A.

Nervous & Endocrine Systems

- Both of them control and coordinate body functions and that they’ll
be working together.
- They’re both important in homeostasis, which is the internal
maintenance of the environment within our body
(by responding to input signals and generating output signals)

Nervous System Endocrine System

Neurons directly contact most Hormones are transported by the
organs blood to body organs
Coordination of body function Coordination of body function
through electrical signals & through release of regulatory
release of (chemical signals) molecules/ chemical signals
regulatory molecules (hormones)
[ both electrical primarily and [e.g. hypothalamus to the
chemical at the synapse signals] pituitary, there’s some neurons
there, but primarily in the
endocrine system]
Signaling: Signaling:
- Neurons use both electrical - Endocrine system uses
and chemical (e.g. only chemical signals
neurotransmitters, (hormones)
neurohormones) signals [hormones are secreted by the
[neurotransmitters -- chemicals endocrine glands / cells into the
secreted by neurons and they blood]
diffuse across a very small gap
(synapse) - Control is more general as
 act on a target cell and then hormone is secreted into
have a response blood and can reach many
organs
neurohormones – hormones that
are produced & released by
neurons into the blood for actions
at distant targets]

- Control is very specific as

neuron contacts target
directly.
[Receptors for the signaling molecule must be present on the target cell
for response to occur]

{Examples of neurotransmitters: 1. Acetylcholine 乙酰胆碱 (Ach) 2. Dopamine

多巴胺 3. Serotonin 血清素 4. Norepinephrine 去甲腎上線素 (noradrenaline)}
B. The Nervous System
Organization
1. Central nervous system
(CNS)
- consists of the brain and the
spinal cord
- can initiate activity without
sensory input {e.g. when you
decide to text a friend}
- need not create any measurable
output to the efferent divisions
{e.g. thinking and dreaming are
complex higher brain functions
that can take place totally within
the CNS}

2. Peripheral nervous system (PNS)

- all neurons that lie outside or partially outside the CNS

a. Cranial nerves
- link receptors and effectors in the head and the neck to the brain
b. Spinal nerves
- link receptors and effectors in the rest of the body to the spinal cord
c.Ganglia 神經節
- collection of nerve cell bodies
outside the CNS (a part of the
PNS)
- important for 1. signal processing
2. integration 整合 of information
3. autonomic function 4. motor
control 5. regulation of reflexes
- appear as knots or swelling along
a nerve
[a cluster of nerve cell bodies inside the CNS, the equivalent of a
peripheral 外周 ganglion (nucleus)]

i. The brain sits in the bony cranium 顱 (good

protective purposes)
ii. The spinal cord runs down the back (dorsal
side 背側) inside the vertebral column
iii. The bones of the cranium and vertebral
column together with membrane (meninges 腦
膜 – important for regulating the movement of
 substances between the blood stream and the brain --> helping to
maintain the brain’s stable environment) and the fluid
(cerebrospinal fluid) protect the nervous tissue(keeping out toxins)
[also important immune roles in our body]
[there’s an inflammation in meninges that’s happening]

C. Functional Classification of Neurons

- multipolar - cell body located - have two - lack an identifiable

CNS off one side of a relatively equal axon but have
interneuro single long fibers (single axon numerous
ns are process (axon) and single branches
highly dendrite) dendrites
branched e.g. peripheral extending off the
but lack sensory neurons – central cell body e.g. Anaxonic CNS
long with the cell bodies interneurons:
extensions located close to the e.g. sensory X apparent axon
CNS and very long neurons in the nose
- typical processes that and eye – much
multipolar extend out of smaller bipolar
efferent receptors in the neurons
neuron lambs and internal
has 5 to 7 organs (the cell
dendrites, bodies are out of the
each direct path of signals
branching passing along the
4 to 6 axon)
times

- single long
axon may
branch
several
times and
end at
 enlarged
axon
terminals
1. Afferent 傳入的 / Sensory neurons (in PNS) – carry information
(about light, temperature, pressure & other stimuli) from sensory
receptors throughout the body into the CNS
2. Interneurons (interconnecting neurons) – lie entirely within the
CNS where they integrate information. Often have complex
branching processes to connect them with many other neurons
3. Efferent / motor neurons (in PNS) – carry information away from
the CNS to body tissues and organs(effectors).
a. Somatic Motor Neurons: Innervate 支配 skeletal muscle and
control voluntary movement
b. Autonomic Neurons: Innervate smooth muscle of many body
organs (digestive tract 消化道, airways etc.) and cardiac muscle of
the heart and control function of these organs (involuntary
functions)

