Bilateral subthalamic nucleus stimulation for generalized dystonia after bilateral pallidotomy

Background: Thalamotomies and pallidotomies were commonly performed before the deep brain stimulation (DBS) era. Although ablative procedures can lead to significant dystonia improvement, longer periods of analysis reveal disease progression and functional deterioration. Today, the same patients seek additional treatment possibilities. Methods: Four patients with generalized dystonia who previously had undergone bilateral pallidotomy came to our service seeking additional treatment because of dystonic symptom progression. Bilateral subthalamic nucleus DBS (B-STN-DBS) was the treatment of choice. The patients were evaluated with the BurkeFahnMarsden Dystonia Rating Scale (BFMDRS) and the Unified Dystonia Rating Scale (UDRS) before and 2 years after surgery. Results: All patients showed significant functional improvement, averaging 65.3% in BFMDRS (P = .014) and 69.2% in UDRS (P = .025). Conclusions: These results suggest that B-STN-DBS may be an interesting treatment option for generalized dystonia, even for patients who have already undergone bilateral pallidotomy. (c) 2012 Movement Disorder Society

Androgen responsive intronic non-coding RNAs

Abstract Background Transcription of large numbers of non-coding RNAs originating from intronic regions of human genes has been recently reported, but mechanisms governing their biosynthesis and biological functions are largely unknown. In this work, we evaluated the existence of a common mechanism of transcription regulation shared by protein-coding mRNAs and intronic RNAs by measuring the effect of androgen on the transcriptional profile of a prostate cancer cell line. Results Using a custom-built cDNA microarray enriched in intronic transcribed sequences, we found 39 intronic non-coding RNAs for which levels were significantly regulated by androgen exposure. Orientation-specific reverse transcription-PCR indicated that 10 of the 13 were transcribed in the antisense direction. These transcripts are long (0.5–5 kb), unspliced and apparently do not code for proteins. Interestingly, we found that the relative levels of androgen-regulated intronic transcripts could be correlated with the levels of the corresponding protein-coding gene (asGAS6 and asDNAJC3) or with the alternative usage of exons (asKDELR2 and asITGA6) in the corresponding protein-coding transcripts. Binding of the androgen receptor to a putative regulatory region upstream from asMYO5A, an androgen-regulated antisense intronic transcript, was confirmed by chromatin immunoprecipitation. Conclusion Altogether, these results indicate that at least a fraction of naturally transcribed intronic non-coding RNAs may be regulated by common physiological signals such as hormones, and further corroborate the notion that the intronic complement of the transcriptome play functional roles in the human gene-expression program.

Niemann-Pick disease type C symptomatology: an expert-based clinical description

Niemann-Pick disease type C (NP-C) is a rare, progressive, irreversible disease leading to disabling neurological manifestations and premature death. The estimated disease incidence is 1:120,000 live births, but this likely represents an underestimate, as the disease may be under-diagnosed due to its highly heterogeneous presentation. NP-C is characterised by visceral, neurological and psychiatric manifestations that are not specific to the disease and that can be found in other conditions. The aim of this review is to provide non-specialists with an expert-based, detailed description of NP-C signs and symptoms, including how they present in patients and how they can be assessed. Early disease detection should rely on seeking a combination of signs and symptoms, rather than isolated findings. Examples of combinations which are strongly suggestive of NP-C include: splenomegaly and vertical supranuclear gaze palsy (VSGP); splenomegaly and clumsiness; splenomegaly and schizophrenia-like psychosis; psychotic symptoms and cognitive decline; and ataxia with dystonia, dysarthria/dysphagia and cognitive decline. VSGP is a hallmark of NP-C and becomes highly specific of the disease when it occurs in combination with other manifestations (e.g. splenomegaly, ataxia). In young infants (<2 years), abnormal saccades may first manifest as slowing and shortening of upward saccades, long before gaze palsy onset. While visceral manifestations tend to predominate during the perinatal and infantile period (2 months–6 years of age), neurological and psychiatric involvement is more prominent during the juvenile/adult period (>6 years of age). Psychosis in NP-C is atypical and variably responsive to treatment. Progressive cognitive decline, which always occurs in patients with NP-C, manifests as memory and executive impairment in juvenile/adult patients. Disease prognosis mainly correlates with the age at onset of the neurological signs, with early-onset forms progressing faster. Therefore, a detailed and descriptive picture of NP-C signs and symptoms may help improve disease detection and early diagnosis, so that therapy with miglustat (Zavesca®), the only available treatment approved to date, can be started as soon as neurological symptoms appear, in order to slow disease progression.

