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Peripheral neuropathy

Damage to the peripheral nervous system which leads to loss of sensitivity or control

Cerebro-spinal fluid

Fluid which bathes the brain and spinal cord and protects them from mechanical damage.

Blood-brain barrier

Tightly packed epithelial cells and other tissues which prevent most substances getting from the blood into the fluid surrounding the brain

Epithelial cells

Cells that cover the internal and external surfaces of organs

Nanoparticles

Very small particles which are less than 10nm in diameter

Spina bifida

A condition when the spinal cord and vertebrae do not develop properly during pregnancy

Capillary

Very small blood vessel with walls made of a single layer of epithelial cells. Exchange of materials, such as nutrients, oxygen and carbon dioxide, takes place between the blood and the cells of the body across the capillary walls.

Folic acid

B vitamin needed for the healthy development of the spinal cord in a foetus (fetus)

Stem cell

Cells which can divide repeatedly without becoming differentiated and have the capacity to develop into a diverse range of specialised cell types.

Radiation

The emission of heat, light or other electromagnetic waves.

Vertebrae

The small bones which make a strong but flexible column down the back (the spine), carrying and protecting the spinal cord.

Protein

A polymer made up of amino acids joined by peptide bonds. The amino acids present and the order in which they occur vary from one protein to another.

Diabetes mellitus

A disease resulting from a lack of insulin production by the pancreas or a loss of the cell response to insulin that causes a loss of control of the glucose balance of the body.

Glucose

A type of sugar: a mono saccharide with 6 carbon atoms (a hexose sugar).

Bladder

The muscular organ in which urine is collected and stored.

L-dopa

Medication which is a precursor to dopamine in the brain which is used to treat Parkinson?s disease

Problems with the nervous system

The brain, spinal cord and peripheral nervous system coordinate and control your body. When they are working well you won’t even notice them. But if something goes wrong with your nervous system the results can be very serious indeed. What’s more, damage and disease in the nervous system can be very difficult to treat.

The peripheral nerves

The peripheral nervous system is vital for carrying information from your sensory receptors to the CNS and from the CNS to your muscles and glands. If you develop problems with these nerves, it can cause serious problems. For example, if you lose the sensation of touch and temperature in the skin of your fingers or feet, you may do real damage to yourself without being aware of it at all.

Damage to the peripheral nervous system is known as peripheral neuropathy. The symptoms of neuropathy range from slight numbness or tingling to severe pain or complete insensitivity of an area of the body to pain or temperature. One of the most common causes of peripheral neuropathy is diabetes, but it can result from many other diseases too.

Neuropathy1 Neuropathy2

The diagram on the left shows the areas most commonly affected by peripheral neuropathy which results from diabetes. Older people who have had diabetes for a long time are particularly at risk of peripheral neuropathy. It can seriously affect their mobility and quality of life. (Photo: Anthony Short)

Spinal cord damage

The spinal cord is the main route for impulses from the body to the brain and from the brain to the effector organs. The spinal cord is protected by the vertebrae which form a protective bony tunnel for the nerves. However if the spinal cord is damaged it can prevent sensory information reaching the brain and prevent motor impulses from reaching the muscles and making movement possible. This can cause a loss of sensation, paralysis or both depending on the level of damage to the spinal cord.

The place where the damage occurs affects whether the person will lose the use of their legs or their legs and arms. Even automatic responses such as the control of the bladder, bowel or even breathing can be lost. Without rapid medical support, a severe spinal injury can even cause death.

Damage to the spinal cord is often the result of an accident or an injury but in spina bifida the vertebrae do not form properly in the early stages of pregnancy. In severe cases there are openings along the spine. This means the spinal cord is not protected properly and it can result in paralysis and also in loss of bowel and bladder control and of skin sensitivity. There are a number of factors which increase the chance of a woman having a baby affected by spina bifida. One of the most important is a lack of one of the B vitamins, folic acid, in the early stages of pregnancy. Doctors advise all women who are trying to get pregnant or who are in the first few months of pregnancy, when the spine develops, to take a folic acid supplement of 0.4mg per day. Click here to learn more about the role of micronutrients in your diet.

Disease and damage in the brain

The brain is so complex that there are many things that can go wrong. Some of the problems involve the neurones that make up the brain while others affect the neurotransmitters that make it possible for the neurones to communicate with each other. Accidental damage as well as diseases can also affect how the brain works. There are many brain diseases which are still not fully understood. Table 1 shows a few of the more common brain diseases and disorders.

Disease Cause Treatment
Parkinson's Click to reveal

Levels of neurotransmitter dopamine in the synapses of affected brain areas fall, so nerve impulses pass less easily between the neurones - or not at all. Movements become slower, muscles feel stiffer and less responsive and affected people may develop a tremor.

Click to reveal

Supply the brain with L-dopa, which allows it to make more dopamine, keeping the levels of neurotransmitter as normal as possible. Sadly high doses can have many side effects. Possible new treatments include electronic stimulation of the brain areas, stem cell therapy and better drugs.

Dementia Click to reveal

A group of diseases including Alzheimer’s which involve the death of brain cells in particular areas. This may be caused by the build up of abnormal proteins or by problems in the blood supply. It is difficult to diagnose but dementia usually affects the memory and personality.

Click to reveal

There are no long-term treatments but some drugs which inhibit the breakdown of neurotransmitters can delay the progress of Alzheimer’s for a time. They allow the brain to make best use of the neurones which are left.

Depression Click to reveal

A broad spectrum of diseases from mild feelings of being sad and low to a condition which is life-threatening. The causes vary – depression may be a response to life events or it may be generated within the brain. There is some evidence that a reduction in the neurotransmitter serotonin is involved in depression.

Click to reveal

There are many treatments from simple measures such as exercise and good diet which can help to increase the natural serotonin production of the brain, through talking therapies and anti-depressant drugs such as SSRIs which boost serotonin levels in the brain.

Getting medicines to the brain is a big problem. The brain is surrounded by a special system called the blood-brain barrier (BBB). In normal blood capillaries there are gaps between the epithelial cells so substances can pass through from the blood to the cells of the body. However in the brain the epithelial cells fit very tightly together so nothing can pass through them. Substances which are needed by the brain (such as glucose, oxygen and water) are transported in but BBB stops a wide range of chemicals getting from the blood to the cerebro-spinal fluid which surrounds the brain and spinal cord. This:

  • Protects them from damage by toxins which may build up in the blood
  • Allows the levels of hormones and neurotransmitters in the brain to be different to the rest of the body
  • Makes it easier to maintain constant conditions in the brain.

The problem is that the BBB makes it very difficult for doctors to get medicines into the brain. All sorts of methods, including special carrier molecules and nanoparticles are being tested to make it easier to get medicines into the areas of the brain where they are needed.

High blood pressure, some infections, radiation and physical damage can all open up the BBB. This can be very dangerous and rapidly lead to death.

the blood-brain barrier

The blood-brain barrier

Question 5