D. Typical Structure of a Neuron

Dendrites - receive information from receptors / other neurons

-Dendritic spines vary from the spikes to mushroom
shaped knobs and increase the surface area of dendrites

Axons - Transmit nerve impulses away from the cell body

- The axon cytoplasm is filled with many types of fibers
and filaments but lacks ribosomes and endoplasmic
reticulum (ER). Proteins for the axon must be synthesized
 on the rough endoplasmic reticulum in the cell body.
- The axon hillock is a cone-shaped area of a neuron
that connects the axon to the soma (the cell body of a
neuron)
Myelin - insulate nerve fibers --> preventing the transmission of
sheath nerve impulses to the surroundings
- speed up the transmission of nerve impulse
Synapse - Region of contact between two neurons / a neuron and
muscle
 allows one neurone to communicate with many other
neurons
[the human CNS also contains electrical synapses
where the presynaptic and postsynaptic cells are
connected by gap junction channels.
This cell-to-cell communication is bidirectional as well as
faster than chemical synapses]

-allow nerve impulses to travel in one direction only

Presynapt - Delivers a signal to the synapse
ic neuron - with swollen tips (synaptic knobs) have vesicles
containing neurotransmitters

Postsynap Receives the signal

tic cell
cell body - small, generally making up one-tenth (1/10) or less of
the total cell volume
- contain nucleus (contain DNA that is the template for
protein synthesis

- vary in structure (size and shape) and function

- Cells of the Nervous System:
1. Neurons: Functional unit of the nervous system ~100 billion in
human brain
2. Gila/ glial cells: support cells – more numerous than neurons,
10-50 times more abundant than the neurons

CN Ependymal cells - specialized cells that create a

S 室管膜細胞 selectively permeable epithelial cell
layer
 separates the fluid compartments of the
CNS

- line the ventricles 腦室 of the brain and

the central canal of the spinal cord

- produce and circulate cerebrospinal

fluid (CSF – cushions the brain and
 removes waste)

- a source of neural stem cells &

immature cells (can differentiate into
neurons and glial cells)
Astrocytes / - highly branched CNS glial cells
Astroglia
星形胶質細胞 - source of neural stem cells

- they come in several subtypes and

form a functional network by
communicating with one another
through gap junction

- provide neurons with metabolic

- provide substrate for ATP production

- help maintain homeostasis in the CNS

extracellular fluid by taking up K+ and
water – control ion and
neurotransmitter balance

- regulate blood flow and maintain the

blood-brain barrier (Prevent harmful
substances from entering the brain)

- secrete Neurotrophic factors

Microglia - act as Scavengers

小胶質細胞 (to protect our CNS from pathogen invasion
病原體入侵, and clean up anything that
shouldn’t be there)

- act as immune cells

[when activated, they remove damaged
cells and foreign invaders (phagocytosis)]

- release inflammatory signals in

response to injury / infection

- activated microglia sometime release

damaging reactive oxygen species
(ROS) that form free radicals
{the oxidative stress caused by ROS is
believed to contribute to
neurodegenerative discases (e.g.
amyotrophic lateral sclerosis 肌萎縮側索硬化症 ALS
 – Lou Gehrig’s disease)}
Oligodendrocytes - wraps myelin around axons,
少突胶質細胞 myelinated multiple axons in the CNS
[neural tissue secretes very little
extracellular matrix --> glial cell creates
structural stability for neurons]

- produce myelin to insulate neurons

(a substance composed of multiple
[the cell bodies in concentric layers of phospholipid
the middle --> membrane)
they’re able to go out
and contact axons of - providing physical support to neurons
different nerve cells [by 1. forming myelin sheaths to stabilize
and myelinated them axons 2. maintaining neural network
(because nerve cells organization 3. protecting against
are in such close mechanical stress and injury]
proximity in the CNS
that it makes good - speed up signal transmission
sense --> it’s less of
a use of resources to - one oligodendrocytes branches and
have one cell forms myelin around portion of
myelinated multiple several axons
axons, whereas in
the PNS)] - important for multiple sclerosis 多發性硬化
症
PN Schwann cells - myelinate single axons
S 施旺細胞
- one Schwann cell associates with one
axon
[a single axon may have as many as 500
different Schwann cells along its
length(allow signal transduction 轉導)]

