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Nervous system

The nervous system is a highly complex network of specialized cells that coordinates voluntary and involuntary actions, processes sensory information, and regulates essential bodily functions such as movement, cognition, and in animals, particularly vertebrates. It is divided into two main parts: the , comprising the and , which serves as the primary processing center, and the peripheral nervous system (PNS), consisting of nerves and ganglia that connect the CNS to the rest of the body, including muscles, organs, and sensory receptors. This intricate system enables rapid communication through electrical and chemical signals, allowing organisms to respond to internal and external stimuli effectively. The CNS is protected by the and and includes the , which contains approximately 86 billion s organized into structures like the (divided into two hemispheres and four lobes: frontal, parietal, occipital, and temporal) responsible for higher functions such as thinking, , and voluntary , and the , which extends from the to the lower back (typically ending at the L1-L2 level) and relays signals between the and while coordinating reflexes. The 's gray matter, rich in cell bodies, handles and , while facilitates signal transmission via myelinated axons. Embryologically, the CNS originates from the formed around the third week of , differentiating into vesicles that develop into mature structures like the from the telencephalon. In contrast, the PNS encompasses all neural elements outside the CNS, including 31 pairs of spinal nerves (emerging from the spinal cord's 31 segments: 8 , 12 thoracic, 5 , 5 sacral, and 1 coccygeal) and 12 pairs of that branch to innervate peripheral tissues. The PNS is further subdivided into the , which governs voluntary and sensory input from the skin, muscles, and joints, and the , which manages involuntary processes like , , and respiration through its sympathetic (activating "fight-or-flight" responses), parasympathetic (promoting "rest-and-digest" activities), and enteric (controlling gastrointestinal functions) divisions. At the cellular level, the nervous system's functionality relies on neurons, the primary signaling units with dendrites that receive inputs and axons (some up to 1 meter long) that transmit impulses via action potentials and neurotransmitters, and supportive glial cells such as (which provide structural support and nutrient delivery), (which produce sheaths for faster signal conduction in the CNS), and (which act as immune defenders). Neurons integrate sensory data—such as touch, pain, or visual cues—process it in the CNS, and generate appropriate motor or autonomic outputs, ensuring adaptive responses to environmental changes like increased sweating during heat or accelerated during . This coordinated signaling underpins complex behaviors, learning, and survival mechanisms across .

Structure

Neurons

Neurons are the fundamental excitable cells of the nervous system, specialized for the rapid transmission of electrical and chemical signals to enable communication across the body. These cells integrate sensory inputs, process information, and generate motor outputs, forming the basis of nervous system function through coordinated signaling. Unlike other cells, neurons exhibit unique electrical excitability due to specialized membrane properties that allow for the generation and propagation of . The of a typical includes the cell body, or , which houses the and organelles essential for protein synthesis and cellular maintenance. Extending from the are dendrites, branched structures that receive synaptic inputs from other neurons, increasing the surface area for signal integration. The arises from the , a specialized near the that initiates action potentials, and extends as a long projection for transmitting signals to distant targets; in myelinated , the sheath—formed by glial cells—insulates the to enhance conduction speed via saltatory propagation. At the axon's end, synaptic terminals release neurotransmitters to communicate with downstream cells. Neurons are classified structurally into unipolar (one process), (two processes), and multipolar (multiple processes) types, with multipolar being the most common in the . Functionally, they divide into sensory neurons (transmitting afferent signals from periphery to ), motor neurons (carrying efferent signals to effectors like muscles), and (facilitating local processing and integration within the nervous system). By neurotransmitter, examples include cholinergic neurons that release for excitatory or inhibitory effects at neuromuscular junctions and adrenergic neurons that release norepinephrine for sympathetic responses. Glial cells provide essential support by maintaining the ionic environment around neurons to sustain excitability. The excitability of neurons arises from voltage-gated ion channels in the plasma membrane, which regulate the flow of ions like sodium (Na⁺) and (K⁺) to establish a resting of approximately -70 mV. Action potentials are triggered when reaches threshold at the axon hillock, leading to rapid Na⁺ influx followed by K⁺ efflux for . The equilibrium potential for an , which drives these fluxes, is described by the ; for , it is given by E_K = \frac{RT}{zF} \ln \left( \frac{[K^+]_o}{[K^+]_i} \right) where R is the , T is , z is the ion's , F is Faraday's constant, and [K^+]_o and [K^+]_i are extracellular and intracellular concentrations, respectively—typically yielding E_K \approx -90 mV in neurons. The Hodgkin-Huxley model, developed from squid axon experiments, mathematically describes action potential generation through time-dependent conductances for Na⁺ and K⁺ channels, expressed as a for membrane potential V and gating variables. Representative examples include pyramidal neurons in the , which are multipolar excitatory cells with a prominent apical and extensive basal , enabling integration of inputs for higher cognitive functions like . In the , Purkinje cells feature highly branched dendritic arbors that receive massive parallel fiber inputs, serving as inhibitory output neurons crucial for and error correction.