A novel phase variation mechanism in the meningococcus driven by a ligand-responsive repressor and differential spacing of distal promoter elements

Phase variable expression, mediated by high frequency reversible changes in the length of simple sequence repeats, facilitates adaptation of bacterial populations to changing environments and is frequently important in bacterial virulence. Here we elucidate a novel phase variable mechanism for NadA expression, an adhesin and invasin of Neisseria meningitidis. The NadR repressor protein binds to operators flanking the phase variable tract of the nadA promoter gene and contributes to the differential expression levels of phase variant promoters with different numbers of repeats, likely due to different spacing between operators. It is shown that IHF binds between these operators, and may permit looping of the promoter, allowing interaction of NadR at operators located distally or overlapping the promoter. The 4-hydroxyphenylacetic acid, a metabolite of aromatic amino acid catabolism that is secreted in saliva, induces nadA expression by inhibiting the DNA binding activity of the NadR repressor. When induced, only minor differences are evident between NadR-independent transcription levels of promoter phase variants, which are likely due to differential RNA polymerase contacts leading to altered promoter activity. These results suggest that NadA expression is under both stochastic and tight environmental-sensing regulatory control, and both regulations are mediated by the NadR repressor that and may be induced during colonization of the oropharynx where it plays a major role in the successful adhesion and invasion of the mucosa. Hence, simple sequence repeats in promoter regions may be a strategy used by host-adapted bacterial pathogens to randomly switch between expression states that may nonetheless still be induced by appropriate niche-specific signals.

Responsive Bürstenpolymere

'Responsive' Bürstenpolymere Bürstenpolymere sind definiert verzweigte Makromoleküle, die aus einer Hauptkette und vielen darauf (kovalent) gepfropften Seitenketten bestehen; ist der Pfropfungsgrad hoch und die Hauptkette wesentlich länger als die Seitenketten, dann haben sie die Form semiflexibler molekularer Zylinder. Lassen sich Form bzw. Ausdehnung eines solchen Zylinders gezielt ansteuern, dann könnten diese Moleküle entweder als (Nano-)Sensoren für die entsprechende Umgebungsbedingung oder als molekulare Motoren eingesetzt werden. Die Idee responsiver Bürstenpolymere beruht auf folgender Überlegung: Die gestreckte Konformation der Hauptkette ist entropisch gegenüber einem entsprechenden Knäuel benachteiligt, weshalb sie ,molekulare Federn‘ darstellen, die auf Änderung der repulsiven Wechselwirkung zwischen den Seitenketten reagieren. Dies wurde für den Wechsel zwischen gutem und schlechtem Lösungsmitteln untersucht. Ein zweites Konzept zur Änderung der Molekülform beruht auf der intramolekularen Phasentrennung (,Segmentbildung‘) miteinander unverträglicher Seitenketten in selektiven Lösungsmitteln, da die Hauptkette durch Ausbildung von Mikrophasen entlang des Moleküls ebenfalls aus ihrer gestreckten Form gebracht werden sollte. Die dritte Möglichkeit zur Änderung der Konformation ist die intramolekulare Vernetzung von Seitenketten, die ebenfalls zu verringerter Abstoßung und damit zur Verkürzung der Zylinder führen sollte. Eine weitere wichtige Untersuchung der Arbeit war der Übergang einer geknäuelten Hauptkette zu einer gestreckten Bürste als Funktion der Pfropfdichte. Zur Beantwortung dieser Fragestellungen wurden zylindrische Bürstenpolymere durch ,Grafting Trough‘ und ,Grafting Onto‘ synthetisiert (PS bzw. PI/PS und PnBMA/PMAA mit Kern/Schale- und ,Segment‘-Architektur) und systematisch Pfropfdichte, Vernetzungsgrad (Vernetzung durch gamma-Bestrahlung) und Lösungsbedingungen verändert. Die Möglichkeit gezielter Ansteuerung der Konformationsänderung durch Vernetzung konnte nach polymeranaloger Modifikation von PI/PS-Bürstenpolymeren durch Photovernetzung und vernetzende Komplexierung erfolgreich bestätigt werden. Zur Untersuchung der Probenreihen wurden AFM, Licht- und Neutronenstreuung herangezogen. Die Analysen bestätigten konsistent die Änderung von Steifigkeit, Zylinderquerschnitt und Streckung der Hauptkette durch Variation von Pfropfdichte, Vernetzung und Lösungsmittelqualität. Für die Änderung der Pfropfdichte gehorchen die Parameter dabei Potenzgesetzen.

