NERVOUS SYSTEM – CNS: THE BRAIN AND SPINAL CORD

Thus the nervous system is composed of two major parts: the central nervous system (CNS) and the
peripheral nervous system (PNS). The central system is the brain and spinal cord, and is where most
information is processed. The peripheral system is the network of nerves throughout the rest of the body.
Nerves connect the brain and spinal cord to the receptors (sense organs) and the effectors (muscles and
glands). Sensory nerves carry excitation from the receptors to the CNS and motor nerves carry excitation
from the CNS to the glands and muscles. Thus, the peripheral nervous system allows signals to travel
between the central nervous system and the body's sensory receptors and motor effectors, such as the
muscles.

The CNS and PNS are anatomical divisions of the nervous system.
CENTRAL NERVOUS SYSTEM

The brain and spinal cord make up the central nervous system (CNS). Most of the cells of the entire
nervous system lie within the central nervous system.

STRUCTURE AND FUNCTIONING OF THE BRAIN

Brain is the master control center of the body.

The brain constantly receives information from
the senses about conditions both inside the body
and outside it. The brain rapidly analyzes this
information and then sends out messages that
control body functions and actions. The brain
also stores information from past experience,
which makes learning and remembering
possible. In addition, the brain is the source of
thoughts, moods, and emotions.

In such simple animals as worms and insects, the

brain consists of small groups of nerve cells. All
animals with a backbone have a complicated
brain made up of many parts. Animals that have
an exceptionally well developed brain include
apes, dolphins, and whales.

Human beings have the most highly developed brain of all. It consists of billions of interconnected cells and
enables people to use language, solve difficult problems, and create works of art.

 Increase in brain size and the

maturation of cortical circuits.
 The maturation of mental processes
and motor skills is associated with
an approximately three to four-fold
enlargement in brain size [1]. A., B.
Photographs of the brains of a 1-
month and 6-year-old child,
respectively. This size increase is
accompanied by a dramatic
development in the complexity of
the neuronal processes, which in
turn is influenced by the genetic
 background and the surroundings.

The human brain is a grayish-pink, jellylike ball with many ridges and grooves on its surface. A
newborn baby's brain weighs less than 1 pound (0.5 kilogram). By the time a person is 6 years old, the
brain has reached its full weight of about 3 pounds (1.4 kilograms). Most of the brain's nerve cells are
present at birth. The increase in weight comes mostly from the growth of nerve cells, development and
growth of supporting cells, and development of connections among cells. During this six-year period, a
person learns and acquires new behavior patterns at the fastest rate in life.

A network of blood vessels supplies the brain with the vast quantities of oxygen and food that it
requires. The human brain makes up only about 2 percent of the total body weight, but it uses about 20
percent of the oxygen used by the entire body when at rest. The brain can go without oxygen for only
three to five minutes before serious damage results.

The brain is at the upper end of the spinal cord. The spinal cord is a cable of nerve cells that extends
from the neck about two-thirds of the way down the backbone. The spinal cord carries messages
between the brain and other parts of the body. In addition, 12 pairs of nerves connect the brain directly
with certain parts of the body.

The brain works in some ways like both a computer and a chemical factory. Brain cells produce
electrical signals and send them from cell to cell along pathways called circuits. As in a computer, these
circuits receive, process, store, and retrieve information. Scientists in various fields work together to
study the structure, function, and chemical composition of the brain. This field of study, called
neuroscience or neurobiology, is rapidly increasing our understanding of the brain. But much remains to
be learned. Scientists do not yet know how physical and chemical processes in the brain produce much
of the brain's activity.

Brain cells
The human brain has from 10 billion to 100 billion neurons. After a person reaches about 20 years of
age, some neurons die or disappear each day. Over a lifetime, this loss equals less than 10 percent of all
neurons. Scientists have found that adults can grow new neurons in the hippocampus, a portion of the
brain associated with learning and memory. The brain's billions of neurons connect with one another in
complex networks. All physical and mental functioning depends on the establishment and maintenance
of neuron networks. A person's habits and skills—such as nail-biting or playing a musical
instrument—become embedded within the brain in frequently activated neuron networks. When a
person stops performing an activity, the neural networks for the activity fall into disuse and eventually
may disappear.

Some axons of neurons have a coating of fatty material called myelin. The myelin insulates the fiber and
speeds the transmission of impulses along its surface. Myelin is white, and tightly packed axons covered
with it form white matter. The neuron cell bodies and the axons without myelin sheaths make up the
gray matter of the brain. The cerebral cortex is made up of gray matter, and most of the rest of the
cerebrum consists of white matter. The neurons are surrounded by glia, cells whose name comes from a
Greek word for glue. Glial cells traditionally have been thought of as a supportive framework for the
neurons. The glia also perform many other important tasks. For example, certain glia keeps the brain
free of injured and diseased neurons by engulfing and digesting them. Other glia produces the myelin
sheaths that insulate some axons. Research using cells grown in laboratories also indicates that glia, like
neurons, may transmit some nerve impulses.

Thus the brain is made up of two types of cells: neurons and neuroglia. The neuron is responsible for
sending and receiving nerve impulses or signals. Neuroglia provide neurons with nourishment,
protection and structural support. Oligodendroglia, astroglia or astrocytes, ependymal and microglial are
four types of glial cells commonly found in the brain.
HOW THE BRAIN IS PROTECTED

The brain is protected by 3 prominent systems:

1. The Meninges

2. The Cerbro-spinal Fluid

3. The Blood Brain Barrier.

1. The Meninges

The brain is found inside the bony covering called the cranium. The cranium protects the brain from
injury. Together, the cranium and bones that protect our face, are called the skull. The hard, thick bones
of the skull shield the brain from blows that could otherwise seriously injure it.
In addition, three protective membranes called meninges cover the brain.

1. The outermost membrane is the tough dura mater, which lines the inner surface of the skull.
2. A thinner membrane, the arachnoid, lies just beneath the dura mater. The layer of meninges
closest to the surface of the brain is called the pia mater.
3. The pia mater has many blood vessels that reach deep into the surface of the brain. The pia
covers the entire surface of brain following the folds of the brain. The major arteries
supplying the brain provide the pia with its blood vessels.
4. The space that separates the arachnoid and the pia is called the subarachnoid space, which is
filled with a clear liquid called cerebrospinal fluid that separates the pia mater and the
arachnoid. This fluid forms a thin cushioning layer between the soft tissues of the brain and
the hard bones of the skull.

2. Cerebrospinal Fluid

Cerebrospinal fluid, also known as CSF, is found within the brain and surrounds the brain and the spinal
cord. It is a clear, watery substance that helps cushion the brain and spinal cord from injury. This fluid
circulates through channels around the spinal cord and brain, constantly being absorbed and replenished.
It is within the hollow channels in the brain, called ventricles, where fluid is produced. The brain
normally maintains a balance between the amount of cerebrospinal fluid that is absorbed and the amount
that is produced. Often, disruptions in the system occur.
The condition, hydrocephalus, may occur when there is a blockage in the pathways through which the
fluid normally travels. It may also arise from an over-production of fluid or a difficulty in absorbing the
fluid that is produced. Because the brain is enclosed within the bony skull, the extra fluid, trapped by
blocked pathways, has no escape. This extra fluid within the brain will produce increased pressure
symptoms: headaches, vomiting, drowsiness and in some cases, confusion.

Brain tumors may block the channels of cerebrospinal fluid within the brain. Rare tumors involving the
ventricles may affect the production and absorption of the fluid. Spinal cord tumors may block the fluid
as it travels around the spinal cord. A surgical procedure of shunting extra fluid may be necessary.

3. Blood Brain Barrier

More than 100 years ago it was discovered that if blue dye was injected into the bloodstream of an
animal, that tissues of the whole body EXCEPT the brain and spinal cord would turn blue. To explain
this, scientists thought that a "Blood-Brain-Barrier" (BBB) which prevents materials from the blood
from entering the brain existed. More recently, scientists have discovered much more about the structure
and function of the BBB.

Similar to all other blood vessels (capillaries) in the body, scientists learned that the brain’s blood
vessels are lined with endothelial cells, which serve as an interface between circulating blood and the
capillary wall. However, unlike other blood vessels in the body, the endothelial cells in the brain are
tightly packed together, creating a nearly impermeable boundary between the brain and bloodstream.

The blood-brain barrier helps block harmful substances, such as toxins and bacteria from entering the
brain. However, the brain needs some kinds of large molecules for nutrition. The capillary walls have
certain enzymes and other properties that enable these particular molecules to pass through the brain.

Through extensive study, scientists have found that compounds that are very small (less than 500 dalton
atomic weight) and/or fat-soluble, including antidepressants, anti-anxiety medications, alcohol, cocaine,
and many hormones are able to slip through the endothelial cells that make up the blood-brain barrier
without much effort.
THE PARTS OF THE BRAIN

The brain has three main divisions:

(1) Forebrain

(2) Midbrain

(3) Hindbrain.