Glial cells

Glial cells, also known as neuroglia, are non-neuronal cells that constitute a significant portion of the nervous system, providing essential structural, metabolic, and immune support to neurons. In the , there are approximately 86 billion neurons and 40–50 billion glial cells, resulting in a glia-to-neuron ratio of approximately 0.5:1 overall, though this ratio varies by region; for instance, in the , the glia-to-neuron ratio is about 3.7:1. These cells do not generate action potentials but play critical roles in maintaining the neural environment, including through interactions with neuronal ion channels. Glial cells are classified into several types, each with specialized functions. Astrocytes, star-shaped cells abundant in the (CNS), maintain the blood-brain barrier by forming end-feet processes around blood vessels, supply nutrients to neurons via glucose transport, and modulate synaptic activity by regulating levels and . in the CNS and Schwann cells in the peripheral nervous system (PNS) produce sheaths that insulate axons, enabling and increasing conduction velocity by up to 100-fold at nodes of Ranvier, the gaps between myelin segments where action potentials are regenerated. , the resident immune cells of the CNS, perform to clear debris and pathogens, and conduct immune surveillance by monitoring the neural for signs of or . Ependymal cells line the ventricles of the and the central canal of the , contributing to the production and circulation of (CSF) through ciliated surfaces that facilitate fluid flow. In response to injury or disease, glial cells contribute to ; for example, activated release pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-α), which can amplify immune responses but may also lead to chronic inflammation if unregulated. A key concept in glial function is the tripartite synapse, where actively participate in synaptic transmission by sensing neurotransmitters via receptors, releasing gliotransmitters like glutamate and ATP, and thereby modulating neuronal communication and . Evolutionarily, glial diversity has increased from , where simpler glial types like sheath provide basic support, to vertebrates, which exhibit more specialized subtypes such as and adapted for complex neural processing.

Vertebrate anatomy

The vertebrate nervous system is divided into the (CNS), consisting of the and , and the peripheral nervous system (PNS), which includes nerves and ganglia outside the CNS. This organization allows for centralized processing in the CNS and distributed communication via the PNS. The , the largest component of the CNS, is subdivided into the , , and . The encompasses the (divided into frontal, parietal, occipital, and temporal lobes), basal nuclei, , and , handling higher cognitive functions and sensory integration. The , part of the , serves as a relay for auditory and visual signals. The includes the and (in the ) for vital functions like breathing and heart rate, as well as the with its anterior, posterior, and flocculonodular lobes for . In humans, the has a mass of approximately 1.3–1.4 kg. The , extending from the to the L1–L2 vertebral level, measures about 45 cm in length in adults and is segmented into , thoracic, , and sacral regions corresponding to 31 pairs of spinal nerves. It consists of central gray matter, containing neuronal cell bodies and dendrites in (sensory) and ventral (motor) horns, surrounded by composed of myelinated axons forming ascending and descending tracts. Neurons and glial cells integrate to form these structures; for instance, the is a major bundle of myelinated axons originating from the and descending through the and to with motor neurons in the ventral horn, enabling voluntary movement. Nuclei, clusters of neuronal cell bodies, are prominent in gray matter regions like the spinal cord's horns and . The CNS is protected by three meninges: the outermost (tough fibrous layer), the middle (web-like with subarachnoid space), and the innermost (adhering to the surface). The brain's ventricles—lateral, third, and fourth—along with central spinal canal, contain (CSF) produced by choroid plexuses, which circulates to cushion and nourish the CNS. The blood-brain barrier, formed by endothelial cells with tight junctions, , basement membrane, and astrocyte end-feet, selectively regulates substance passage from blood to brain tissue. The PNS comprises the , which innervates skeletal muscles and skin via sensory (afferent) and motor (efferent) fibers, and the , controlling involuntary functions. The autonomic division includes the sympathetic system (thoracolumbar outflow, promoting "fight or flight" responses like increased heart rate) and parasympathetic system (craniosacral outflow, fostering "rest and digest" activities like slowing heart rate), balanced for . The , a semi-autonomous network in the with more neurons than the , regulates independently but modulates via autonomic inputs. Peripheral nerves include 12 pairs of emerging from the (e.g., olfactory for , optic for , vagus for visceral control) and 31 pairs of spinal nerves (8 , 12 thoracic, 5 , 5 sacral, 1 coccygeal), which are mixed sensory-motor and attach via (sensory) and ventral (motor) roots. These nerves form the communication between the CNS and periphery.