Functional and molecular characterization of ethylene responsive factor genes involved in grape ripening

Grape berry is considered a non climacteric fruit, but there are some evidences that ethylene plays a role in the control of berry ripening. This PhD thesis aimed to give insights in the role of ethylene and ethylene-related genes in the regulation of grape berry ripening. During this study a small increase in ethylene concentration one week before véraison has been measured in Vitis vinifera L. ‘Pinot Noir’ grapes confirming previous findings in ‘Cabernet Sauvignon’. In addition, ethylene-related genes have been identified in the grapevine genome sequence. Similarly to other species, biosynthesis and ethylene receptor genes are present in grapevine as multi-gene families and their expression appeared tissue or developmental specific. All the other elements of the ethylene signal transduction cascade were also identified in the grape genome. Among them, there were ethylene response factors (ERF) which modulate the transcription of many effector genes in response to ethylene. In this study seven grapevine ERFs have been characterized and they showed tissue and berry development specific expression profiles. Two sequences, VvERF045 and VvERF063, seemed likely involved in berry ripening control due to their expression profiles and their sequence annotation. VvERF045 was induced before véraison and was specific of the ripe berry, by sequence similarity it was likely a transcription activator. VvERF063 displayed high sequence similarity to repressors of transcription and its expression, very high in green berries, was lowest at véraison and during ripening. To functionally characterize VvERF045 and VvERF063, a stable transformation strategy was chosen. Both sequences were cloned in vectors for over-expression and silencing and transferred in grape by Agrobacterium-mediated or biolistic-mediated gene transfer. In vitro, transgenic VvERF045 over-expressing plants displayed an epinastic phenotype whose extent was correlated to the transgene expression level. Four pathogen stress response genes were significantly induced in the transgenic plants, suggesting a putative function of VvERF045 in biotic stress defense during berry ripening. Further molecular analysis on the transgenic plants will help in identifying the actual VvERF045 target genes and together with the phenotypic characterization of the adult transgenic plants, will allow to extensively define the role of VvERF045 in berry ripening.

Synthesis and characterization of temperature- and light-responsive polymers and block copolymers

In summary, thermoresponsive polyacrylamides with various amounts of different photoswitchable side groups, i. e. azobenzene, salicylideneaniline and fulgimide were successfully prepared. As such, in a first step three different chromophores with an amine functionality were synthesized. The synthesis of the stimuli-responsive materials was based on the RAFT polymerization of activated ester acrylates followed by a polymer analogous reaction with different amines. The procedure has been designed to allow the synthesis of well-defined materials with functional groups. All copolymers prepared in this way showed a LCST in aqueous solution. The LCST was in general decreased by increasing the amount of hydrophobic dye incorporated into the thermoresponsive polymer. However, in the case of the fulgimide, the LCST was hardly affected by the chromophore. For azobenzene containing PNIPAM polymers and analogues, higher LCST values were measured after irradiation of the polymer sample solutions with UV-light (Delta LCSTmax = 7.3°C). A reversible light-induced solubility change within a certain temperature range was possible. In contrast to this, irradiated samples of salicylideneaniline containing thermoresponsive copolymers showed an irreversible increase in the LCST (Delta LCSTmax = 13.0°C). Fulgimide chromophores did not influence the LCST of PNIPAM based copolymers after UV-light exposure.rnSimilar to the thermoresponsive polyacrylamides with azobenzene side groups, poly(oligo(ethylene glycol) methyl ether methacrylate) [P(OEGMA)] polymers with azobenzene end groups showed a LCST shift upon UV-irradiation. These polymers were synthesized by RAFT polymerization using a functional chain transfer agent (CTA). For this, PFP-CTA was used as a RAFT-agent for end group functionalization of (thermoresponsive) polymers. In contrast to the statistically arranged copolymers with azobenzene side groups, P(OEGMA) polymers with terminal azobenzene showed a linear increase of the LCST shifts with increasing amount of chromophore (Delta LCSTmax = 4.3°C). Noteworthy, the chemical nature of the end group exhibited a strong influence on the LCST in the case of short thermoresponsive P(OEGMA) polymers.rnThe investigation on temperature- and lightresponsive polymers was transferred onto block copolymers capable to self-assemble into polymeric micelles. Therefore, PEO-b-PNIPAM block copolymers with azobenzene moieties were synthesized successfully. These polymers showed a “smart” behavior in aqueous solution, as the reversible formation and disruption of the micelles could either be controlled by temperature or using light as a stimulus. The usefulness of these materials was demonstrated by encapsulation of a hydrophobic dye in the core of the micelle. Such materials might have a great potential as a model system for several technical or biological applications.rnFinally, double thermoresponsive block copolymers forming micellar structures in a certain temperature range with functional end groups could successfully be synthesized. These “smart materials” based on POEGMA-b-PNIPMAM have been demonstrated to be very promising for a temperature selective immobilization on a protein surface. This might be a suitable concept for further biological applications.rnConcluding, different thermoresponsive copolymers and block copolymers with lightresponsive moieties arranged along the backbone or located at the chain ends were successfully prepared and investigated. By controlling the nature of functional groups and their respective incorporation ratios, the LCST could be dialed in precisely. Further, the LCST of the polymers could be triggered by light. A light-controlled disruption of micellar structures could be shown for functional block copolymers. The importance of end groups of thermoresponsive polymers was demonstrated by a temperature-controlled protein-polymer binding of a terminal biotin-functionalized double thermoresponsive polymer. The synthetic approaches and the material properties presented here should be promising for further research and applications beyond this dissertation.rn