Each part consists chiefly of nerve cells, called

neurons, and supporting cells, called glia.

FOREBRAIN

The Forebrain comprises of

a) Two cerebral hemispheres: Cerebrum (gray matter and white matter)

b) Each hemisphere is divided into 4 lobes: Frontal, Parietal, Temporal and Occipital
c) Limbic System: Thalamus, Hypothalamus, Hippocampus, Amygdala
d) Basal Ganglia: Caudate Nucleus, Putamen, Globus Pallidus

Foremost important region of forebrain includes two symmetrical cerebral hemispheres that
make up the cerebrum. The cerebrum makes up about 85 percent of the weight of the human brain.
The cerebrum is noteworthy for its convoluted surface. The bumps or the bulges are called gyri, and the
grooves (narrow channels in between) are called sulci or, if they are especially deep, fissures. The
precise pattern of gyri and sulci can vary considerably from person to person, but many features are
common to all people.
The postcentral gyrus lies immediately posterior to the central sulcus, and the precentral gyrus lies
immediately anterior to the central sulcus. The neurons of the postcentral sulcus are involved in somatic
sensation, and those of the precentral gyrus control voluntary movement. Neurons in the superior
temporal gyrus are involved in hearing. A thin layer of nerve cell bodies called the cerebral cortex or
cortex forms the outermost part of the cerebrum (like the bark of the tree). Most of the cerebrum beneath
the cortex consists of nerve cell fibers. Some of these fibers connect parts of the cortex. The cerebral
cortex is folded into a surface with many ridges and grooves.

A large groove called the longitudinal fissure (Fig-3) divides the cerebrum or the cerebral cortex into
halves called the left cerebral hemisphere and the right cerebral hemisphere. The hemispheres are
connected by bundles of nerve fibers, the largest of which is the corpus callosum.

Each hemisphere, in turn, is divided into four lobes (regions). Each lobe has the same name as the bone
of the skull that lies above it. The lobes are (1) the frontal lobe, at the front; (2) the temporal lobe, at the
lower side; (3) the parietal lobe, in the middle; and (4) the occipital lobe, at the rear. Fissures in the
cerebral cortex form the boundaries between the lobes. The two major fissures are the central fissure
and the lateral fissure. Lobes are simply broad regions of the brain. Each lobe may be divided, once
again, into areas that serve very specific functions. It must be remembered that each lobe of the brain
does not function alone. There are very complex relationships between the lobes of the brain.

Sensory messages are received and interpreted primarily in the cerebral cortex. Various parts of the body
send nerve impulses to the thalamus, which routes them to the appropriate areas of the cerebral cortex
known as primary sensory cortex, receiving messages from the sense organs as well as messages of
touch and temperature from throughout the body. Areas in the frontal lobes called the motor cortex send
out nerve impulses that control the voluntary movements of all the skeletal muscles. Parietal lobes
consists of somatosensory cortex which processes information from the skin and internal body receptors
for touch, temperature and body position. The sense of taste may also be processed near this area.
Similarly, occipital lobes comprises of the visual cortex that processes visual information from the eyes
and portions of the temporal lobes receive messages from the ears which is known as auditory cortex.
Each primary sensory area of the cortex sends information to the adjacent regions known as sensory
association cortex where perception and interpretation takes place and every lobe of the brain has areas
of association cortex that analyze, process, and store information. These association areas make possible
all our higher mental abilities, such as thinking, speaking, and remembering. These are made up of
neurons that make connections between the sensory information and stored memories, images and
knowledge.
Messages within the brain are delivered in many ways. The signals are transported along routes called
pathways. Any destruction of brain tissue by a tumor can disrupt the communication between different
parts of the brain. The result will be a loss of function such as speech, ability to read or ability to follow
simple spoken commands. Messages can travel from one bulge on the brain to another (gyri to gyri),
from one lobe to another, from one side of the brain to the other, from one lobe of the brain to structures
that are found deep in the brain, e.g. thalamus or from the deep structures of the brain to another region
in the central nervous system.

Contralateral functioning: One side of the brain controls the opposite side of the body. It has been
found that specific regions of the brain, when electrically stimulated will cause movement or sensation
to occur in a very specific part of the body. Touching one side of the brain sends the electrical signals to
the other side of the body. If we touched the motor region on the right side of the brain, we would cause
the opposite side or the left side of the body to move. Stimulating the left primary cortex would cause
the right side of the body to move. The messages for movement and sensation will always cross to the
other side of the brain and cause the opposite limb to move or feel a sensation. If your brain tumor is
located on the right side of the brain in an area that controls the movement of your arm, your left arm
may be weak or paralysed.

In general, the left hemisphere or side of the brain is responsible for language and speech. Because of
this, it has been called the "dominant" hemisphere. The right hemisphere plays a large part in
interpreting visual information and spatial processing. In about one third of the individuals who are left-
handed, speech function may be located on the right side of the brain. Left-handed individuals may need
specialized testing to determine if their speech center is on the left or right side.

Lobes of the Brain and their Functions

1. Frontal Lobe- The frontal lobe is home to our cognitive thinking, and it is this process that
determines and shapes an individual's personality. In human beings, the frontal lobe attains maturity
when the individual is around the age of 25. This means that by the time we are 25 years of age, we
have achieved a level of cognitive maturity. The frontal lobe is extremely vulnerable to injury due to
its location as it's in front of the central cranium. The frontal lobe is made up of the anterior portion
(prefrontal cortex) and the posterior portion, and is divided from the parietal lobe by the central
sulcus. The anterior portion consists of prefrontal cortex which is responsible for higher cognitive
functions, and the posterior portion consists of the premotor and motor areas, thus, governing our
voluntary movements.

The functions of the frontal lobe include reasoning, planning, organizing thoughts, behavior, sexual
urges, emotions, problem-solving, judging, and organizing parts of speech and motor skills
(movement).

The areas that produce movement of parts of the body are found in the primary motor cortex or
precentral gyrus. It guides our eye and head movements and sense of orientation. The prefrontal
cortex plays an important part in our memory, intelligence, concentration, temper and personality. It
helps us set goals, make plans and judge our priorities. The frontal lobe also helps in controlling
emotions by means of its connection with the limbic system.

Broca's area is found commonly in the left frontal lobe which is important in the production of
speech. It allows a person to speak smoothly and fluently, and damage to this region may cause
inability to pronounce words clearly and to produce words clearly and there is difficulty in
producing sounds of speech.- Broca’s aphasia (Aphasia refers to an inability to use or understand
either written or spoken language). One is unable to move the tongue or facial muscles in the
appropriate way to make words. The individual can still read and understand spoken language but
has difficulty in writing (i.e. forming letters and words, doesn't write within lines). The frontal lobes
of the cerebrum play a key role in many thinking processes that distinguish human beings from other
animals. The frontal lobes are particularly important for abstract thinking, for imagining the likely
consequences of actions, and for understanding another person's feelings or motives. Injury or
abnormal development of the frontal lobes can result in the loss of these abilities.

2. Occipital Lobes- The smallest of all the four lobes, the occipital lobes are located in the rearmost
portion of the skull and because of their location, they are not particularly vulnerable to injury,
although significant trauma can disrupt the visual-perceptual system. It is responsible for visual
perception system, as it contains the primary visual cortex. The functions of the occipital lobe
include visual reception, visual-spatial processing, movement and color recognition. These lobes
 contain regions that contribute to our visual field or how our eyes see the world around us. They help
us see light and objects and allow us to recognize and identify them. This region is called the visual
cortex. Located at the back of the head, the occipital lobe, or the visual cortex, is in charge of image
sensory (it helps with recognition of shapes and colors), it is also the part of the brain that dreams
derive from. The occipital lobe on the right interprets visual signals from your left visual space,
while the left occipital lobe does the same for your right visual space. Damage to one occipital lobe
may result in loss of vision in the opposite visual field. Damages to the occipital lobe can result in
loss of vision, seeing distorted images, inability to recognize words, difficulty reading and writing,
seeing visual illusions, difficulty locating shapes and recognizing colors.

3. Temporal Lobes- (temporal means ‘near the temples’) are found just behind the temples of the
head. There are two temporal lobes, each of which are located on each side of the brain; left and
right, at about the level of the ears. The temporal lobes contain the primary auditory cortex, and
hence, are responsible for all auditory processing.

The primary auditory cortex helps us hear sounds and gives sounds their meaning, e.g. the bark of a
dog. These lobes also contain the hippocampus, responsible for formation of long-term memory and
sorting new information. The functions of both (left and right) temporal lobes include distinguishing
and discrimination of smell and sound from other smells and sounds respectively.

Between them, they control visual memory (right lobe) and verbal memory (left lobe), Left temporal
lesions result in impaired memory for verbal material. Right side lesions result in recall of non-
verbal material, such as music and drawings.