Comparative anatomy and evolution

The evolution of the nervous system traces back to the earliest metazoans, where precursors to neural signaling appear in sponges (Porifera), which lack true neurons but possess choanocytes capable of intercellular signaling via calcium waves and chemical mediators, enabling coordinated cellular responses without a centralized network. In contrast, cnidarians (such as jellyfish in the Radiata clade) represent the first appearance of a true nervous system in the form of a diffuse nerve net, consisting of interconnected ectodermal and endodermal neuronal networks that facilitate basic sensory-motor integration without centralization, marking a key innovation around 600 million years ago. This decentralized architecture underscores the basal eumetazoan condition, where neural elements evolved independently of bilaterian centralization. With the emergence of , nervous systems underwent significant centralization, featuring ventral nerve cords and ganglia that supported more complex behaviors. In annelids and nematodes, the ventral nerve cord serves as a longitudinal chain of segmental ganglia, coordinating locomotion and along the body axis, a configuration hypothesized to reflect the urbilaterian . Arthropods advanced this further with a prominent (supraesophageal ganglion) and segmented ventral nerve chain, including specialized structures like the in , which are neuropils dedicated to olfactory learning and . Molluscan nervous systems exhibit remarkable diversity, culminating in cephalopods such as the , which possess a distributed comprising over 500 million neurons organized into lobes for advanced , manipulation, and arm-specific processing, rivaling complexity despite . In the vertebrate lineage, nervous system evolution built upon the simple dorsal hollow nerve cord of early chordates, progressively expanding into a centralized with the telencephalon undergoing marked elaboration in mammals to support higher . Key evolutionary principles include the concept of "" neurons—individually recognizable, invariant cells in like Aplysia californica, which have facilitated detailed studies of behaviorally relevant circuits, such as those underlying gill withdrawal reflexes. Allometric scaling governs relative to body complexity, with neural tissue typically increasing as body mass raised to approximately 0.75, reflecting metabolic constraints and adaptive pressures across metazoans. The nematode exemplifies minimal complexity, with its entire nervous system comprising exactly 302 neurons whose full has been mapped, providing a foundational model for neural wiring. Underlying this diversity is the deep conservation of ion channels, such as voltage-gated sodium and types, which originated at the metazoan base and enable generation across phyla.

