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Antiphospholipid syndrome (APS) is an autoimmune disease associated with antiphospholipid antibodies (aPL) presence. Some neurological conditions are associated with this syndrome thus testing the presence of these antibodies can provide more information about the patient. Some neurological manifestations that are associated with these antibodies are stroke, convulsions/epilepsy, dementia, cognitive deficits, headaches/migraine, multiple sclerosis‐like, transverse myelitis, and ocular symptoms (Rodrigues, Carvalho, & Shoenfeld, 2010).
(Ayşe Dilara Türkmen)

Rodrigues, C., Carvalho, J. and Shoenfeld, Y., 2010. Neurological manifestations of antiphospholipid syndrome. European Journal of Clinical Investigation, 40(4), pp.350-359.

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Cultures are used to test for diagnosis and treatment of infections. Urinary tract infections, pneumonia, strep throat, MRSA (Methicillin-resistant Staphylococcus aureus) and meningitis can be detected and tested for appropriate antibiotic treatment.

(Alessandra Tommasi)

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Electromyography & Nerve Conduction Studies

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Electromyography & Nerve Conduction Studies

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In addition to the use of EEG, various more complex methods of electrodiagnostic testing can be used to test for various brain, spinal cord and nerve disorders. More specifically, electrodiagnostic testing involves the use of an electromyography; which helps to determine whether muscle weakness or sensory issues are due to damage/injury to the following:

- Spinal Nerve Root
- Peripheral Nerves
- Neuromuscular Junction

More specifically, an Electromyography (EMG) is a mildly invasive procedure, whereby a needle is inserted into the patient's muscle to record the electrical activity which takes place during rest and activity. Unlike other neuroimaging methods such as EEG & CT, the electromyography requires the expertise of a neurologist rather than a neuropsychologist.

In contrast, nerve conduction studies involve the study of the measure of speed at which motor or sensory nerves conduct impulses. The procedure involves several electrodes being placed on the skin of the patient.

The link below explains these 2 methods in detail:

(Ella Rosie Baker)

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Electroencephalography (EEG) is a simple, painless procedure in which the brain's electrical activity is recorded as wave patterns, printed on paper, and/or recorded in a computer. EEG can help identify the following:

For example, EEG can help identify where a seizure originates and show changes in electrical activity associated with confusion, which may result from disorders such as liver failure ( liver encephalopathy) or certain drugs.

For the procedure, an examiner places small, round adhesive sensors (electrodes) on the person's scalp. The electrodes are connected by wires to a machine, which produces a record (tracing) of small changes in voltage detected by each electrode. These tracings constitute the electroencephalogram (the EEG).

If a seizure disorder is suspected but the initial EEG is normal, another EEG is done after using a tactic that makes seizure activity more likely. For example, the person may be deprived of sleep, be asked to breathe deeply and rapidly (hyperventilate), or be exposed to a flashing light (stroboscope).

Sometimes (for example, when behavior that resembles a seizure is difficult to distinguish from a psychiatric disorder), the brain's electrical activity is recorded for 24 hours or longer while people are monitored in the hospital by a video camera. The camera detects the seizure-like behavior, and by examining the EEG at that moment, doctors can determine whether brain activity indicates a seizure or is normal, suggesting a psychiatric disorder.

An electroencephalogram (an EEG) is a recording of the brain's electrical activity. The procedure is simple and painless. About 20 small adhesive electrodes are placed on the scalp, and the brain's activity is recorded under normal conditions. Sometimes the person is exposed to various stimuli, such as bright or flashing lights, to try to provoke a seizure.

Electromyography and nerve conduction studies help doctors determine whether muscle weakness, sensory loss, or both result from injury to the following:

In electromyography (EMG), a small needle is inserted into a muscle to record the electrical activity of the muscle when the muscle is at rest and when it is contracting. Normally, resting muscle produces no electrical activity. A slight contraction produces some electrical activity, which increases as the contraction increases.