It contains Wernicke's area in the left temporal lobe, which is involved in understanding the
meaning of words. Language can be affected by temporal lobe damage. A person with Wernicke’s
aphasia would be able to speak fluently and pronounce words correctly, but the words would be the
wrong ones entirely. An individual can make speech sounds. These sounds however have no
meaning for the individual is unable to understand what is said by him or others.

4. Parietal Lobes- The parietal lobes interpret, simultaneously, sensory signals received from other
areas of the brain such as our vision, hearing, motor, sensory and memory. Together, the new
information that is received and memories give meaning to objects. A furry object touching your
skin, which purrs and appears to be your cat, will have a different meaning than a furry object that
barks and you see to be a dog. Parietal lobe is located behind the central sulcus, and above the
occipital lobe.

It has four anatomical boundaries; the central sulcus, which separates the parietal lobe from the
frontal lobe, the parieto-occipital sulcus which separates the parietal and occipital lobes, the lateral
sulcus which separates the parietal from the temporal lobe, and the medial longitudinal fissure which
divides the two hemispheres (right and left). The parietal lobe is responsible for integrating sensory
 information from various parts of the body. The optic nerves pass through the parietal lobe to the
occipital lobe.

The functions of the parietal lobe include information processing, movement, spatial orientation,
speech, visual perception, recognition, perception of stimuli, pain and touch sensation, cognition.
Any damage to the parietal lobes result in abnormalities in spatial processing.

LIMBIC SYSTEM- Part of the forebrain and these structures are found in the inner margins of the upper
brain and it includes the thalamus, hypothalamus, hippocampus and amygdale. This system is involved
in learning, motivation and emotions.

Thalamus-

At the upper end of the brain stem are the hypothalamus and the thalamus. There are actually two
thalami, one on the left side of the brain stem and one on the right side. Each thalamus receives
nerve impulses from various parts of the body and routes them to the appropriate areas of the
cerebral cortex. The thalami also relay impulses from one part of the brain to another. Thalamus
serves as a relay station for almost all information that comes and goes to the cortex. The passing of
information also happens in the reverse direction. Information is also passed from the cerebral cortex
to the thalamus, which is then in turn sent out to the other parts of the body. It is located between the
mid-brain and fore-brain. Anatomically speaking, the thalamus is located on top of the brain stem,
closer to the center of the brain, The other thalamus function is to regulate the sleeping and
wakefulness states. The thalamus also has a major role to play in regulating arousal, level of
awareness and activity. Major role of the thalamus is related to the motor systems of the body.

Hypothalamus-

It lies at the base of the brain, under the thalamus. It is a small structure that contains nerve
connections that send messages to the pituitary gland, the master gland of the body (which controls
other endocrine glands). The hypothalamus handles information that comes from the autonomic
nervous system. It plays a role in controlling our behaviour such as when we eat, sexual behaviour,
sleeping, body temperature, emotions, secretion of hormones and movement. The hypothalamus also
has nerve centers that control certain body processes. Most of these centers maintain constant
conditions within the body. For example, some centers regulate the amount of water in the body.
Certain neurons detect changes in the level of water in the body's blood and tissues and relay this
information to the hypothalamus. For example, certain neurons detect changes in the level of water
in the body's blood and tissues and relay this information to the hypothalamus. If the water level is
too low, the hypothalamus produces the sensation of thirst, which causes the person to drink water.
At the same time, the hypothalamus sends messages that cause the kidneys to reduce the amount of
water they remove from the body. If the water level becomes too high, the messages from the
hypothalamus eliminate thirst and increase the amount of water removed by the kidneys. Other
centers in the hypothalamus operate on the same principle in regulating hunger and body
temperature. The hypothalamus indirectly regulates many body processes by controlling the
pituitary's production and release of chemical messengers called hormones. Among other functions,
these hormones regulate the body's rate of growth and its sexual and reproductive processes.
Hippocampus- The most important functions of the hippocampus includes long-term memory
(especially episodic memories relating to personal events and related emotions) and spatial
navigation. It is instrumental in forming LTM (permanent) memories that are then stored elsewhere
in the brain.

Acetylcholine, the neurotransmitter is involved in the memory function of hippocampus. It is located

within the temporal lobes on each side of the brain and electrical stimulation of the temporal lobe
may produce memory like or dream like experience. It has been observed that brain injury or to be
more specific, damage to the hippocampus (as in some cases of amnesia) affects the person's ability
to form new memories. In case of Alzheimer's disease, hippocampus is one of those brain parts, that
is primarily affected. This causes memory loss and disorientation. People with weak hippocampus
lack spatial memory and may forget about where they have been or where to go. This is why, it is
said that a strong and intact hippocampus is required for spatial navigation tasks.

Individuals who suffer damage to these structures may lose the ability to form new memories,
though they may retain information about events occurring before the damage. These individuals can
learn new physical skills, but when performing them do not remember having done the activities
before.

Amygdala- It is an area of the brain located near the hippocampus and located just above the
hypothalamus gland of the brain. The amygdala is an almond shaped, one inch long mass of nuclei,
situated deep within the temporal lobes of the brain. We have two amygdalae, each one situated a
few inches away from either ear. This tiny mass has been associated with a person's mental and
emotional state.

This name amygdala comes from the Greek word for almond and has been named so because its size
and shape bears resemblance to that of an almond. This amygdala features presence of several nerves
that connect it to various centers of the brain such as the neocortex and visual cortex and forms a
part of the limbic system which is an important part of the nervous system. Amygdala is seen to be
linked to the orbital frontal cortex, the striatum and thalamus, which are all structures involved in
emotional processing.

The main function of amygdala is emotional and social processing. It processes and stores memories
of emotional events and is also involved in current emotional responses, e.g. responsible for fear
responses and memory of fear. Information from the senses goes to the amygdale before the upper
part of the brain is even involved, so people respond to danger almost spontaneously. People who
have had strokes that resulted in damage to amygdala are seen to depict every other expression than
that of fear. Lesions caused to amygdala resulted in behavioral and emotional abnormalities.
Conditions such as autism, phobias, post-traumatic stress disorder, anxiety and depression are seen
to be linked to the abnormal functioning of the amygdala.
 BASAL GANGLIA

These are a collection of nuclei found on both sides of the thalamus, outside and above the limbic
system. Although glutamate is the most common neurotransmitter here as everywhere in the brain,
the inhibitory neurotransmitter GABA plays the most important role in the basal ganglia.

It comprises of the following:

1.
2.
3.

Caudate Nucleus
Putamen
Globus Pallidus

1. Caudate Nucleus:

The caudate begins just behind the frontal lobe and curves back towards the occipital lobe. It sends its
messages to the frontal lobe. Obsessive compulsive disorder (OCD) is likely to involve an overactive
caudate. On the other hand, an underactive caudate may be involved in various disorders, such as
Attention Deficiency Disorder, depression, aspects of schizophrenia, and just plain lethargy. It is also
involved in PAP syndrome, a dramatic loss of motivation only recently discovered.

2. The Putamen:

The putamen lies just under and behind the front of the caudate. It appears to be involved in
coordinating automatic behaviors such as riding a bike, driving a car etc. Problems with the putamen
may account for the symptoms of Tourette's syndrome.

3. The Globus Pallidus:

Located just inside the putamen, with an outer part and an inner part.
It receives inputs from the caudate and putamen and provides outputs to the substantia nigra

The caudate nucleus and the putamen together comprise the “Corpus Striatum”

CORPUS STRIATUM

 The largest group of these nuclei are

called the corpus striatum ("striped
body").
 Made up of the caudate nucleus
("tail"), the putamen ("shell").
 The putamen is connected to the
caudate head by bridges of cells.
 Because of the striated appearance
of these cell bridges, the caudate and
putamen are collectively referred to
as the striatum or neo-striatum

LENTIFORM NUCLEUS

The putamen and the globus

pallidus together comprise the
“Lentiform Nucleus”
MIDBRAIN

The midbrain is the smallest region of the brain and also is the most superior part of the brainstem.

Comprised of:

1. Cerebral Peduncles
2. Tectum
a. Superior and Inferior Colliculi
3. Tegmentum
a. Substantia Nigra
b. Red Nucleus
c. Ascending and Descending Reticular Formation

Cerebral Peduncles

The main function of the cerebral peduncle is to transfer motor signals from the brain down to the
brainstem. It's made up of a thick bundle of nerve fibers, called the cortico-spinal tracts, which carry
motor signals from your brain to your muscles.

Cranial nerves 3 (oculomotor) and 4 (trochlear) originate in the cerebral peduncle.

Cerebral Peduncles communicate with Cerebellum through the red Nucleus. This communication results
in the fine tuning of motor movements by way of - proprioception. (Proprioception is the body's sense of
self in the environment, meaning that, even with a blindfold on, you can sense things like where your
hands, arms, and feet are relative to one another or if you're upside down or right-side up)
Tectum

The tectum is considered the dorsal, or roof, part of the midbrain and controls visual and auditory
reflexes. It contains the ‘Corpora Quadrigemina’ - two superior and two inferior colliculi.