Liquid crystalline elastomers as stimuli-responsive microactuators

Liquid crystalline elastomers (LCEs) are known to perform a reversible change of shape upon the phase transition from the semi-ordered liquid crystalline state to the chaotic isotropic state. This unique behavior of these “artificial muscles” arises from the self-organizing properties of liquid crystals (mesogens) in combination with the entropy-elasticity of the slightly crosslinked elastomer network. In this work, micrometer-sized LCE actuators are fabricated in a microfluidic setup. The microtubular shear flow provides for a uniform orientation of the mesogens during the crosslinking, a perquisite for obtaining actuating LCE samples. The scope of this work was to design different actuator geometries and to broaden the applicability of the microfluidic device for different types of liquid crystalline mesogens, ranging from side-chain to main-chain systems, as well as monomer and polymer precursors. For example, the thiol-ene “click” mechanism was used for the polymerization and crosslinking of main-chain LCE actuators. The main focus was, however, placed on acrylate monomers and polymers with LC side chains. A LC polymer precursor, comprising mesogenic and crosslinkable side-chains was synthesized. Used in combination with an LC monomer, the polymeric crosslinker promoted a stable LC phase, which allowed the mixture to be isothermally handled in the microfluidic reactor. If processed without the additional LC components, the polymer precursor yielded actuating fibers. A suitable co-flowing continuous phase facilitates the formation of a liquid jet and lowers the tendency for drop formation. By modification of the microfluidic device, it was further possible to prepare core-shell particles, comprised of an LCE shell and filled with an isotropic liquid. In analogy to the heart, a hollow muscle, the elastomer shell expels the inner liquid core upon its contraction. The feasibility of the core-shell particles as micropumps was demonstrated. In general, the synthesized LCE microactuators may be utilized as active components in micromechanical and lab-on-chip systems.

From anionic polymerization in continuous flow to macromolecular architectures and stimuli-responsive surfaces

The thesis can be divided in four parts and summarized as follows:(i) The investigation and development of a continuous flow synthesis procedure affording end-functional polymers by anionic polymerization and subsequent termination in one reaction step and on a multigram scale was carried out. Furthermore, the implementation of not only a single hydroxyl but multiple orthogonal functionalities at the chain terminus was achieved by utilizing individually designed, functional epoxide-based end-capping reagents.(ii) In an additional step, the respective polymers were used as macroinitiators to prepare in-chain functionalized block copolymers and star polymers bearing intriguing novel structural and material properties. Thus, the second part of this thesis presents the utilization of end-functional polymers as precursors for the synthesis of amphiphilic complex and in some cases unprecedented macromolecular architectures, such as miktoarm star polymers based on poly(vinyl pyridine), poly(vinyl ferrocene) and PEO.(iii) Based on these structures, the third part of this thesis represents a detailed investigation of the preparation of stimuli-responsive ultrathin polymer films, using amphiphilic junction point-reactive block copolymers. The single functionality at the block interface can be employed as anchor group for the covalent attachment on surfaces. Furthermore, the change of surface properties was studied by applying different external stimuli.(iv) An additional topic related to the oxyanionic polymerizations carried out in the context of this thesis was the investigation of viscoelastic properties of different hyperbranched polyethers, inspired by the recent and intense research activities in the field of biomedical applications of multi-functional hyperbranched materials.