Development

Embryonic development

The embryonic development of the nervous system in vertebrates begins with neural induction, a process where signals from the dorsal , known as the Spemann-Mangold organizer, direct overlying cells to form the instead of . In the landmark 1924 experiment by and Hilde Mangold using , transplantation of the dorsal blastopore lip induced a secondary neural axis in host embryos, demonstrating the organizer's inductive capacity. Subsequent molecular studies revealed that organizer-derived proteins such as noggin and chordin inhibit (BMP) signaling in the ectoderm, thereby promoting neural fate. Following induction, shapes the into the , the precursor to the (CNS). During primary , which occurs in the third week of embryogenesis, the thickens and folds along its midline to form the neural groove, with the neural folds elevating and fusing to create a hollow . cells, arising at the junction of the neural folds and , delaminate and migrate to form (PNS) components, including sensory and autonomic neurons, as well as such as Schwann cells. Secondary then completes the caudal through mesenchymal cavitation, ensuring continuity of the . Regionalization of the neural tube establishes distinct domains along the anteroposterior and dorsoventral axes through morphogen gradients and transcription factors. , expressed in nested patterns along the anteroposterior axis, specify segmental identities, such as rhombomeres in the and regions, with their activation mediated by caudal factors like CDX and . Ventrally, Sonic hedgehog (Shh), secreted from the and floor plate, patterns cell fates via concentration-dependent Gli transcription factors, inducing motor neurons and . Dorsally, Wnt signaling from the roof plate promotes progenitors and antagonizes Shh, contributing to the binary dorsoventral organization. These signals culminate in the formation of three primary brain vesicles by the end of the fourth week: the prosencephalon (), mesencephalon (), and rhombencephalon (). In humans, key milestones include neural tube closure by the fourth week, with the anterior neuropore sealing around day 25 and the posterior neuropore by day 28, marking the transition from open neural folds to a closed tube. Brain flexures emerge concurrently, including the cephalic flexure at the midbrain level and cervical flexure at the hindbrain-spinal cord junction, which accommodate rapid growth and position the forebrain rostrally. Cell proliferation during this phase is driven by neural stem cells in the ventricular zone, expanding the neuroepithelium. Failure of neural tube closure leads to defects such as , where the anterior neuropore remains open, resulting in absence of the and calvaria, and , involving incomplete posterior closure and exposure of the . These conditions arise primarily from multifactorial causes, including , and affect approximately 1 in 2,875 U.S. births for and about 1 in 5,100 for annually (as of 2023 data). is evolutionarily conserved across chordates, with the invagination process evident in cephalochordates like amphioxus, underscoring its ancient origin in the common ancestor. Neurogenesis proceeds through a coordinated of , , and orchestrated by neural cells, initially as neuroepithelial cells transitioning to radial . Radial glia undergo symmetric divisions to expand the pool in the ventricular zone, followed by asymmetric divisions generating intermediate progenitors or neuroblasts that commit to neuronal fates. Differentiating neurons then along radial glial scaffolds toward the cortical plate, establishing laminar via somal translocation or , with ceasing as gliogenesis predominates later in embryogenesis.

Post-embryonic development and plasticity

Post-embryonic development of the nervous system involves dynamic processes that refine neural circuits in response to experience, extending from infancy through adulthood. Following the initial surge of during early postnatal periods, where synapse density peaks in the human cerebral cortex around 3-5 years of age, the brain undergoes extensive refinement. , which eliminates unused connections, intensifies during , reducing up to 40% of synapses to streamline efficient neural pathways. Concurrently, myelination of axons, which enhances signal conduction speed, progresses into early adulthood, particularly in prefrontal regions, supporting cognitive maturation. Adult neurogenesis, the generation of new neurons, persists in select mammalian brain regions postnatally, including the subgranular zone of the and the . In the , these newborn neurons integrate into circuits involved in learning and memory, while subventricular zone-derived cells primarily contribute to replenishment. (BDNF), a key , promotes survival and differentiation of these progenitors, modulating in response to environmental stimuli. Neural plasticity mechanisms underpin experience-dependent adaptations throughout life, with long-term potentiation (LTP) strengthening synapses through repeated activity and long-term depression () weakening them to refine connectivity. These processes align with the Hebbian , often summarized as "cells that fire together wire together," where correlated presynaptic and postsynaptic activity drives synaptic changes. Critical periods exemplify heightened early in life; for instance, monocular visual deprivation in kittens during a brief postnatal window irreversibly shifts in , as demonstrated in foundational experiments. Environmental enrichment further illustrates , increasing cortical thickness in through enhanced synaptic and dendritic arborization. As aging progresses, neural plasticity gradually declines, with reduced LTP induction and slower dendritic remodeling contributing to cognitive impairments. However, compensatory mechanisms persist, such as exercise-induced upregulation of BDNF and hippocampal , which mitigate age-related losses and support functional recovery. Structural plasticity, including dendritic spine remodeling—where spines form, stabilize, or retract in response to activity—facilitates circuit adaptation, notably after brain injury, enabling functional reorganization in surviving networks. This post-injury spine turnover, observed via imaging, correlates with behavioral improvements in motor and sensory domains.