- each Schwann cell wraps around a 1-

1.5mm segment of the axon, leaving
tiny gaps (nodes of Ranvier), between
the myelin-insulated areas

- secrete neurotrophic
(trophic=movement) factors (help it
to grow in the right direction, and
help it to move in the right direction)

Satellite cells - a nonmyelinating Schwann cell

- form supportive capsules around

nerve cell bodies located in ganglia 神
經節(groups of nerves / brain cells that
 衛星胶質細胞 are closely related)
[protective layer around neurons in ganglia
(as a physical barrier against mechanical
damage) and help maintain the shape and
stability of neuronal cell bodies]

- regulating the extracellular

environment
(regulate the levels of ions,
neurotransmitters and nutrients around
neurons, maintaining a stable extracellular
environment; help control pH levels and ion
balance, similar to astrocytes in the CNS)

- modulating 調節 neuronal signaling

(Influence neuronal excitability by
absorbing or releasing neurotransmitters
(e.g. glutamate & GABA) and help modulate
synaptic activity, ensuring proper
communication between neurons)

- Involvement in Pain Sensation

(In cases of nerve injury / inflammation,
satellite cells can become activated and
contribute to chronic pain by releasing pro-
inflammatory molecules; interact with
sensory neurons, amplifying pain signals in
conditions like neuropathy 神經病變)

- Role in repair & regeneration

(After nerve injury, satellite cells can help
regulate the repair process by releasing
growth factors and supporting neuronal
recovery; assist Schwann cells in promoting
regeneration in the PNS)

- Each Schwann cells form myelin around a small segment of one

axon
[The cell body sits on a
myelinated axon. The Schwann
cells are located on the myelin.
Each section of unmyelinated
axon membrane between two
Schwann cells in the Node of
Ranvier (gaps – It almost allows
a jumping of the signal between
these nodes (that speeds up the
 conduction), which as well as this being insulated to stop leakage of
signal)
As the Schwann cell rotates, the myelin is wound around the axon
in multiple layers, causing axon to be sheathed in the myelin (living
insulation – it does have to allow movement of nutrients and helping
to provide that insulation for the electrical signals)]

E. Membrane Potential (the electrical basis of neural function)

[the difference in electrical charge between the inside and outside of
a neuron]
1. All living cells in the body maintain a potential (voltage – the
measure of potential energy generated by separated charges)
difference across the cell membrane --> membrane potential
2. Neurons and muscles (excitable cell – cells that can generate
electrical signals in response to environmental stimuli) can alter their
membrane potential in response to stimulation
3. The membrane potential at rest (cells not actively signaling) is the
resting membrane potential

- It depends on:
i. the uneven distribution of positively and negatively
charged ions on each side of the membrane
(electrical gradient / force)
ii. the ion permeability of the plasma membrane (the
phospholipid component of the PM (plasma
membrane) is insulator and prevents ions from
moving freely but the PM leaks due to other
components e.g. leak channels)
(X channel to interact with the outside
world)

This uneven distribution of charge is often

shown by the charge symbols clustered 聚集
on each side of the cell membrane
 that would be creating some force,
because they want to be together,
but they can’t as the lipid membrane
is separating them
 the only way that they could do if
there was some ion permeability of
that membrane (channels)
[inside it has lots of negative charge
anions, and outside it has lots of positive
charge cations]
 - When we begin, the cell has no
membrane potential: the ECF
(composed of Na+ and Cl- ions) and
the ICF (K+ and large anions, A-) are
electrically neutral

- The system is in chemical

disequilibrium (concentration
gradients for all four ions)

- cell membrane act as an insulator

(prevent free movement of ions
between the ICF and ECF)
[If the membrane permeable to every ion --
> they would just freely diffuse, balance
out chemically and electrically to be
identical
-->there would be a net zero and the
membrane potential would be zero]
- insert a leak channel for K+ into the
membrane (making the cell freely
permeable K+)
[the transfer of just one K+ from the cell to
the ECF creates an electrical disequilibrium
(the ECF has a net positive charge (+1)
while the ICF has a net negative charge (-
1))]
 the cell now has a membrane
potential difference, with the inside of
the cell negative relative to the
outside

- As additional K+ ions leave the cell,

going down their concentration
gradient, the inside of the cell
becomes more negative, and the
outside becomes more positive
(electrical gradients: opposite charges
attract, like charges repel)

F. Equilibrium potential
[The potential, for any ion, at which there is no net flux of that ion
across the membrane because the chemical and electrical forces
that tend to move the ion exactly balance --> no net movement of
K+]

- Two forces (gradients) at work:

 i. Chemical Force: moves K+ out as
present at higher concentration inside
ii. Electrical Force: attracts K+ back into
cell as negative charge accumulated
inside

The concentration gradient

sending K+ out of the cells is
exactly opposed by the
electrical gradient pulling K+
into the cell.