The superior colliculi

are located below the
thalamus and receive
visual sensory input.

The inferior colliculi are

located below the
superior colliculi and are
involved with
processing auditory
stimuli.

Tegmentum

Consists of portions beneath the

1.
tectum and includes:
2.
3. Reticular formation
Substantia Nigra
Red Nucleus
Substantia Nigra

Substantia nigra ("black

substance" is located in the
upper portions of the midbrain,
below the thalamus. It gets its
color from neuromelanin, a
close relative of the skin
pigment.

One part uses dopamine

neurons to send signals up to
the striatum. Also, Parkinson's
disease is due to the death of
dopamine neurons here.

The other part of the substantia

nigra is mostly GABA
neurons. It's main known
function is controlling eye
movements.

Red Nucleus

Its reddish colour, is due to the presence of

an iron-containing pigment in the cytoplasm
of many of its neurons.

Afferent fibers reach the red nucleus from:-

1. the cerebral cortex through the
corticospinal fibers.
2. the cerebellum through the superior
cerebellar peduncle.
3. the lentiform nucleus, subthalamic and
hypothalamic nuclei, substantia nigra,
and spinal cord.

Efferent fibers leave the red nucleus and pass

to;
1. the spinal cord through the rubrospinal
 tract.
2. the reticular formation
3. the thalamus.
4. the substantia nigra
The Reticular Formation

It is a set of interconnected nuclei located

throughout the brain stem - runs through
the midbrain, pons and the medulla.

Its dorsal tegmental nuclei are in the

midbrain while its central tegmental
nuclei are in the pons and its central and
inferior nuclei are found in the medulla (of
hindbrain).

The brain stem controls most of the

involuntary functions as well as reflexes of
the body while the cerebral cortex is the
seat of consciousness and thinking
abilities. The Reticular Formation
connects (forms a bridge) between the
lower parts of the brain (brain stem) to the
cerebral cortex through various neural
paths.

The reticular formation has two components:

1. Ascending Reticular Formation

It is also called the Reticular Activating System (RAS). One of the major functions of the RAS is the
regulation of transition between sleep and wakefulness. This system also plays a role in REM sleep.

2. Descending Reticular Formation

The system is responsible for providing an integrated (cardiovascular, respiratory and motor) response to
external stimuli. The ability to filter out information from external sources and focus on one particular
fact, detail or thought is controlled by the RAS. It also controls coordination during walking, sexual
functions and eating habits. The descending reticular nuclei in the brain are involved in reflexive
behavior such as coughing, chewing, swallowing and vomiting.
HINDBRAIN

Comprised of

1. Cerebellum
2. Pons
3. Medulla Oblongata

1. Cerebellum-

It lies below the back part of the cerebrum and is known as the ‘little brain’. The cerebellum has a right
and a left hemisphere, with a finger-shaped structure called the vermis in the middle. A folium (plural =
"folia") is a wrinkle on the surface of the cerebellum
The Cerebellum is divided into 3
lobes.

1. Anterior
2. Posterior
3. Flocculonodular Lobes.

These lobes are divided by two

fissures
1. Primary fissure
2. Posterolateral fissure.

The surface of each hemisphere is made up of grey

matter surrounding a large mass of white matter
(nerve cells with myelinated axons).

The white matter contains several deep nuclei

embedded in the white matter
  the dentate
 emboliform
 globose
 fastigi nuclei

The cerebellum is the part of the brain most responsible for balance, posture, and the coordination of
movement. The cerebellum is responsible for coordinating movement like coordinating voluntary
movements such as walking, skating, gymnastics, dancing, driving etc., planning, motor activities,
learning and remembering of physical skills and for some cognitive abilities.

Learned reflexes , skills and habits are also stored here which allows them to become more or less
automatic. The cerebellum controls movement by collecting sensory nerve inputs, such as limb
position, balance information and vision, and synthesizing them together to control movement by
sending nerve transmissions down motor nerve outputs. The learning of physical tasks is done by trial
and error and then stored into cerebellar memory. This is the reason that we never forget certain skills
such as riding a bike.

Damage to the cerebellum or the cerebellar peduncles is very common in multiple sclerosis. The
cerebellum helps us maintain our posture, our sense of balance or equilibrium by controlling the tone of
our muscles and senses the position of our limbs. A tumor affecting the cerebellum may cause an
individual to stagger and sway when they walk or have jerky movements of the arms and legs (a
drunken appearance). An individual trying to reach an object may misjudge the distance and location of
the object and fail to reach the object. The cerebellum is important in our ability to perform rapid and
repetitive actions such as typing.

In the cerebellum, nerve pathways connect the right half of the cerebellum with the left cerebral
hemisphere and the right side of the body. Pathways from the left half connect with the right cerebral
hemisphere and the left side of the body. This is known as IPSILATERAL FUNCTIONING. The
implications are that right-sided abnormalities in the cerebellum produce symptoms on the same side of
the body.
2. Pons

The pons forms a very small part of the brain amd

appear as a bulge/swelling above the medulla.
Measures only around 2.5 cm in length.

It’s a bridge between the lower and the upper parts

of the brain.

The Pons provides inputs to cerebellar cortex

through “pontine nuclei”

The signals to and from the cerebrum and

cerebellum pass through the pons.

The main function of pons is to basically act as a highway for relay of many signals to and from the
cerebrum and the cerebellum. The pons may play a vital role in REM cycle, sleep and in arousal. This is
the center that acts as the point of origin for various nerves in the body, including the important cranial
nerves. The different nerves that emerge from the pons include:

 Trigeminal nerve - This is the fifth cranial nerve which is both sensory and motor in nature. It is
responsible for sensation on the face and it also innervates the muscles of the mandible, which are
responsible for biting, chewing and swallowing food.

 Abducens nerve - This is a motor nerve which is responsible for sideways movement of the eyes.

 Facial nerve - This is a motor nerve which affects the muscles of facial expression, like muscles that
help in smiling, raising eyebrows and bringing about various expressions on the face, like shock,
fear, joy, etc. You may like to know more about cranial nerves and their functions.

 Vestibulocochlear nerve - This is a sensory nerve which has two parts - the cochlear portion, which
is involved with transmission of sound from the ear to the brain. The other part is the vestibular
portion, which transmits information from the inner ear and helps in maintaining balance and
coordination.

There are two centers in the pons that affect respiration.

 The apneustic center in the lower pons that seems to stimulate and prolongs inspiration thereby
controlling the intensity of breathing.

 The pneumotaxic center located in the upper pons that inhibits inspiration. It decreases the depth
and frequency of breaths.
3. Medulla Oblangata

The medulla is the most inferior part of the brain stem. The medulla oblongata is a portion of the
hindbrain that controls autonomic functions which are life sustaining functions such as breathing,
digestion, heart and blood vessel function, swallowing and sneezing.

Motor and sensory neurons from the midbrain and forebrain travel through the medulla. As a part of the
brainstem, the medulla oblongata helps in the transferring of messages between various parts of the
brain and the spinal cord.

Cell bodies of some cranial nerves are found here:

• Glossopharyngeal nerve - Taste sensation, swallowing

• Vagus nerve – Digestion, heart rate
• Spinal accessory nerve – muscles used in head movement
• Hypoglossal nerve – tongue movement

Because the nuclei of the vagus nerve are found in the medulla, it is a center for circulation and
respiration. It is also quite important to swallowing. It controls muscles of the pharynx, larynx and
velum. (Note: Most of the cranial nerves important for speech and swallowing are located in the
medulla.).

The medulla oblongata connects the higher levels of the brain to the spinal cord, and is responsible for
several functions of the Autonomic Nervous System which include:
 Cardiac center – sympathetic, parasympathetic nervous system
 Vasomotor center – barroreceptors (are sensors located in the blood vessels of all vertebrate
animals. They sense the blood pressure and relay the information to the brain, so that a proper
blood pressure can be maintained.)
 Reflex centers of vomiting, coughing, sneezing, and swallowing. These reflexes which include
the
o pharyngeal reflex,
o the swallowing reflex (also known as the palatal reflex),
o the masseter reflex can be termed, bulbarreflexes.
The Brain Stem

The brain stem is a stalk like structure that connects the cerebrum with the spinal cord. It may be
considered as a "stem" or structure holding up the cerebrum.

It consists
1. of three structures:
2.
3. The midbrain,
Pons
Medulla oblongata.