Function

Neuronal signaling and synapses

Neurons communicate through electrical and chemical signals, with action potentials serving as the primary mechanism for propagating information along axons. The resting of a is typically around -70 mV, maintained by the unequal distribution of ions across the and the selective permeability of the , primarily to ions. This potential can be described by the Goldman-Hodgkin-Katz (GHK) equation, which accounts for the contributions of multiple ions: V_m = \frac{RT}{F} \ln \left( \frac{P_K [K^+]_o + P_{Na} [Na^+]_o + P_{Cl} [Cl^-]_i}{P_K [K^+]_i + P_{Na} [Na^+]_i + P_{Cl} [Cl^-]_o} \right) where V_m is the membrane potential, R is the gas constant, T is temperature, F is Faraday's constant, P denotes permeability, and subscripts i and o indicate intracellular and extracellular concentrations, respectively. When a neuron receives sufficient excitatory input, the membrane depolarizes to a threshold (around -55 mV), triggering an action potential via the opening of voltage-gated sodium channels, allowing Na⁺ influx that rapidly drives the potential toward +40 mV. This is followed by repolarization through sodium channel inactivation and potassium channel opening, leading to K⁺ efflux that restores the negative potential. Action potentials adhere to the all-or-none principle: once initiated, they propagate with fixed amplitude and duration, independent of stimulus strength, ensuring reliable signal transmission over long distances. At synapses, action potentials trigger the release of signaling molecules to convey information to the postsynaptic neuron. Synaptic transmission occurs via two main types: chemical and electrical. In chemical synapses, the arriving opens voltage-gated calcium channels in the presynaptic terminal, causing Ca²⁺ influx that promotes the fusion of synaptic vesicles with the presynaptic membrane through proteins like SNARE complexes. This releases neurotransmitters into the synaptic cleft, where they diffuse to bind postsynaptic receptors. Electrical synapses, in contrast, enable direct flow between neurons via gap junctions formed by proteins, allowing rapid, bidirectional transmission without chemical intermediaries, though they are less common in vertebrate central nervous systems. Neurotransmitter binding generates postsynaptic potentials that modulate the postsynaptic . Excitatory postsynaptic potentials (EPSPs) depolarize the , typically through Na⁺ or Ca²⁺ influx via ionotropic receptors, increasing the likelihood of reaching threshold. Inhibitory postsynaptic potentials (IPSPs), conversely, hyperpolarize the , often via Cl⁻ influx or K⁺ efflux, reducing excitability. These graded potentials summate temporally and spatially at the postsynaptic site, with integration governed by the \tau = R_m C_m, where R_m is and C_m is ; longer \tau values allow greater temporal summation of inputs. Major neurotransmitter classes include , monoamines, and peptides. Amino acids like glutamate (excitatory) and (inhibitory) act rapidly; glutamate binds ionotropic receptors (e.g., , NMDA) to open cation channels, while targets GABAA receptors for Cl⁻ conductance. Monoamines such as and serotonin modulate slower via metabotropic G-protein-coupled receptors, influencing second-messenger pathways. Neuropeptides, like , typically act on metabotropic receptors for prolonged effects. Ionotropic receptors directly gate ion channels for fast synaptic responses, whereas metabotropic receptors indirectly alter excitability through intracellular signaling. Neurotransmitter release follows quantal principles, where each vesicle represents a quantum of transmitter; spontaneous miniature EPSPs (mEPSPs) reflect single-vesicle release, with evoked responses comprising multiples of these quanta. After release, neurotransmitters are cleared from the cleft to terminate signaling, primarily via reuptake into presynaptic terminals or glia through transporter proteins (e.g., SERT for serotonin) or enzymatic degradation (e.g., acetylcholinesterase for acetylcholine). These mechanisms recycle or inactivate transmitters, preventing prolonged receptor activation.

