My complete understanding NOW is that abnormal minute ventilation is a disorder of the peripheral nervous system….and involves the autonomic nervous system [sympathetic and parasympathetic] and the somatic [motor] parts and this disorder WILL affect the central nervous system [the brain and the spine. This is the reason for the disturbance of cognition and memory and mood and psychomotor activity and speed during attacks of bipolar depression and mania.
Disorders, injuries, toxins, and viruses can lead to problems with the peripheral nervous system. Such conditions can lead to problems with sensation, muscle strength, and muscle control.
Verywell / Gary Ferster
How the Peripheral Nervous System Works https://www.verywellmind.com/what-is-the-peripheral-nervous-system-2795465
So the evidence that Kraepelin collected and that Paula and I found in our preliminary studies point to injury to the peripheral nervous centre NOT the central nervous centre UNLESS the peripheral nervous centre is responding to a hidden problem in the brain, a problem which necessitates keeping minute ventilation abnormal in health and under duress; a hidden problem such as chronically raised intracranial pressure due to head trauma [in this case] at birth. It is hard to know which system is responding to what without further research.
To understand how disruptions to the peripheral nervous system cause cognitive impairment when parts of the peripheral nervous system outside the brain get injured one must look at the following explanation by Merck Manual: https://www.merckmanuals.com/en-ca/home/brain,-spinal-cord,-and-nerve-disorders/peripheral-nerve-and-related-disorders/overview-of-the-peripheral-nervous-system
Overview of the Peripheral Nervous System
, MDCM, New York Presbyterian Hospital-Cornell Medical Center
Last full review/revision Dec 2020
CLICK HERE FOR THE PROFESSIONAL VERSION
The peripheral nervous system refers to the parts of the nervous system that are outside the central nervous system, that is, those outside the brain and spinal cord.
Thus, the peripheral nervous system includes
- The nerves that connect the head, face, eyes, nose, muscles, and ears to the brain (cranial nerves)
- The nerves that connect the spinal cord to the rest of the body, including the 31 pairs of spinal nerves
- More than 100 billion nerve cells that run throughout the body
Using the Brain to Move a Muscle
|Moving a muscle usually involves communication between the muscle and the brain through nerves. The impetus to move a muscle may originate in the brain, as when a person consciously decides to move a muscle—for example, to pick up a book. Or the impetus to move a muscle may originate with the senses. For example, special nerve endings in the skin (sensory receptors) enable people to sense pain or a change in temperature. This sensory information is sent to the brain, and the brain may send a message to the muscle about how to respond. This type of exchange involves two complex nerve pathways:The sensory nerve pathway to the brainThe motor nerve pathway to the muscle|
|If sensory receptors in the skin detect pain or a change in temperature, they transmit an impulse (signal), which ultimately reaches the brain.The impulse travels along a sensory nerve to the spinal cord.The impulse crosses a synapse (the junction between two nerve cells) between the sensory nerve and a nerve cell in the spinal cord.The impulse crosses from the nerve cell in the spinal cord to the opposite side of the spinal cord.The impulse is sent up the spinal cord and through the brain stem to the thalamus, which is a processing center for sensory information, located deep in the brain.The impulse crosses a synapse in the thalamus to nerve fibers that carry the impulse to the sensory cortex of the cerebrum (the area that receives and interprets information from sensory receptors).The sensory cortex perceives the impulse. A person may then decide to initiate movement, which triggers the motor cortex (the area that plans, controls, and executes voluntary movements) to generate an impulse.The nerve carrying the impulse crosses to the opposite side at the base of the brain.The impulse is sent down the spinal cord.The impulse crosses a synapse between the nerve fibers in the spinal cord and a motor nerve, which is located in the spinal cord.The impulse travels out of the spinal cord along the length of the motor nerve.At the neuromuscular junction (where nerves connect to muscles), the impulse crosses from the motor nerve to receptors on the motor end plate of the muscle, where the impulse stimulates the muscle to move.|
|If the sensation occurs suddenly and is severe (as when stepping on a sharp rock or picking up a cup of very hot coffee), the impulse may travel to the spinal cord and directly back to the motor nerve, bypassing the brain. The result is a quick response of a muscle—by immediately withdrawing from whatever is causing the pain. This response is called a spinal reflex.|
Dysfunction of peripheral nerves may result from damage to any part of the nerve:
- Axon (the part that sends messages)
- Body of the nerve cell
- Myelin sheath (the membranes that surround the axon and that function much like insulation around electrical wires, enabling nerve impulses to travel quickly)
Damage to the myelin sheath is called demyelination, as occurs in Guillain-Barré syndrome.
Typical Structure of a Nerve Cell
|A nerve cell (neuron) consists of a large cell body and nerve fibers—one elongated extension (axon) for sending impulses and usually many branches (dendrites) for receiving impulses. The impulses from the axon cross a synapse (the junction between two nerve cells) to the dendrite of another cell.Each large axon is surrounded by oligodendrocytes in the brain and spinal cord and by Schwann cells in the peripheral nervous system. The membranes of these cells consist of a fat (lipoprotein) called myelin. The membranes are wrapped tightly around the axon, forming a multilayered sheath. This myelin sheath resembles insulation, such as that around an electrical wire. Nerve impulses travel much faster in nerves with a myelin sheath than in those without one.|
Insulating a Nerve Fiber
|Most nerve fibers inside and outside the brain are wrapped with many layers of tissue composed of a fat (lipoprotein) called myelin. These layers form the myelin sheath. Much like the insulation around an electrical wire, the myelin sheath enables nerve signals (electrical impulses) to be conducted along the nerve fiber with speed and accuracy. When the myelin sheath is damaged (called demyelination), nerves do not conduct electrical impulses normally.|
Peripheral nerve disorders can affect
- One nerve (mononeuropathy)
- Two or more peripheral nerves in separate areas of the body (multiple mononeuropathy)
- Many nerves throughout the body but usually in about the same areas on both sides of the body (polyneuropathy)
- A spinal nerve root (the part of the spinal nerve connected to the spinal cord)
- A plexus (a network of nerve fibers, where fibers from different spinal nerves are sorted and recombined to serve a particular area of the body)
- The neuromuscular junction (where the nerve and muscle connect)
If motor nerves (which control muscle movement) are damaged, muscles may weaken or become paralyzed. If sensory nerves (which carry sensory information—about such things as pain, temperature, and vibration) are damaged, abnormal sensations may be felt or sensation may be lost.