Name:_________________________________________Date:_________

Case Study: Neurons and Cell Communication

Part 1: Christmas Lights

Jenna was home from college for Thanksgiving and was

helping her mom put up Christmas lights when she noticed
that her mother, Margaret, was having trouble holding onto
the wires and her hand seemed to be shaking. After the
third time she dropped the wire, Jenna asked if there was
anything wrong.

Her mother sat down with a sigh “I’ve just been tired lately, it feels like everything takes so much energy that I
just don’t have.” When her mother stood back up, she stumbled and nearly fell.

Jenna returned to college to finish the semester but she was still troubled. She spoke to her father on the
phone to ask if there were other things her mother wasn’t telling her. Her father admitted that her mother often
had slow speech and was losing her balance more frequently. She also complained about numbness or
tingling in her hands. The biggest issue was fatigue; some days her mother wouldn’t even get out of bed.

She tried to reassure her father: “Mom is only 40 years old, surely it can’t be anything serious.” Though she
tried to reassure her father, she knew from her biology classes that those symptoms could indicate a
neurological disorder. Neurological disorders affect the brain and nerves.

Jenna suggested her mother see a neurologist, a type of doctor that specializes in nerves and nervous
system disorders. That doctor could use magnetic resonance imaging (MRI) to see if there’s anything
wrong.

1. What are Margaret’s symptoms?

2. What is a “neurological disorder?”

3. What is fatigue? What illnesses could cause fatigue?

4. How would a neurologist determine if there was a problem in the brain?

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 Part 2: A Lesson on the Neuron

Margaret finally took her daughter’s advice and decided to see a doctor about how she felt tired all the time
and experiencing tingling in her hands. The doctor performed several tests in the office but said he wanted to
do a spinal tap, to get fluid from her brain and spinal cord. Margaret was alarmed, was there something
wrong with her brain?

The doctor tried to reassure her as he scheduled the spinal tap. “We just need to rule some things out.” In the
meantime, I’d like you to start taking this antibiotic, just in case you have an inner ear infection that might be
causing the dizzy spells.”

Margaret was skeptical, she’d had ear infections before and this didn’t seem like an ear problem. She felt the
doctor might be hiding something from her so she decided to call Jenna.

Jenna told her that a spinal tap might indicate an infection on the brain, like meningitis. The test might also
show that it’s not a problem with her brain, but instead might be related to her neurons in her brain and
nervous system. and how her nerves were communicating with the rest of the body. She explained further:
“Your central nervous system is your brain and spinal cord, where you have cells called neurons which do
your brain’s work. The brain can then send and receive messages from your peripheral nervous system,
where your muscles and senses are.”

Jenna sent her mother a text message with a link to a video that explained neurons.
** Watch “2-Minute Neuroscience: The Neuron” - https://youtu.be/6qS83wD29PY or biol.co/2mneuron

5. Sketch a neuron and label the important features of a neuron. Annotate the features to include basic
functions of each part of the cell.

6. What is the difference between the central and peripheral nervous system?

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Part 3: A Lesson on Neurotransmitters

After Margaret watched the video, she felt like she understood more about how nerve cells worked, but she didn’t
quite understand how signals got from the brain to other parts of the body. Why would this cause her to be tired, or
dizzy, or have numbness in her hands? Jenna explained to her mother how communication in the neurons work:

● Neurons are cells, and they have many cell components, like mitochondria and cell membranes.
● When an action potential travels down the neuron, it reaches the axon terminal and then that signal must
move across a space between two communicating neurons. That space is called the SYNAPSE.
● The axon terminals contain vesicles which store neurotransmitters. When the signal reaches the end of the
axon, vesicles release the chemical into the gap.
● The dendrites of the next neuron contain receptors which will activate when they are stimulated by the
neurotransmitter. Eventually, the neurotransmitters will move back into the axon through reuptake
channels. These channels can be blocked by reuptake inhibitors.

7. Jenna texted her mother a drawing communicating neuron. Use the underlined words to label the drawing..

After viewing the image, Margaret got an idea. “Do you think my neurotransmitters aren’t working right?”

Jenna responded: “It’s possible, there are some disorders, like myasthenia gravis, where the receptors are
damaged by the immune system. The muscles just won’t work because they aren’t getting the signal. “
“Oh dear. Is there any way to fix that?”
“Actually there is. Some drugs can increase the amount of neurotransmitter in the synapse by blocking reuptake
channels, those drugs are called reuptake inhibitors. If it is myasthenia gravis, you will have some options”

8. Which of the following would INCREASE communication between the neurons? (Place a check mark.)
Increase the amount of neurotransmitters ____ Increase reuptake inhibitors _____
Decrease number of dendrites ____ Increase the number of receptors _____

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.Part 4 - A Lesson on Myelin Sheaths
Margaret had taken a nerve conduction test and the lumbar
puncture (spinal tap). Her neurologist noted that there were
antibodies in the spinal fluid and found her nerves were not
conducting as quickly as they should. She called her
daughter with the news, she had multiple sclerosis. MS is
considered an autoimmune disorder because symptoms are
caused by the body’s immune system attacking healthy cells.
Symptoms can be sporadic because myelin can repair itself.
To reduce symptoms, Margaret will take steroids that
suppress the immune system.

Jenna was also able to find some promising research on

drugs that can increase the rate of myelin repair. She shared
this research with her mother:

Clemastine Fumarate Shows Promise in Treating MS

Among the current investigations, a 2017 study published in Lancet suggested that an
over-the-counter allergy drug called clemastine fumarate may promote myelin repair in the
brains of people with MS.

In the study, 50 people with relapsing MS and optic nerve damage were given either a twice-daily
dose of clemastine or a placebo for 150 days. The participants then underwent visual evoked
potentials, which measure signal transmission from the retina of the eye through the optic nerve
to the brain.

Results revealed that the delay in visual evoked potentials was reduced by 1.7 milliseconds per eye
for the time that people were being treated with clemastine. This reduction in the nerve
transmission delay suggests that myelin repair occurred along the optic nerve signaling pathway.

9. Why are symptoms of MS sporadic?

10. Why is MS considered an autoimmune disorder?

11. What happened to the retina signals of patients who took clemastine?

12. Another drug called Guanabenz has been found to increase the survival of oligodendrocytes (cells that
produce myelin). How could this drug be helpful for someone with MS?

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