Neural circuits and systems

Neural circuits are organized networks of interconnected neurons that process sensory information, integrate signals, and generate coordinated outputs to drive behavior and physiological responses. These circuits form the functional units of the nervous system, enabling everything from simple reflexes to complex cognitive processes through patterned activity across populations of neurons. In vertebrates, circuits exhibit modular architectures that allow for efficient , with basic building blocks like synapses linking individual neurons into larger ensembles that can be tuned for specific tasks. Common circuit types include and loops, which dictate the direction and recurrence of signal propagation. loops enable unidirectional information flow, such as in where excitatory inputs propagate across layers without immediate recurrence, facilitating rapid . loops, in contrast, incorporate recurrent connections that refine or modulate outputs, often through inhibitory that prevent overexcitation and stabilize activity. Convergent patterns integrate multiple inputs onto a single or output, enhancing signal detection by summing diverse sources, while divergent patterns distribute a single input to multiple targets, amplifying or broadcasting signals for broader influence. Local projections confine interactions within a region or spinal segment, supporting fine-tuned processing, whereas long-range projections connect distant areas, such as cortico-thalamic pathways, to coordinate global functions like or movement. Reflex arcs represent fundamental circuit motifs for rapid, involuntary responses mediated by the . Monosynaptic arcs involve a direct connection between a and a , exemplified by the knee-jerk , where stretching the activates muscle spindles, leading to immediate via segments L2-L4 without involvement. Polysynaptic arcs incorporate for more complex coordination, as in the , where nociceptive input from triggers flexor and extensor inhibition through dorsal horn , protecting the body from harm. These arcs operate independently of higher brain centers, ensuring swift action while integrating briefly with sensory inputs for precision. Central pattern generators (CPGs) are endogenous neural circuits that produce rhythmic motor outputs without external rhythmic cues, underlying behaviors like and . In the lamprey, spinal CPGs generate alternating bursts for undulatory swimming, driven by glutamatergic and glycinergic interactions among and motor neurons.00581-4) For , medullary CPGs in mammals orchestrate respiratory rhythms via interconnected pre-Bötzinger and retrotrapezoid neurons, modulated by chemosensory feedback. These oscillators rely on and intrinsic bursting properties to sustain cycles. Specific vertebrate circuits illustrate advanced organization. Basal ganglia loops process motor planning through direct and indirect pathways: the direct pathway disinhibits the to facilitate selected movements, while the indirect pathway suppresses competitors via subthalamic nucleus excitation, enabling adaptive action selection. In the hippocampus, theta rhythms (4-8 Hz) emerge from circuit interactions between pyramidal cells, , and entorhinal inputs, synchronizing neuronal firing to support spatial navigation and memory encoding. Key concepts in circuit function include , where multiple afferents summate to sharpen outputs, and , where one input fans out to recruit ensembles, both optimizing information processing. maintains circuit tuning by scaling synaptic strengths and intrinsic excitability, ensuring stable firing rates and network balance despite perturbations, as seen in cortical adaptations over days. Evolutionarily, simpler circuits appear in ; for instance, escape responses rely on giant fiber systems, where sensory stimuli activate medial or lateral giants to trigger rapid tail-flips via electrical synapses, providing a foundational model for studying circuit .