Ten of the 12 cranial nerves orginate in the

brain stem (except smell and vision which are
extensions of the cerebrum)

It serves as a relay station, passing messages back and forth between various parts of the body and the
cerebral cortex. The bottom part of the brain stem is called the medulla oblongata or medulla. The
medulla has nerve centers that control breathing, heartbeat, and many other vital body processes. Just
above the medulla is the pons, which connects the hemispheres of the cerebellum. The pons also
contains nerve fibers that link the cerebellum and the cerebrum. The pons and the medulla oblongata
control our breathing, blood pressure and heart rhythms. These functions are important to our survival.
Messages from the cortex to the spinal cord and nerves that branch from the spinal cord are sent through
the pons and the brain stem. Destruction of these regions of the brain will cause "brain death". The heart
can no longer beat on its own. Lungs cannot work on their own. Unable to breathe, oxygen will not be
delivered to the brain. Brain cells which require oxygen to survive will die. Originating in the brain stem
are ten of the twelve cranial nerves that control hearing, eye movement, facial sensations, taste,
swallowing and movement of the face, neck, shoulder and tongue muscles. The cranial nerves for smell
and vision are extensions of the cerebrum.
 SPINAL CORD
The spinal cord is long and thin tubular structure
comprising of millions of nerve cells that send
projections up and down the cord and out into the
other parts of the body.

Lodged in bony structure called the vertebral or

spinal column. The spinal cord originates and is
continuous with the medulla oblongata in brain
and extends to lumbar region (L1 or L2) of the
vertebral column, i.e., it runs the length of the
back, extending from the base of the brain to about
the waist.

The spinal cord is about 45 cm long in men and 43

cm long in women. The length of the spinal cord is
much shorter than the length of the bony spinal
column.

Average diameter of spinal cord is ½ inch in

cervical and lumbar region and ¼ inch in thoracic
region.

The spinal cord is only 2/3rd as long as the vertebral

column, the rest of the space is filled up by a mass
of spinal roots composing the cauda equine. (The
area within the vertebral column beyond the end of
the spinal cord is called the cauda equine- Known
as horse's tail in Latin), This bundle of nerves
governs the sensation and function of the bladder,
bowel, sexual organs, and legs.

The spinal cord contains two basic types of nerves,

sensory and motor.

 The sensory fibers enter the cord on its dorsal

(back) side and the motor nerves leave on its
ventral (front) side.
 In all, there are 31 sets of spinal nerves, each
set containing one sensory and one motor nerve
 on the left side and one of each on the right side
of the cord.

The spinal cord consists of a small hollow center called central canal which is further surrounded by H-
shaped area consisting of gray matter.

The gray color comes from the predominance of unmyelinated cell bodies in this area. The surrounding
white matter consists of myelinated axons that travel up and down the cord.

Protections of Spinal Cord

The outermost protection of the spinal cord is the bony structure called the vertebral or spinal
column.

The spinal cord is covered with the same three protective membranes as the brain, called the
meninges: Dura mater, Arachnoid membrane, and Pia mater.

 Epidural space lies between dura mater and arachnoid membrane and comprises of adipose tissue
and blood vessels.

 Subarachnoid space- lies between arachnoid membrane and pia mater, and contains the lymph
like fluid called cerebrospinal fluid.

 Cerebro-Spinal Fluid (CSF) is present in subarachnoid space and central canal. It provides
physical support to spinal cord, and in general CNS, by absorbing the shock and acts as a
transport system throughout the CNS for providing nutrients and removal of waste.
Functions of Spinal Cord
Spinal cord has the following two major functions:

1. Relay station: It carries sensory information from receptors throughout the body to the brain and
conducts information from the brain to muscles and glands. All the information going from the brain
to the limbs travels through the spinal cord. This then allows for movement. The spinal cord is the
first relay station for sensory information (what we feel in our arms and legs) on its way to
consciousness in various centers of the brain. Bladder functions, sensory functions and movement
are all dependent on information travelling up and down the spinal cord.

2. Reflex Action: It plays a key role in various reflexes. A reflex action, also known as a reflex, is an
involuntary and nearly instantaneous movement in response to a stimulus. The path taken by
the nerve impulses in a reflex is called a reflex arc. In higher animals, most sensory neurons do not
pass directly into the brain, but synapse in the spinal cord. This characteristic allows reflex actions to
occur relatively quickly by activating spinal motor neurons without the delay of routing signals
through the brain, although the brain will receive sensory input while the reflex action occurs.
Classification of Reflex Arcs

1. On the basis of function:

a) Autonomic reflex arc - affecting inner organs
b) Somatic reflex arc - affecting muscles.

2. On the basis of number of neurons involved:

a) When a reflex arc consists of only two neurons, one sensory neuron, and one motor neuron, it is
defined as Monosynaptic. Monosynaptic refers to the presence of a single chemical synapse.

b) Polysynaptic reflex arcs, one or more interneurons connect afferent (sensory)

and efferent (motor) signals.

Malfunctions and disorders of Spinal Cord

Spinal cord disorders cause various patterns of deficits depending on which nerve tracts within the cord
or which spinal roots outside the cord are damaged. Disorders affecting spinal nerves, but not directly
affecting the cord, cause sensory or motor abnormalities or both only in the areas supplied by the
affected spinal nerves.

Spinal cord dysfunction causes paresis, loss of sensation, reflex changes, and autonomic dysfunction
(e.g., bowel, bladder, and erectile dysfunction; loss of sweating). Autonomic and reflex abnormalities
are usually the most objective signs of cord dysfunction. Paraparesis occurs when the motor and sensory
loss is below the levels of the arms and thus involves the thoracic or lumbar region. Quadraparesis is the
term used to describe sensory and motor malfunction which involves both arms and legs and usually
involves a problem in the cervical area (neck).

Sometimes an injury that crushes or compresses the spinal cord can permanently damage the bundles of
nerves that normally send messages between the brain and the rest of the body leading to spasticity. This
nerve damage can significantly affect movement or sensation. By interrupting the messages to the
muscles, the injury can lead to the muscle tightness and spasms known as spasticity.
THE WORKING / FUNCTIONING OF THE BRAIN

The structure of our brain determines how we experience the world. Our experiences, in turn, influence
how our neurons develop and connect with one another. Individual brains can differ significantly,
depending on a person's background and experience. The fingers activate the same general area of the
sensory cortex in everyone's brain. But this area is larger in people who use their fingers particularly
often—for example, people who play stringed instruments, or people who read braille (an alphabet of
small raised dots developed for the blind).

Scientists have developed many methods to study how the brain works. Experiments with animals have
revealed a great deal about the workings of various areas of the brain. Scientists have also learned much
about the normal activity of the brain by observing injured brains. Damage to a specific part of the brain
causes predictable problems in speech, movement, or mental ability.

Surgeons have mapped the functions of many areas of the cerebral cortex by electrically stimulating the
brain during brain surgery. Surgical operations on the brain do not require that the patients be
unconscious because the brain feels no pain directly. Thus, the patients can tell the surgeons what they
experience when particular brain areas are stimulated.

Brain surgery has revealed that certain functions of the cerebrum occur chiefly in one hemisphere or the
other. Surgeons treat some cases of epilepsy by cutting the corpus callosum. This operation produces a
condition called the split brain, in which no communication occurs between the cerebral hemispheres.
Studies of split-brain patients suggest that the left hemisphere largely controls our ability to use
language, mathematics, and logic. The right hemisphere is the main center for musical ability, the
recognition of faces and complicated visual patterns, and the expression of emotion.

Other brain tests include the Computed tomography (CT scan) wherein a scanner takes multiple X-rays,
which a computer converts into detailed images of the brain and skull, Magnetic resonance imaging
(MRI scan) which uses radio waves in a magnetic field to create highly detailed images of the brain and
other parts of the head. An Electroencephalogram (EEG) is one where brain activity is monitored
through electrodes placed on the skin on the head. EEG can help diagnose seizures, or other brain
problems

Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are safe new
technologies that enable scientists to study healthy, living brains at work. These technologies do not
require any physical contact with the brain. They produce images similar to X rays that show which
parts of the brain are active while a person performs a particular mental or physical task. PET shows the
parts of the brain that are using the most glucose (a form of sugar), and fMRI shows the parts where
high oxygen levels indicate increased activity.
The following are the main functions of the brain:

1. In receiving sensory messages: Sensory messages are received and interpreted primarily in the
cerebral cortex. Various parts of the body send nerve impulses to the thalamus, which routes them to
the appropriate areas of the cerebral cortex. An area of the sensory cortex called the somatosensory
cortex receives messages that it interprets as bodily sensations, such as touch and temperature. It lies
in the parietal lobe of each hemisphere along the central fissure. Each part of the somatosensory
cortex receives and interprets impulses from a specific part of the body.

Other specialized areas of the cerebrum receive the sensory impulses of seeing, hearing, taste, and
smell. Impulses from the eyes travel to the visual cortex in the occipital lobes. Portions of the
temporal lobes receive messages from the ears. The area for taste lies buried in the lateral fissure,
and the center of smell is on the underside of the frontal lobes.