The record produced by EMG is called the electromyogram. It is abnormal if muscle weakness results from a problem with a spinal nerve root, peripheral nerve, muscle, or neuromuscular junction. Each type of problem produces a distinctive pattern of abnormalities, which can be identified based on the person's symptoms and results of the examination and electromyography.

Unlike CT or EEG, which can be done routinely by technicians, EMG requires the expertise of a neurologist, who chooses the appropriate nerves and muscles to test and interprets the results.

Nerve conduction studies measure the speed at which motor or sensory nerves conduct impulses. A small electrical current stimulates an impulse along the nerve being tested. The current may be delivered by several electrodes placed on the surface of the skin or by several needles inserted along the pathway of the nerve. The impulse moves along the nerve, eventually reaching the muscle and causing it to contract. By measuring the time the impulse takes to reach the muscle and the distance from the stimulating electrode or needle to the muscle, doctors can calculate the speed of nerve conduction. The nerve may be stimulated once or several times (to determine how well the neuromuscular junction is functioning).

Results are abnormal only if the symptom results from a problem with a nerve or neuromuscular junction. For example,

If nerve conduction is slow, the cause may be a disorder that affects one nerve, such as carpal tunnel syndrome (painful compression of a nerve in the wrist). Or the cause may be a disorder that affects nerves throughout the body (a polyneuropathy), as when diabetes damages nerves throughout the body, starting with those in the feet.

However, results may be normal if the affected nerves are small and do not have a myelin sheath (the outer layer of tissues that helps nerves conduct impulses faster). Results are also normal if the disorder involves only the brain, spinal cord, spinal nerve roots, or the muscle. Such disorders do not affect the speed of nerve conduction.

For this test, doctors use stimuli for sight, sound, and touch to activate specific areas of the brain, that is, to evoke responses. EEG is used to detect the response evoked by the stimuli. Based on these responses, doctors can tell how well those areas of the brain are working. For example, a flashing light stimulates the retina of the eye, the optic nerve, and the nerve pathway to the back part of the brain where vision is perceived and interpreted.

Evoked responses are particularly useful in testing how well the senses are functioning in infants and children. For example, doctors can test an infant's hearing by checking for a response after a clicking sound is made at each ear.

Evoked responses are also useful in identifying the effects of multiple sclerosis and other disorders on areas of the optic nerve, brain stem, and spinal cord. Such effects may or may not be detected by MRI.

Evoked responses can also help predict the prognosis for people who are in a coma. If stimuli do not evoke typical brain activity, the prognosis is likely to be poor.

Imaging tests commonly used to diagnose nervous system (neurologic) disorders include the following:

In myelography, x-rays of the spinal cord are taken after a radiopaque contrast agent is injected into the subarachnoid space via a spinal tap. Myelography has been largely replaced by MRI, which usually produces more detailed images and is simpler and safer to do.

Myelography with computed tomography (CT) is used when doctors need more detail of the spinal cord and surrounding bone than MRI can provide. Myelography with CT is also used when MRI is not available or cannot be done safely (for example, when a person has a heart pacemaker).

Cerebrospinal fluid flows through a channel (the subarachnoid space) between the layers of tissue (meninges) that cover the brain and spinal cord. This fluid, which surrounds the brain and spinal cord, helps cushion them against sudden jarring and minor injury.

For a spinal tap (lumbar puncture), a sample of cerebrospinal fluid is withdrawn with a needle and sent to a laboratory for examination.

The cerebrospinal fluid is checked for evidence of infections, tumors, and bleeding in the brain and spinal cord. These disorders may change the content and appearance of the cerebrospinal fluid, which normally contains few red and white blood cells and is clear and colorless. For example, the following findings suggest certain disorders:

Cloudy fluid, due to the presence of many white blood cells, suggests meningitis (infection and inflammation of the tissues covering the brain and spinal cord) or sometimes encephalitis (infection and inflammation of the brain).