Sensory-motor integration

Sensory systems process various modalities of information from the environment and the body, relaying signals through primary afferents to the via thalamic nuclei. The handles touch, pressure, pain, temperature, and , with sensory receptors in the skin, muscles, and joints sending signals through ascending pathways to the (S1). Visual information is transduced by photoreceptors in the and relayed via the to the primary visual cortex (), while auditory signals from hair cells in the pass through the and to the primary auditory cortex (A1). These pathways ensure that sensory data is organized topographically for precise perception. A key example of sensory relay is the dorsal column-medial lemniscus (DCML) pathway, which transmits fine touch, vibration, and from mechanoreceptors in the . First-order neurons ascend ipsilaterally in the dorsal columns of the to the medulla, where second-order neurons decussate and project via the to the of the , ultimately reaching S1. This pathway enables discriminative touch and conscious essential for coordinated movement. Motor systems exhibit hierarchical control, integrating reflexive responses at the spinal level with higher-order planning in the cortex to generate voluntary actions. Spinal reflexes, such as the knee-jerk response, involve local circuits that bypass the brain for rapid, automatic adjustments. and contribute to posture and automatic movements via extrapyramidal tracts, including the rubrospinal and vestibulospinal pathways, which modulate muscle tone and balance. At the apex, the (M1) and premotor areas orchestrate complex sequences through the pyramidal tract, primarily the , which decussates in the medulla to directly influence lower motor neurons for skilled, voluntary movements. Efferent pathways thus form a descending : for fine, fractionated control of distal muscles, and extrapyramidal for proximal and . This organization allows seamless transitions from instinctive reflexes to intentional behaviors, with loops refining output. Sensory-motor integration occurs through closed-loop mechanisms that combine afferent input with efferent commands to adapt and refine actions in real time. Sensorimotor loops, particularly involving the , detect discrepancies between predicted and actual sensory outcomes, enabling error correction during movement. For instance, the receives sensory via mossy and climbing fibers and compares it to internal models of motor commands, adjusting outputs to minimize errors in timing and coordination. Mirror neurons exemplify social aspects of integration, firing both during action execution and observation of similar actions in others. Discovered in the by Rizzolatti's team in the of monkeys, these neurons activate in area F5 when grasping objects or observing others grasp, facilitating action understanding and imitation. In humans, analogous activity in the and supports by simulating observed emotions and intentions. Proprioception, mediated by muscle spindles, provides critical feedback on limb position and velocity for smooth . These intrafusal fibers detect stretch via and II afferents, relaying signals to the and to prevent overextension and guide precise movements. The vestibulo-ocular (VOR) stabilizes gaze during head turns by coordinating vestibular input with ocular motor nuclei, generating compensatory eye movements opposite to head velocity through direct pathways. A core principle of this integration is in sensorimotor regions, where the anticipates sensory consequences of actions to optimize . In the , forward models generate predictions that suppress expected reafferent signals, allowing efficient detection of novel errors and rapid adaptation. This mechanism underpins anticipatory adjustments, as seen in cerebellar circuits, enhancing overall behavioral efficiency.

Pathology

Developmental and congenital disorders

Developmental and congenital disorders of the nervous system arise from disruptions during embryonic or fetal stages, leading to structural or functional abnormalities that persist into infancy and beyond. These conditions often stem from genetic mutations, environmental teratogens, or multifactorial interactions that interfere with critical processes like closure, progenitor proliferation, and synaptic maturation. Unlike acquired pathologies, they manifest early due to prenatal origins, affecting neuronal migration, differentiation, and connectivity. Neural tube defects (NTDs) represent a primary category of congenital malformations, occurring when the fails to close properly between the third and fourth weeks of gestation. Common forms include , characterized by incomplete closure of the spinal neural tube resulting in exposed and , and , a lethal condition involving absence of the and cerebral hemispheres due to failed anterior closure. The incidence of NTDs varies globally but averages about 1 per 1,000 live births in populations without programs. is a well-established risk factor, as it impairs and methylation critical for neural tube formation, with maternal supplementation reducing NTD risk by up to 70%. Genetic factors, such as polymorphisms in the (MTHFR) gene, exacerbate susceptibility by disrupting metabolism, particularly when combined with low dietary intake. Prenatal diagnosis relies on for initial screening, with (MRI) providing detailed visualization of involvement and associated anomalies to guide management. Neurodevelopmental disorders encompass a spectrum of conditions influenced by genetic and environmental perturbations during brain assembly. Autism spectrum disorder (ASD) arises from imbalances in and connectivity, where genetic variants affecting neuronal adhesion and signaling—combined with environmental exposures like advanced parental age or prenatal infections—lead to excessive synaptic density and altered . deficits, often linked to microglial dysfunction and impaired , contribute to the core features of social communication challenges and repetitive behaviors observed in ASD. , as seen in due to trisomy 21, results from effects that disrupt and neuronal in the developing and . The extra impairs progenitor cell division and migration, leading to reduced volume and cognitive deficits, with affected individuals showing delayed milestones in language and motor skills. Congenital malformations further illustrate vulnerabilities in (CSF) dynamics and brain growth. involves accumulation of CSF due to blockage in its flow or absorption pathways, often from congenital or genetic anomalies like L1CAM mutations that narrow ventricular passages. This obstruction, present from birth, causes ventricular enlargement and increased , potentially compressing surrounding neural tissue. , marked by a head circumference below the third percentile, reflects depleted neural progenitors and cortical thinning; for instance, infection targets proliferating neural stem cells, inducing and cell-cycle arrest to halt brain expansion. Diagnostic prenatal MRI enhances detection of these malformations by delineating ventricular dilation or cortical layering defects not fully resolved by . Teratogens, as exogenous agents crossing the , exemplify environmental contributors to these disorders. Prenatal exposure induces fetal (FAS), featuring through direct neurotoxic effects on precursors and disrupted migration, resulting in coordination deficits and . These disruptions highlight how substances like interfere with embryonic signaling pathways, underscoring the need for preconceptional risk mitigation. Overall, such disorders emphasize the intricate interplay of genetic predispositions and teratogenic insults during vulnerable developmental windows.