2. In controlling movement: Some reflex actions do not involve the brain. If a person touches a hot
stove, for example, pain impulses flash to the spinal cord, which immediately sends back a message
to withdraw the hand. However, the brain plays the major role in controlling our conscious
movements as well as those we are unaware of. The basal ganglia are groups of neurons that lie at
the base of the cerebrum. The basal ganglia help control well-learned movement sequences involved
in such activities as walking or eating. Areas in the brain stem control the movements of the body's
involuntary muscles, which line the walls of the stomach, intestines, and blood vessels.

The cerebral cortex and the cerebellum together largely regulate voluntary movements. The motor
cortex in each cerebral hemisphere sends nerve impulses to the particular muscles used in an
activity, such as writing or throwing a ball. The motor cortex lies in the frontal lobe in front of the
central fissure. Each area of the motor cortex controls the movements of a specific part of the body.
The largest areas control those parts of the body that make the most complicated and precise
movements. Thus, a large area controls the lips and tongue, which make complex movements in
speaking. Much smaller areas control the relatively simple movements made by such parts as the
back and shoulders.

The major motor pathways to the body cross over in the brain stem. The motor cortex of the left
hemisphere thus controls movements on the right side of the body. Similarly, the right motor cortex
directs movements on the left side of the body. More than 90 percent of all people are right-handed
because the left motor cortex, which directs the right hand, is dominant over the right motor cortex,
which directs the left hand.

The cerebellum coordinates the muscle movements ordered by the motor cortex. Nerve impulses
alert the cerebellum when the motor cortex orders a part of the body to perform a certain action.
Almost instantly, impulses from that part of the body inform the cerebellum of how the action is
being carried out. The cerebellum compares the movement with the intended movement and then
 signals the motor cortex to make any necessary corrections. In this way, the cerebellum ensures that
the body moves smoothly and efficiently.

3. In the use of language: In the late 1800's, scientists observed that damage to particular parts of the
brain caused the same language disabilities in most patients.
 Damage to the left frontal lobe in Broca's area, named for French surgeon Pierre Paul Broca,
destroyed the ability to speak.
 Damage to the left temporal lobe in Wernicke's area, named for German neurologist Carl
Wernicke, caused difficulty understanding language.
 These observations led many scientists to think that the brain processed words in an orderly
relay through a series of language-related areas. But new imaging technologies such as PET
and fMRI enable scientists to observe the brain directly while people speak, listen, read, and
think. PET and fMRI studies show that language processing is extremely complex. Language
areas are spread widely through the brain, and different types of language tasks activate these
areas in many sequences and patterns.

4. In regulating body processes: The main control centers for body processes are in the brain stem.
Nerve centers in the medulla regulate such body functions as breathing, heartbeat, and blood flow.
Other areas within the brain stem control swallowing and the movements of the stomach and
intestines.

The hypothalamus also has nerve centers that control certain body processes. Most of these centers
maintain constant conditions within the body. For example, some centers regulate the amount of
water in the body. Certain neurons detect changes in the level of water in the body's blood and
tissues and relay this information to the hypothalamus. If the water level is too low, the
hypothalamus produces the sensation of thirst, which causes the person to drink water. At the same
time, the hypothalamus sends messages that cause the kidneys to reduce the amount of water they
remove from the body. If the water level becomes too high, the messages from the hypothalamus
eliminate thirst and increase the amount of water removed by the kidneys. Other centers in the
hypothalamus operate on the same principle in regulating hunger and body temperature.

A slender stalk of tissue connects the hypothalamus with the master gland of the body, the pituitary.
The hypothalamus indirectly regulates many body processes by controlling the pituitary's production
and release of chemical messengers called hormones. Among other functions, these hormones
regulate the body's rate of growth and its sexual and reproductive processes.

5. In producing emotions: The emotions we experience involve many areas of the brain as well as
other body organs. A group of brain structures called the limbic system plays a central role in the
production of emotions. This system includes portions of the temporal lobes, parts of the
hypothalamus and thalamus, and other structures.
 An emotion may be provoked by a thought in the cerebral cortex or by messages from the sense
organs. In either case, nerve impulses are produced that reach the limbic system. These impulses
stimulate different areas of the system, depending on the kind of sensory message or thought. For
example, the impulses might activate parts of the system that produce pleasant feelings involved in
such emotions as joy and love. Or the impulses might stimulate areas that produce unpleasant
feelings associated with anger or fear.

6. In thinking and remembering: Scientists have only an elementary understanding of the

extraordinarily complicated processes of thinking and remembering. Thinking involves processing
information over circuits in the association cortex and other parts of the brain. These circuits enable
the brain to combine information stored in the memory with information gathered by the senses.
Scientists are just beginning to understand the brain's simplest circuits. Forming abstract ideas and
studying difficult subjects must require circuits of astonishing complexity. Some aspects of human
thinking—such as religious or philosophical beliefs—are still beyond scientists' understanding and
may always be.

Scientists also have much to learn about the physical basis of memory. Certain structures of the
limbic system appear to play major roles in storing and retrieving memories. These structures
include the amygdaloid complex and the hippocampus, both in the temporal lobe. Individuals who
suffer damage to these structures may lose the ability to form new memories, though they may retain
information about events occurring before the damage. These individuals can learn new physical
skills, but when performing them do not remember having done the activities before.
THE CHEMISTRY OF THE BRAIN

As in all other cells, many complex chemical processes occur within the neurons of the brain. However,
some chemical processes occur only within and among neurons. Scientists are especially interested in
gaining a fuller understanding of these processes and how they relate to the transmission of nerve
impulses.

A nerve impulse is an electrical and chemical process controlled by the nerve cell membrane. The
process involves ions (electrically charged atoms) of chemical elements, such as sodium and potassium.
The membrane, which has pores, maintains varying concentrations of these ions inside the neuron and in
its surrounding fluids. As the membrane selectively allows ions to enter and leave the cell, an electric
charge—the nerve impulse—travels along the neuron.

The brain's chemical messengers: Certain chemicals called neurotransmitters make it possible for a
nerve impulse to travel from the axon of one neuron to the dendrite of another. An impulse cannot be
transmitted electrically across the synaptic cleft, the tiny gap between the axon and the dendrite. Instead,
when an impulse reaches the end of the axon, it triggers the release of neurotransmitter molecules from
the cell. These molecules cross the synaptic cleft and attach themselves to sites called receptors on the
dendrite of the other neuron. This action alters the electrical activity of the receiving neuron in one of
two ways. Some transmitters stimulate the neuron to produce a nerve impulse. Others tend to prevent the
neuron from producing an impulse.

Neurons may manufacture more than one neurotransmitter, and their membrane surfaces may contain
receptors for more than a single transmitter. A neuron may "learn" from past experience and change the
proportions of its various neurotransmitters and receptors. Thus, the brain has great flexibility and can
alter its response to situations encountered over spans of time ranging from seconds to decades.

The brain produces many kinds of chemicals that are used as neurotransmitters. The most important
ones are acetylcholine, dopamine, norepinephrine, and serotonin. The chemicals are not distributed
evenly throughout the brain. Each is found only or primarily in specific areas. For example, the cell
bodies of neurons that contain dopamine are in the midbrain of the brain stem. The axons of these cells
reach into other areas, including the frontal lobes of the cerebrum and an area near the center of the brain
called the corpus striatum. These dopamine pathways function in the regulation of emotions and in the
control of complex movements.

During the 1970's, researchers discovered that morphine and related drugs relieve pain by attaching to
receptors in certain regions of the brain. This discovery suggested that the brain produces its own
painkillers that attach to these same receptors. Further research led to the discovery of endorphins and
enkephalins, two neurotransmitters that bind to these receptors.
BRAIN CHEMISTRY AND MENTAL ILLNESS

All the brain's functions depend on the normal action of neurotransmitters. An excess or deficiency of a
specific transmitter or group of transmitters may lead to a serious disorder in thought, mood, or
behavior. For example, studies have suggested that chemical imbalances in the brain play a significant
role in several types of mental illnesses.

The following are those neurotransmitters which play a significant role in our mental health.

1. Serotonin

Many studies have linked low levels of the neurotransmitter serotonin to depression, and some anxiety
disorders, especially obsessive-compulsive disorder. Impulsive and aggressive forms of behavior,
violence, and even suicide are also associated with imbalance in Serotonin. The class of medications
called SSRIs (selective serotonin reuptake inhibitors) prevents the neurons that release this chemical
from taking it back in once it is in the synapse. As a result, the person has more serotonin available to
attach to receptors in the brain, which can ease the symptoms of depression.

2. Dopamine

Neurons in the core of the brain release dopamine - a neurotransmitter that affects processes that control
movement, emotional response, and the ability to experience pleasure and pain. Too much dopamine has
been associated with schizophrenia, and too little is associated with the muscular rigidity and tremors
found in Parkinson’s disease.

In people who have Parkinson disease, dopamine-transmitting neurons in this area of the brain die,
which causes progressive loss of movement control.