 Nernst equation – used for a cell that is freely permeable to only one
ion at a time
61 [ion]out
Eion  log
z [ion]in

z = the charge on the ion, i.e. K+=+1
[ion]out = concentration of the ion outside the cell (ECF)
[ion]in = concentration of the ion inside the cell (ICF)
Goldman-Hodgkin-Katz equation – used to calculate the actual
membrane potential of cells (multi-ion equation)
RT
Em= F log ¿ ¿
Em = membrane potential (in volts)
R = universal gas constant (8.314 J/mol K)
T = absolute temperature (in Kelvin)
F = Faraday’s constant (approximately 96485 C/mol)
Pion = relative permeability of the membrane to the
specific ion
[ion]out = concentration of the ion outside the cell (ECF)
[ion]in = concentration of the ion inside the cell (ICF)

G. Resting membrane potential

- The membrane potential when a neuron is at rest (X transmitting
signals)
- similar to the K+ equilibrium potential because at rest cells are
much more permeable to K+ than to other ions (because the
selective permeability of ion channels and the distribution of ion
pumps – e.g. Potassium leak channels, Na+/K+ pump)
- typically around -70mV (negative inside compared to outside)
[Cation: K+ is the major cation within cells, and Na + dominates the
extracellular fluid
 Anion: Cl- mostly remain with Na+ in the extracellular fluid
Phosphate ions and negatively charged proteins are the major anions of
the intracellular fluid]

K+ leak channel

Used a potassium channel to allow K+ to

leak across a membrane that was
otherwise impermeable to ions

(allowing a diffusion)
Na+/K+ pump (by Na+-K+ - Na+ and K+ diffuse in and out of
ATPase) cells through Leak channels (open
channels) in the membrane

- most cells are about 40 times

more permeable to K+ than to Na+

- a small amount of Na+ leaks into

the cell, making inside of the cell
less negative than it would be if
3Na+ are pumped out for Na+ were totally excluded
every 2K+ pumped in
[because Na+-K+ ATPase - additional Na+ that leaks in is
helps maintain the electrical promptly pumped out by the Na+-
gradient (electrogenic K+ ATPase
pump)]
(finally controlling - at the same time, K+ ions that leak
everything) out of the cell are pumped back in

{The positive and negative things want

to attract, they don’t want to be
separated from one another, but also
things want to move down their
concentration gradients  requires
energy (that’s why this particular pump
is called ATP – as an energy source)}
[the most important ion is potassium as those cells are so much at rest, so
much more permeable (40 times more permeable to potassium than
anything else --> there’s a lot of movement of potassium)]
In nerve cells, sodium and potassium are both extremely important ions in
generating / electrical conduction
{If we had a cell with no free movement of ions, it’s still got a membrane
potential (there’s many ions that are being separated, but it’s not actively
able to do anything about it) / X equilibrium (because all the potassium

Q1. What happens to the resting membrane potential of a cell if

the extracellular K+ concentration increases?

 It becomes more positive

[Because the increase in extracellular K+ concentration can lead to

a gradual increase in the intracellular K+ concentration (as K+ ions
move into the cell)]

Q2. If ECF K+ concentration decreases from 3.5 mM to 2.8 mM,

what happens to the resting membrane potential?

 It becomes more negative

[When the ECF K+ concentration decreases, the gradient between

the inside and outside of the cell becomes greater]
ions inside then there is no outside)}

H. Action Potentials (the basis of neural communication) &

Conduction
[a rapid, all-or-none electrical signal that travels along a neuron’s
membrane --> allowing communication (between neurons and
muscles)
it is triggered when a graded potential reaches the threshold (~ -
55mV) at the axon hillock]
- large depolarizations that travel for long distances through a neuron
without losing strength
- rapid signaling over long distance {e.g. from toe to brain}
- all-or-none – if the threshold is reached, the action potential always
occurs at full strength

I. Graded Potentials (electrical signals)

[small, localized changes in membrane potential that occur in
response to stimuli ≠ action potentials --> X follow the “all-or-none”
principle (a neuron either fires an action potential (nerve impulse) /
it does not) and can vary in strength]