Acquired and degenerative disorders

Acquired and degenerative disorders of the nervous system encompass a of conditions arising from external insults, injuries, , or cellular in neural tissues, leading to impaired , cognitive decline, and motor deficits. These disorders contrast with developmental anomalies by emerging later in due to environmental exposures, vascular events, or age-related protein accumulation. Globally, neurodegenerative conditions contribute significantly to , with affecting approximately 57 million people worldwide in 2021, over 60% of whom live in low- and middle-income countries. Neurodegenerative diseases represent a major subset, characterized by the progressive loss of neurons and synaptic connections, often driven by protein misfolding and aggregation. In (AD), the most common form, extracellular amyloid-beta plaques and intracellular neurofibrillary tangles composed of hyperphosphorylated accumulate, particularly in the , leading to and . The ε4 (APOE4) serves as the strongest genetic risk factor for sporadic AD, increasing susceptibility by promoting aggregation and , with carriers of one ε4 facing a threefold higher risk and two alleles up to a 90% lifetime risk. In the United States alone, an estimated 7.2 million individuals aged 65 and older live with Alzheimer's in 2025. Parkinson's disease (PD) involves the degeneration of dopaminergic neurons in the , resulting in depletion and the formation of intraneuronal Lewy bodies containing aggregates, which manifest as bradykinesia, rigidity, and . (ALS), another motor neuron disease, features the selective degeneration of upper and lower s in the cortex, , and , leading to and without sensory involvement. Across these conditions, plays a pivotal role in progression, with activated releasing pro-inflammatory cytokines that exacerbate neuronal damage and protein pathology. Traumatic brain injury (TBI) constitutes a key acquired disorder, often resulting from mechanical forces that cause concussions or more severe (DAI), where shearing disrupts tracts and impairs neural communication. TBI increases vulnerability to long-term neurodegeneration, including elevated risks for Alzheimer's and Parkinson's. , a vascular disorder, arises from ischemic blockage or hemorrhagic rupture in cerebral arteries, affecting specific vascular territories such as the supplying motor and sensory cortices, leading to focal deficits like or . Ischemic strokes account for about 87% of cases, with outcomes influenced by reperfusion therapies. Infectious and immune-mediated disorders further illustrate acquired nervous system pathology. (MS) is an autoimmune condition where autoreactive T-cells infiltrate the , causing demyelination of axons in the and resultant conduction delays, manifesting as relapsing-remitting or progressive neurological symptoms. , often infectious, involves brain parenchymal inflammation; for instance, targets the , leading to seizures, memory loss, and potential if untreated. diseases, such as Creutzfeldt-Jakob disease, exemplify rapid neurodegeneration via infectious protein misfolding, where misfolded prions propagate conformational changes in normal prion protein, causing spongiform and swift cognitive-motor decline.

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