There is some evidence that the brain produces too much dopamine in a severe mental illness called
schizophrenia. This excess of dopamine may create emotional disturbances and cause a person to see
things and hear sounds that do not exist.

Some of these people seem to have been helped by medications that block dopamine receptors in the
brain, thereby limiting the neurotransmitter's effect.

3. Norepinephrine

It is a neurotransmitter that is involved in various arousal systems in the brain (systems that bring about
alertness and attention) and in the sympathetic nervous system . In the sympathetic nervous system, it is
norepinephrine that causes the blood vessels to narrow, raising blood pressure, and speeds the breathing
and heart rates. Norepinephrine also functions as a hormone when it is released by the adrenal glands
located just above the kidneys, with similar results. Norepinephrine, epinephrine, and other hormones
produced by the adrenal gland are involved in the "fight or flight" response of the body to stress.

Strongly linked to physical responses and reactions, it can increase heart rate and blood pressure as well
as create a sense of panic and overwhelming fear/dread. This neurotransmitter is similar to adrenaline
and is felt to set threshold levels to stimulation and arousal. Emotionally, anxiety and depression are
related to norepinephrine levels in the brain, as this neurotransmitter seems to maintain the balance
between agitation and depression.

4. Acetylcholine

The neurotransmitter acetylcholine is used to promote excitatory actions for cognition, memory and
arousal. It regulates your ability to process sensory input and access stored information. Acetylcholine
controls your brain speed by determining the rate at which electrical signals are processed throughout
your body. When your brain speed slows, the brain doesn’t react as fast as it used to. This leads not
only to reduced cognition, but to slowed impulses that result in organs functioning less well.

Alzheimer’s disease, Dementia and Myasthenia Gravis are conditions associated with imbalances of
acetylcholine.

Too much acetylcholine is associated with depression, and too little in the hippocampus has been
associated with dementia.

5. GABA (Gamma-Amino Butyric Acid)

Gamma-Aminobutyric Acid (GABA) is a neurotransmitter that is inhibitory, that is, it decreases the
ability of other neurotransmitters to work. GABA is involved in our level of excitability. This
neurotransmitter is important in brain areas involving emotion and anxiety.

Low levels of GABA are associated with Bipolar Disorder, Mania. Low levels of GABA are also
associated with problems of poor impulse control, including clinical conditions such as gambling,
temper tantrums, and stealing. When GABA is low in the brain, impulsive behaviors are not inhibited
(stopped) by logical or reasonable thinking.

High levels of GABA produce more control, relaxation, and even sedation. Alcohol works by increasing
GABA levels. Some anti-anxiety medication increases GABA at the receptor sites.

How drugs affect brain chemistry: Psychiatrists treat some mental illnesses with drugs that restore the
brain's normal chemical activity. For example, many tranquilizers that relieve the symptoms of
schizophrenia block the brain's receptors for dopamine. However, it seems unlikely that a single
neurotransmitter is responsible for schizophrenia or other complex mental illnesses, such as bipolar
disorder and depression. These disorders probably result from chemical disturbances involving several
neurotransmitters. For example, some drugs that have proved successful in treating depression influence
norepinephrine, while others influence serotonin. Still others affect both of these neurotransmitters.

Drugs/ medicines affect our feelings or behavior by altering the process of synaptic transmission. They
produce their effects by changing the complex biochemical events that occur when one neuron
communicates with another. Such effects take two major forms. If a particular drug facilitates the impact
of a specific neurotransmitter, it is an agonist of that transmitter. In contrast, if a drug interferes with or
inhibits the impact of a neurotransmitter, it is said to be an antagonist of the transmitter.

These effects may be summarized as follows:

AGONISTIC OR EXCITATORY EFFECTS ANTAGONISTIC OR INHIBITING

EFFECTS
Specific drugs can increase the amount of Specific drugs can block the synthesis of a
neurotransmitter synthesized by neurons neurotransmitter
Specific drugs can increase the release of the Specific drugs can disrupt the mechanism
neurotransmitter by specific neurons through which neurotransmitters are
released into the bloodstream
Specific drugs can activate receptors that normally Specific drugs can act as false transmitters
respond to neurotransmitters, enhancing the impact of to bind with and deactivate receptors that
these transmitters normally respond to specific
neurotransmitters
Specific drugs can block the reuptake or breakdown of Specific drugs can cause neurotransmitters
neurotransmitters in the synapse so that their effects to leak from synaptic vesicles, so that
persist longer than would otherwise be the case enzymes break down the neurotransmitters,
before they can be released into the synapse.

Certain drugs produce a feeling of well-being or reduce tension and worry by temporarily altering the
normal chemistry of the brain. For example, amphetamines increase mental activity by causing brain
cells to release an excessive amount of dopamine. Abuse of amphetamines can create mental
disturbances like those that occur in some forms of schizophrenia.

A person's senses, emotions, thought processes, and judgment can be altered dramatically and
dangerously by hallucinogenic drugs. These drugs include mescaline, psilocybin, and LSD (lysergic
acid diethylamide). Each of these drugs structurally resembles one or more neurotransmitters. Mescaline
resembles dopamine and norepinephrine, and LSD and psilocybin resemble serotonin. Scientists think a
hallucinogenic drug may produce its effects by combining with the brain's receptors for the natural
transmitter that it resembles. Hallucinogenic drugs may produce disturbances in brain chemistry that last
long after their contact with the brain. For example, scientists believe that the drug called MDMA,
 marketed as Ecstacy, may cause permanent damage to neurons that release serotonin. This damage may
produce harmful effects on mood, thoughts, sleep, and motivation.

DISORDERS OF THE NERVOUS SYSTEM

Consideration of disorders of the nervous system is the province of neurology; psychiatry deals with
behavioral disturbances of a functional nature. The division between these two medical specialties
cannot be sharply defined, because neurological disorders often manifest both organic and mental
symptoms. Diseases of the nervous system include genetic malformations, poisonings, metabolic
defects, vascular disorders, inflammations, degeneration, and tumors, and they involve either nerve cells
or their supporting elements. Vascular disorders, such as cerebral hemorrhage or other forms of stroke,
are among the most common causes of paralysis and other neuralgic complications.
The nervous system is subject to infection by a great variety of bacteria, parasites, and viruses. For
example, meningitis, or infection of the meninges covering the brain and spinal cord, can be caused by
many different agents. On the other hand, one specific virus causes rabies. Some viruses causing
neurological ills affect only certain parts of the nervous system. For example, the virus that causes
poliomyelitis commonly affects the spinal cord; viruses causing encephalitis attack the brain.

Injuries, diseases, and inherited disorders can damage the brain. However, the seriousness of brain damage
depends chiefly on the area of the brain involved rather than on the cause of the damage. Modern
instruments and techniques enable physicians to diagnose brain disorders earlier and more accurately than
in the past. For example, an instrument called an electroencephalograph (EEG) measures the patterns of
electrical activity produced by the brain. Differences from normal EEG patterns may indicate damage to
the brain and also help locate the area of the damage. Computer-assisted EEG's can record and organize
vast amounts of electrical data. The brain's responses to specific visual, auditory, and touch stimuli can be
measured. Scientists can diagnose disorders by comparing the responses with average results obtained from
large numbers of people. Another important technique is computed tomography (CT). It involves X-raying
the brain in detail from many angles. A computer then analyzes the X-ray data and constructs a cross-
sectional image of the brain on a TV screen. Magnetic resonance imaging (MRI) uses magnetic fields and
radio waves to produce images of the brain's structure.

1. Injuries are the leading cause of brain damage among people under 50 years of age. A blow to the head
may cause temporary unconsciousness without permanent damage. Severe injuries to the head may cause
more serious brain damage. Head injuries before, during, or shortly after birth may cause cerebral palsy.
There are several types of cerebral palsy, all of which involve lack of control of muscle movements.

2. Stroke is the most common serious disorder of the brain. A stroke occurs when the blood supply to part
of the brain is cut off. Nerve cells in the affected areas die, and the victim may lose the ability to carry out
functions controlled by those areas. Many stroke victims suffer paralysis on one side of the body. Other
symptoms include difficulty in speaking or in understanding language. Most strokes result from damage to
the blood vessels caused by hypertension (high blood pressure) or arteriosclerosis (hardening of the
arteries). Some victims of massive strokes die, but many other stroke victims survive and ecover at least
partially.

3. Tumors - A brain tumor is a growth in the brain that leads to increased pressure inside the skull and the
destruction and compression of normal brain tissue, causing loss of function. Symptoms of a tumor include
headache, seizures, unusual sleepiness, a change in personality, or disturbances in sense perception or
speech.

