begins with basic differential amplifiers, digitization of signals, polarity, localization, filters, sensitivity and common mode rejection.  The course goes on to discuss instrumentation used in nerve conduction instruments, and the averaging capabilities and artifact rejection used in evoked potentials.  The course also includes electrical safety.

Competencies addressed:

Clinical Skill Domain 3: Practical Underlying Science Knowledge

14. Patient Safety - Take appropriate precautions to ensure patient's electrical safety

15. Digital Instrumentation: Identify, explain and describe appropriate use of the following:

  • differential amplifier
  • polarity & localization
  • common mode rejection
  • filters and use of filters
  • sensitivity
  • display gain
  • time base
  • sampling rate
  • calibration
  • impedance (need for low and balanced)
  • video monitoring
  • post-acquisition review 
  • reformatting montages
  • frequency
  • duration calculation
  • voltage calculation
  • montages and their use
  • electrode types, their impact on recorded potential
  • verification & documentation of optimal equipment functioning
  • malfunctioning equipment/instrument
  • analog to digital conversion and impact of sampling rate
  • dwell time
  • performance of routine recording procedure

16. Reformatting Digitally Recorded Data

  • explain how re-formatting of EEG data is possible after the recording
  • explain the role of the system reference in reformatting data

Objectives addressed in this module include:

    • identification of neuro-signals, frequency bands and basic waveform analysis
    • analysis of the function of the differential amplifier 
    • illustration of the digitization of analog signals, sampling rate, aliasing, dwell time and Nyquist Theorem
    • demonstrating skills in EEG polarity determination and EEG input/output voltages
    • describing the use of an instrument or system reference and how this enables remortgaging of data after recording
    • explaining the usefulness of common average references and Laplacian Source Derivation montages
    • recognizing in phase cancellation or equipotential and summation 
    • differentiating aspects of common mode rejection as a positive and sometimes negative factor in NDT
    • appreciating the importance of electrode impedance in quality waveforms and optimal differential amplifier functionality
    • identifying the uses of high and low frequency filters, notch filters, and their impact on waveform amplitude and morphology
    • exploring the usefulness of sensitivity and differentiating it from display gain
    • appreciating the usefulness of montages in localization
    • visualizing electrical field distributions including horizontal dipoles and the dipole of the human eye
    • describing the need for averaging in evoked potentials (EP) and the method of accomplishing it
    • identifying the differences between EEG signals and EP signals
    • describing the need for artifact rejection in EP 
    • describing isolated ground function, directional electromagnetic fields, relationships between harmonics and wavelengths
    • recognize skin's ability of capacitance and how this contributes to noise in NDT recording
    • comparing various types of stimulations and instrumentation settings for stimuli such as intensity, stimulus rate, duration, click polarity, pattern reversal, etc.
    • solving polarity problems in neurodiagnostics
    • examining the use of instrumentation settings in nerve conduction studies
    • introduction to the use of instrumentation in different modalities used in intraoperative neuromonitoring including EP, TCeMEP, Nerve Conduction studies, Free-run and Triggered EMG
    • identifying the usefulness of processing EEG and EP signals to better monitor changes over time, including power spectral array, FFT and trending of data

This course addresses the procedures and techniques involved in eye-tracking studies in infants.