Doctors do not do a spinal tap when the pressure within the skull is increased, for example, when there is a mass (such as a tumor or abscess) in the brain. In such cases, a spinal tap may suddenly reduce pressure below the brain. As a result, the brain may shift and be pressed through one of the small openings in the relatively rigid tissues that separate the brain into compartments (called herniation). Herniation puts pressure on the brain and may be fatal. The medical history and neurologic examination help doctors determine whether herniation is a risk. For example, doctors use an ophthalmoscope to examine the optic nerve, which bulges when the pressure within the skull is increased. As another precaution before a spinal tap is done, CT or MRI of the head is often done to check for masses.

Cerebrospinal fluid flows through a channel (called the subarachnoid space) between the middle and inner layers of tissue (meninges) that cover the brain and spinal cord. To remove a sample of this fluid, a doctor inserts a small, hollow needle between two bones (vertebrae) in the lower spine, usually the 3rd and 4th or the 4th and 5th lumbar vertebrae, below the point where the spinal cord ends, and then into the subarachnoid space-the space between the layers of tissue (meninges) that cover the spinal cord (and brain). Usually, people lie on their side with their knees curled to their chest. This position widens the space between the vertebrae, so that the doctor can avoid hitting the bones when the needle is inserted.

Cerebrospinal fluid is then allowed to drip into test tubes, and the samples are sent to a laboratory for examination.

For a spinal tap, people typically lie on their side in a bed and draw their knees to their chest. A local anesthetic is used to numb the insertion site. Then, a needle is inserted between two vertebrae in the lower spine below the end of the spinal cord.

During a spinal tap, doctors can measure the pressure within the skull. Pressure can be higher than normal in people with idiopathic intracranial hypertension and certain other disorders of the brain and surrounding structures. Pressure is measured by attaching a gauge (manometer) to the needle used for the spinal tap and noting the height of the cerebrospinal fluid in the gauge.

A spinal tap may be done for other reasons:

A spinal tap usually takes no more than 15 minutes.

About 1 of 10 people develops a headache when standing up after a spinal tap (called a low-pressure headache). The headache usually disappears after a few days to weeks. However, if the headache is still troublesome after a few days, doctors may inject a small amount of the person's blood into the area around where the spinal tap was done. This procedure, called a blood patch, slows the leakage of cerebrospinal fluid and may relieve the headache. Other problems are very rare.

Echoencephalography uses ultrasound waves to produce an image of the brain. This simple, painless, and relatively inexpensive procedure can be used in children younger than 2 years because their skull is thin enough for ultrasound waves to pass through. It can be done quickly at the bedside to detect hydrocephalus (previously called water on the brain) or bleeding.

CT and MRI have largely replaced echoencephalography in older children and adults because they produce much better images in these age groups.

Genetic abnormalities cause many neurologic disorders-particularly movement disorders, including those that cause tremor or problems walking. Genetic tests can sometimes help doctors diagnose certain nerve and muscle disorders.

When genetic testing is recommended, people are usually referred to a genetic counselor. If they are not, people may request an appointment with one.

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Tests for Brain, Spinal Cord, and Nerve Disorders - Brain, Spinal Cord, and Nerve Disorders - MSD Manual Consumer Version

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Electroencephalography (EEG) is a simple, painless procedure in which the brain's electrical activity is recorded as wave patterns, printed on paper, and/or recorded in a computer. EEG can help identify the following: For example, EEG can help identify where a seizure originates and show changes in electrical activity associated with confusion, which may result from disorders such as liver failure ( liver encephalopathy) or certain drugs.

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The possibility of the correlation between low-levels of the B12 vitamin and cognitive impairments has been researched recently, the results being in its favor.
Based on low to moderate quality of evidence, treatment with vitamin B12 and folate in patients who have mild cognitive impairment seems to slow the rate of brain atrophy compared with patients who have mild cognitive impairment receiving a placebo. Whether this translates into clinical benefit is unknown.
(Corina Draghici)

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Laboratory test on a biological sample (urine, hair, blood, saliva) for detecting the presence/absence of drugs or byproducts produced through their metabolism. The aim is to detect traces of cocaine, cannabinoids (marijuana, THC), opiates (heroin, morphine) MDMA, ecstasy, methadone, benzodiazepines, barbiturates.