Treatment may involve radiation, chemotherapy, and/or surgery. For cancerous tumors, physicians may
combine surgery with drugs or radiation. One type of radiation, called stereotactic radiosurgery, is
sometimes used as an alternative to traditional surgery. In stereotactic radiosurgery, doctors use computers
and a CT scan or MRI to produce a three-dimensional image of the brain. Beams of radiation are then
focused precisely on the target, which may be a tumor or a blood-vessel malformation. The individual
beams are either too brief or too weak to harm areas of the brain in the path of the radiation. But their
combined effect will destroy the target. These procedures are quick and painless and allow patients to
resume moderate activity the same day.

4. Infectious diseases caused by bacteria or viruses can damage the brain. The most common of these
infectious diseases are encephalitis and meningitis, either of which may be caused by bacteria or viruses.
Encephalitis is an inflammation of the brain. Meningitis is an inflammation of the meninges, the
membranes that cover the brain and spinal cord. Chorea is a disease of the brain that mainly affects
children from 7 to 15 years old. Most cases of chorea occur with rheumatic fever and may be caused by the
same bacteria which cause that disease. A virus disease called poliomyelitis attacks the brain and spinal
cord. Vaccines to prevent polio were developed in the 1950's.

5. Genetic disorders Our genes (the hereditary materials in cells) carry instructions for the development of
our entire bodies, including the brain. These instructions are extremely complex, and so errors occasionally
occur. These errors can lead to serious defects in the structure and functioning of the brain. Some infants
are mentally retarded at birth because genetic errors caused the brain to develop improperly during the
mother's pregnancy. In Down syndrome, for example, an extra chromosome is present. Chromosomes are
structures in the cell nucleus that contain the genes. The extra chromosome causes mental retardation as
well as physical defects. Another disorder that causes mental retardation is fragile-X syndrome. This
disorder results from an abnormality on the X chromosome, one of the chromosomes that determine a
person's sex.

Some children suffer severe brain damage after birth because of an inherited deficiency of an enzyme that
the body needs to use foods properly. For example, a child who has phenylketonuria (PKU) lacks an
enzyme needed to convert a certain amino acid (protein part) into a form the body can use. This amino
acid, phenylalanine, accumulates in the blood and damages developing brain tissues. A diet low in
phenylalanine can prevent brain damage in people who have PKU.
Some genetic errors damage the brain only later in life. Huntington's disease, for example, usually strikes
during middle age. The disease causes various areas of the cerebrum and basal ganglia to wither away.
Involuntary jerky movements are the main early symptoms of Huntington's disease. However, the disease
eventually leads to incurable mental disintegration.

Scientists believe that genetic factors play an important role in most cases of Alzheimer's disease. This
disease most commonly strikes after age 60. It is characterized by an increasingly severe loss of memory
and other mental abilities. Most people with Alzheimer's disease eventually cannot care for themselves and
become bedridden.

Heredity also plays a role in some types of mental illness. Many children of schizophrenics apparently
inherit a tendency to develop schizophrenia. Studies have also revealed an inherited tendency to develop
bipolar disorder. These tendencies may involve inherited defects in brain chemistry. Researchers continue
to study these tendencies and how they interact with environmental conditions to produce mental illness.

6. Epilepsy. Victims of epilepsy suffer seizures that occur when many nerve cells in one area of the brain
release abnormal bursts of impulses. A seizure may cause temporary uncontrolled muscle movements or
unconsciousness. Defects in genes cause some cases of epilepsy, but the cause of most cases is not known.
Physicians treat epilepsy with drugs that reduce the number of seizures or prevent them entirely.

7. Multiple sclerosis develops when axons in parts of the brain and spinal cord lose their myelin sheaths.
As a result, the axons cannot carry nerve impulses properly. Symptoms vary depending on what brain areas
are affected, but they may include double vision, loss of balance, and weakness in an arm or leg. No cure is
yet known. Drugs can relieve some of the symptoms. Some of these drugs help slow the loss of myelin.

8. Parkinson's disease- Parkinson's is characterized by tremor (shaking), rigid muscles, difficulty making
quick, smooth movements, and difficulty standing and walking. Many people also develop depression and
anxiety and, later in life, problems with memory loss and dementia. It usually develops late in life, but it
can occur in younger people. Parkinson's is originates in the death of cells in the ‘substantia nigra’ and the
loss of dopamine and melanin produced by those cells. It progresses to other parts of the basal ganglia and
to the nerves that control the muscles, involving other neurotransmitters. Possible causes or contributing
factors include environmental toxins, head trauma, and genetics.There are treatments available that slow
the course of Parkinson's and alleviate the symptoms. Most involve replacing or mimicking the lost
dopamine and other neurotransmitters. Unfortunately, the disease slowly progresses to where the
treatments only work for a few hours at a time. Parkinson's does not directly cause death and many patients
live long lives with it.

9. Huntington's disease- Huntington's disease is a rare inherited (genetic) disorder that causes parts of the
brain to break down and lose some normal functions (degeneration). It is also called Huntington's chorea.
Symptoms of the disease usually develop after age 40 and include rapid, jerky movements (twitches in the
face and jerks of the arms) that cannot be controlled (chorea/ dance) and the gradual loss of mental abilities
(dementia), leading to personality changes, behavior problems, and memory loss.It is a hereditary disease
(with a dominant gene) involving cell death in the caudate nucleus.

10. Cerebral palsy- A nonprogressive disorder of movement resulting from damage to the brain
before, during, or immediately after birth. Causes may include fetal infection, environmental toxins, or
lack of oxygen.
People with cerebral palsy have various motor problems, such as spasticity, paralysis, and even seizures.
Spasticity is where some muscles are constantly tight and so interfere with normal movement. Although
cerebral palsy tends to remain relatively stable throughout life, there is no cure and is very difficult to deal
with for both the person and his or her family.

11. Aphasia is the term used to describe an acquired loss of language that causes problems with any
or all of the following: speaking, listening, reading and writing. Some people with aphasia have trouble
using words and sentences (expressive aphasia). Some have problems understanding others (receptive
aphasia). Others with aphasia struggle with both using words and understanding (global aphasia). Aphasia
can cause problems with spoken language (talking and understanding) and written language (reading and
writing). Typically, reading and writing are more impaired than talking or understanding. The severity of
the aphasia depends on the amount and location of the damage to the brain.

 Broca’s (expressive or motor) Aphasia - Damage to a discrete part of a the brain in the left
frontal lobe (Broca’s area) of the language-dominant hemisphere has been shown to significantly
affect use of spontaneous speech and motor speech control. Words may be uttered very slowly
and poorly articulated.

 Wernicke’s Aphasia - Damage to the posterior superior areas of the language dominant
temporal lobe (often called Wernicke’s area) has been shown to significantly affect speech
comprehension. In other words, information is heard through an intact auditory cortex in the
anterior temporal lobe, however, when it arrives at the posterior association areas, the
information cannot be sufficiently “translated.” In contrast to Broca’s aphasia, the person with
Wernicke’s aphasia talks volubly and gestures freely. Speech is produced without effort, and
sentences are of normal length. However, the person’s speech is devoid of meaning.

 Global Aphasia - If damage encompasses both Wernicke’s and Broca’s areas, global aphasia
can occur. In this case, all aspects of speech and language are affected. Patients can say a few
words at most and understand only a few words and phrases. They usually cannot carry out
commands or name objects. They cannot read or write or repeat words said to them.

 Anomic aphasia is one of the milder forms of aphasia. The term is applied to
persons who are left with a persistent inability to supply the words for the very things
they want to talk about, particularly the significant nouns and verbs. Their speech is
fluent and grammatically correct but it is full of vague words (such as ‘thing’) and
circumlocutions (attempts to describe the word they are trying to find). The feeling is
often that of having the word on the tip of one’s tongue, which results in their speech
having lots of expressions of frustration.
  Primary Progressive Aphasia: Symptoms begin gradually, often before age 65,
and worsen over time. People with primary progressive aphasia can lose the
ability to speak and write and, eventually, to understand written or spoken
language. This condition progresses slowly, so you may continue caring for
yourself and participating in daily life activities for several years after the
disorder's onset. Primary progressive aphasia is a type of frontotemporal
dementia, a cluster of related disorders that results from the degeneration of the
frontal or temporal lobes of the brain, which include brain tissue involved in
speech and language

12. PAP Syndrome (French: perte d'auto-activation psychique, i.e., loss of subjective auto-
activation). Also called Athymhormic syndrome- It is a rare neurological syndrome characterized by
extreme passivity, apathy, blunted affect, and a profound generalized loss of self-motivation and conscious
thought.

For example, a patient with this syndrome might sustain severe burns on contact with a hot stove, due to
lacking the will to move away despite experiencing severe pain. PAP is characterized by an unusual lack of
motivation.

Damage to the caudate nucleus means that nothing carries any emotional significance anymore. People
with PAP also ignore the usual social and moral motivations we all take for granted. They don't quite "get"
that their lack of action could have significant consequences. Without the motivating influence of the basal
ganglia, the frontal lobe simply stops planning for the future.