- Variable strength signals --> travel over short distances and lose
strength as they travel through the cell (local current flow)
[loose strength  current leak & cytoplasmic resistance]
- used for short-distance communication
{If strong can / if reach integrating center of neuron (trigger zone
that contain high many voltages gated Na+ channels) --> cause
action potential
[can be excitatory (depolarizing) / inhibitory (hyperpolarizing) /
suprathreshold (strong enough to cause action potential)]}

- In neurons, depolarizations / hyperpolarization that occur in the

dendrites and cell body, less frequently near the axon terminals

J. Gated Channels Control Ion Permeability of Neuronal

Membrane

- Channels may be gated (opened / closed) by various factors

[voltage, neurotransmitters (1. chemically gated)], mechanical
means (2. Mechanically gated) [stretch, vibration]
 - spend most of their time in a closed state --> allow these channels
to regulate the movement of ions through them
[opens -- ions move through the channel just as they move through open
channels
close -- it may be much of the time; it allows no ion movement between
the ICF and ECF]

- gated ion channels alternate between open / closed states

depending on intra- & extracellular conditions

1. Chemically gated channels (commonly found in synapses and

neuromuscular junctions)

- the gating is controlled by intracellular messenger molecules /

extracellular ligands (a molecule that binds to a specific receptor
on a cell’s surface / inside the cell, triggering a biological response
– e.g. neurotransmitters) that bind to the channel protein

- a crucial in signal transmission in the nervous system and muscle

contraction

- Excitatory: Na+ channels – allow positive ions onto the cell

depolarizing the membrane and driving it closer to firing an action
potential
Inhibitory:
Cl- channels – allow negative ions into the cell making it harder
for the membrane to depolarize
K+ channels – allow positive ions out of the cell making it harder
for the membrane to depolarize

2. Mechanically gated channels (found in sensory cells (e.g. touch,

hearing) and various other tissues)

- respond to physical forces (e.g. increased temp. /pressure) that

puts tension on the membrane and pops the channel gate open
 - involved in processes like respond to touch sensation and
hearing

3. Voltage-gated channels -- control ion movements during action

potentials:
- Open and close in response to membrane potential changes (the
electrical state of the cell changes)
- Selective for particular ions (Na+, K+, Ca2+, Cl-)
- Function:
1) Action Potentials – they are crucial in the generation
and propagation 傳播 of action potentials in neurons and
muscle cell
2) Signal Transduction 轉導 – they help in transmitting
electrical signals over long distances in the nervous
system and muscle contractions

- Channelopathies 離子通道病 – ion channels loose / change function

because amino acid sequence is altered 改變 (most common is cystic
fibrosis (Chloride channel))

 Signaling by Neurons
I. changes in membrane potential give rise to action potentials -->
nerve impulses
[The generation of a nerve impulse (action potential) is a highly
coordinated electrochemical process that allow neurons to communicate.
This process relies on the movement of ions across the neuron’s
membrane, regulated by gated ion channels]

II. In a typical neuron, action potential is generated at the axon

hillock (all the signals coming in are integrated and decided if an
action potential will be triggered). They then are conducted down
the axon to the presynaptic terminal
III. When it reaches the axon terminal, the action potential
electrical signal is passed to the associated neuron

K. Electrical signaling: Depolarization and Hyperpolarization

[Electrical signaling depends on changes in membrane potential due
to changes in membrane ion permeability and ion distribution
(different channels being opened and closed at different times)]

- Depolarization – a decrease in the membrane potential, making the

inside of the neuron less negative (closer to zero)
 [happens when Na+ channels open --> allowing Na+ ions to rush into
the cell
if depolarization reaches the threshold (~ -55mV) --> an action
potential is triggered --> leading to nerve signal transmission]
{At rest, the cell membrane of a neuron is only slightly permeable
to Na+
If the membrane suddenly increases its Na+ permeability, Na +
enters the cell, moving down its electrochemical gradient --> the
addition of positive Na+ to the intracellular fluid depolarizes the
cell membrane and creates an electrical signal}

- Hyperpolarization – an increase in the membrane potential, making

the inside of the neuron more negative (farther from zero)
[occurs when K+ channels remain open longer than needed -->
allowing extra K+ to leave the cell / when Cl- channels open -->
allowing Cl- to enter
The neuron becomes less likely to fire an action potential (because it
is further from the threshold) --> harder to trigger an action
potential from further away]