The consumption of the abovementioned substances, along with ethil alcohol abuse, is toxic for the organism and it may result into important neurological and cognitive impairments in different domains (e.g., executive functions, memory, motor functions) manifested as a variety of symptoms (neuropsychological, neurological, psychological and psychiatric). Therefore identifying and quantifying the consumption of one or more of these drugs is essential for discriminating neuropsychological symptoms related to them from those related to other pathologies.

(Silvia Fornaro)

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EEG is a method used to record electrical activity of the brain trough the application of electrodes along the sculp (in certain circumstances intracranial electrodes). It is normally used to exclude neurological illness within psychiatry since the abnormalities found are commonly not specific.
EEG can be useful in evaluating or diagnosing:
- suspected drug toxicity
and lithium toxicity in patients who develop symptoms at therapeutic levels, suspected AED toxicity and suspected intoxication from other psychotropic drugs
- acute confusional state (in order to establish
the diagnosis and following the course of delirium)
- cognitive impairments, such as dementia and cognitive impairment related to depression or to
medication effects
- a variety of other deseases presenting with psychiatric symptoms, particularly when findings in the history, mental state examination, physical examination, or laboratory
tests suggest a neurological or medical basis for the patient’s
symptoms (e.g. epilepsy)

(Roberta Vertullo)

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The thyroid secretes two main hormones into the bloodstream: thyroxine, also called T4, which  in turn is converted to tri-iodothyronine (T3). T3 has an improtant role in regulating body’s metabolism.
These two hormones are secreted by the thyroid gland, which is regulated by the pituitary gland.
When the level of T3 and T4 drops below normal, the pituitary secrets a hormone called thyroid-stimulating hormone (TSH), which leads the thyroid gland to produce more T4.

Blood tests done for  thyroid function will assess the amount of TSH, T4 and sometimes T3 in the bloodstream.
- If the TSH level is high and the FT4 (test to asses the amount of T4) result is low this suggests an underactive thyroid (hypothyroidism).
- If the TSH level is low and the FT4 result is high this indicates an overactive thyroid (hyperthyroidism).
Both conditions can be associated with cognitive impairments, depression or psychosis.
(Celeste Bittoni)

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This test is of particular importance because is a general examination used to detect a wide range of disorders, such as anemia, infection and leukemia. the component and features measured are:

Red blood cells

White blood cells

Hemoglobin (and the oxygen transportation)

Hematocrit, which the proportion of red blood cells to the fluid component, or plasma, in your blood

Platelets, which help with blood clotting. platelet count is very important.

This test, similarly to all the other laboratory test, are important for the neuropsychological evaluation because permit to understand the health state of the patient in order to do an optimal diagnosis and exclude other types of illnesses

(Sabrina Bartolotta)

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This test measures how much glucose in the blood is bound to hemoglobin red blood cells. It is used to diagnose or to monitor diabetes. Results of such test could be potentially useful to the Neuropsychologist to highlight a condition such as diabetes in X patient, as this illness can damage blood vessels leading to cognitive impairment.

(Angela Boschetti)

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MRI scan can be used as an integrative information to the neuropsychological assessment or as a confirmation/rejection of the hypothesis of the presence of a brain tumor or of a gray/white matter volume and/or density alteration. Thus, it can be useful in the case the neuropsychologist suspects a neurodegenerative disease, a tumor, a traumatic lesion or an ischemic stroke.
(Stella Piccolo)

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With this analysis is possible to identify the metabolites, the final products of our metabolism that give us important informations about the functionality of our digestion and escretion organs, like the liver and the kidneys. Moreover, from urine we can detect which kind of diet the patient is going through, how much water he/she drinks and which drugs he/she is taking.

Other elements that are detected with this laboratory test are the hormones.

All this factors are relevants since they influence the cognitive condition of the subject.

(Matteo Panizzolo Terrin)

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1) blood test for the cortisol levels, serotonin levels, hematologic test for hemoglobin levels and count of red blood cells
2) EEG laboratory testing for epilepsy
(Spela Ocvirk)

Sara: Thanks, very good