 Net flow of ions across a membrane depolarizes / hyperpolarizes the

cell creating an electrical signal
 a significant change in membrane potential occurs with the
movement of a small number of ions (Na+ and K+ concentrations
inside & outside the cell remain unchanged --> X chemical balance )
[small movement of ions --> electrical change but does not result in
a chemical change]

- resistance & potential

Two sources of resistance to current flow:
1. Membrane resistance (resistance to ion flow across the cell
membrane)
o The lipid bilayer of the membrane is an insulator -->
preventing free ion movement
o Ion channels provide selective pathways --> their number and
state (open / closed) affect resistance
 High membrane resistance (few open channels) --> helps
the signals travel further without decay 衰減
 Low membrane resistance (many open channels) -->
allows more ion leakage --> reducing signals strength
2. Internal (cytoplasmic) resistance (resistance to ion flow within the
cytoplasm (axon / dendrites))
o the cytoplasm contains organelles and proteins --> create
obstacles 障礙 for ion movement
o The diameter of the neuron also affects this resistance (large
diameters have lower internal resistance)
 High internal resistance --> slows down signal conduction
 Low internal resistance --> allows faster conduction
(especially in wider axons)
A Case Study
1. Multiple Sclerosis (MS – the common and best-known demyelinating
disease)
 [It is probably caused by a problem in the immune system. The
immune system mistakenly attacks the myelin sheath covering nerve
fibers. This results in the slowing of nerve impulse transmission (the
nervous system responses are slower because the myelin is broken
down) and poor coordination. People with MS usually have problems
with muscle movement, body balance, pins and needles 發麻 & 刺痛 

that’s depending on where in the CNS the first attack is coming]

E.g. Sarah, a 25-year-old graduate student studying neuroscience, has

been experiencing recurrent 反覆 episodes 發作 of weakness, numbness 麻木,
and visual disturbances 視覺障礙. After undergoing a series of medical tests,
she is diagnosed 診斷 with relapsing-remitting multiple sclerosis (RRMS).
How might demyelination lead to the symptoms Sarah is experiencing?

 This is an autoimmune condition – are brought on by antibodies

attacking self-cells, and those antibodies can be made more or less
at different times
That means in most cases of MS, they can come and go with it, can
there be times when symptoms are better and times when their
worst, not in all cases (some people have a constantly progressive
MS / towards the end of having MS / often people will move into a
secondary progressive)

 when the immune system responds to that virus, it makes

antibodies to neutralize / kill the virus, those antibodies, instead of
only binding to the virus, are able to recognize myelin sheets of
 oligodendrocytes. And if an antibody is going to go and bind to that
myelin sheath of an oligodendrocyte, that’s going to bring in the
immune system to attack and kill the oligodendrocyte (antibody
binds to this myelin sheath it will bring in macrophages – phagocytic
cells, they will go and essentially try to kill the cell that the antibody
is bound to, because normally that would be a virus infected cell
and we want to get rid of it as we’re trying to stop the virus )
[T cells need to another bit of the immune system that actually go
and try and attack intracellular virus]

{MS could be caused by the common ‘kissing disease’ virus (Epstein-

Barr virus – EBV), which is also responsible for infectious 傳染性
mononucleosis 單核細胞增多症, and the virus may play a role in initiating the
autoimmune attack on myelin.
One leading hypothesis: EBV infects B cells and alters immune function,
leading to an abnormal immune response against myelin. The virus may
also contribute to chronic inflammation in the CNS, promoting
demyelination and neurodegeneration (while EBV infection alone does not
guarantee that someone will develop MS) genetic and environmental
factors -- it is increasingly considered a major risk factor}
[it depends which bits of those CNS myelin sheaths are attacked]

- demyelination disrupts 破壞 membrane potential regulation,

impairing nerve signal transmission and leading to symptoms
(weakness, numbness and visual disturbances)
- demyelination disrupts normal depolarization by impairing the
function and distribution of voltage-gated ion channels. Since myelin
speeds up electrical transmission, its loss leads to slower / failed
depolarization, resulting in muscle weakness, sensory disturbances,
and fatigue 疲勞
- demyelination disrupts the normal conduction of action potentials
1. Slowed signal transmission – Without myelin, action
potentials travel more slowly / fail to propagate 傳播, leading to
muscle weakness and fatigue
2. Erratic 不穩定 / Blocked Signals – Misfiring neurons can cause
numbness, tingling / pain
3. Energy demand increases – the neuron has to work harder to
conduct impulses, leading to early neural exhaustion 疲憊