Stimuli-responsive materials for self-healing in corrosion protection

The corrosion of metallic materials is a crucial issue on an economical and ecological scale. Corrosion protection becomes then necessarily needed. The main focus of the thesis is to develop stimuli-responsive nanocontainers for self-healing in corrosion protection. A nanocontainer is efficient if distinct payloads can be selectively released via different stimuli because unwanted and unspecific release can be avoided. For anti-corrosion, the wanted nanocontainer is the one able to release its self-healing agents or corrosion inhibitors upon change of pH- or/and redox-potential due to the variation of these two signals at the corroded sites. Conducting polymers such as polyaniline (PANI) were chosen for building the shell of capsules due to their important characteristics of being both pH- and redox responsive.

Synthesis and application of stimuli responsive tunable systems based on physical interactions

Novel single step synthetic procedure for hydrophobically modified alkali soluble latexes (HASE) via a miniemulsion-analogous method is presented. This facile method simplifies the copolymerization of the monomers with basically “opposite” character in terms of their hydrophilic/hydrophobic nature, which represent one of the main challenges in water based systems. Considered systems do not represent classical miniemulsions due to a high content of water soluble monomers. However, the polymerization mechanism was found to be rather similar to miniemulsion polymerization process.rnThe influence of the different factors on the system stability has been investigated. The copolymerization behavior studies typically showed strong composition drifts during copolymerization. It was found that the copolymer composition drift can be suppressed via changing the initial monomer ratio.rnThe neutralization behavior of the obtained HASE systems was investigated via potentiometric titration. The rheological behavior of the obtained systems as a function of the different parameters, such as pH, composition (ultrahydrophobe content) and additive type and content has also been investigated.rnDetailed investigation of the storage and loss moduli, damping factor and the crossover frequencies of the samples showed that at the initial stages of the neutralization the systems show microgel-like behavior.rnThe dependence of the rheological properties on the content and the type of the ultrahydrophobe showed that the tuning of the mechanical properties can be easily achieved via minor (few percent) but significant changes in the content of the latter. Besides, changing the hydrophobicity of the ultrahydrophobe via increasing the carbon chain length represents another simple method for achieving the same results.rnThe influence of amphiphilic additives (especially alcohols) on the rheological behavior of the obtained systems has been studied. An analogy was made between micellation of surfactants and the formation of hydrophobic domains between hydrophobic groups of the polymer side chain.rnDilution induced viscosity reduction was investigated in different systems, without or with different amounts or types of the amphiphilic additive. Possibility of the controlled response to dilution was explored. It was concluded that the sensitivity towards dilution can be reduced, and in extreme cases even the increase of the dynamic modulus can be observed, which is of high importance for the setting behavior of the adhesive material.rnIn the last part of this work, the adhesive behavior of the obtained HASE systems was investigated on different substrates (polypropylene and glass) for the standard labeling paper. Wet tack and setting behavior was studied and the trends for possible applications have been evaluated.rnThe novel synthetic procedure, investigation of rheological properties and the possibility of the tuning via additives, investigated in this work create a firm background for the development of the HASE based adhesives as well as rheology modifiers with vast variety of possible applications due to ease of tuning the mechanical and rheological properties of the systems.

Correlation of 6-18F-fluoro-L-dopa PET uptake with proliferation and tumor grade in newly diagnosed and recurrent gliomas

6-(18)F-fluoro-l-dopa ((18)F-FDOPA) measured with PET as a biomarker of amino acid uptake has been investigated in brain tumor imaging. The aims of the current study were to determine whether the degree of (18)F-FDOPA uptake in brain tumors predicted tumor grade and was associated with tumor proliferative activity in newly diagnosed and recurrent gliomas.

Factors predicting protracted improvement after pallidal DBS for primary dystonia: the role of age and disease duration

In many patients, optimal results after pallidal deep brain stimulation (DBS) for primary dystonia may appear over several months, possibly beyond 1 year after implant. In order to elucidate the factors predicting such protracted clinical effect, we retrospectively reviewed the clinical records of 44 patients with primary dystonia and bilateral pallidal DBS implants. Patients with fixed skeletal deformities, as well as those with a history of prior ablative procedures, were excluded. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores at baseline, 1 and 3 years after DBS were used to evaluate clinical outcome. All subjects showed a significant improvement after DBS implants (mean BFMDRS improvement of 74.9% at 1 year and 82.6% at 3 years). Disease duration (DD, median 15 years, range 2-42) and age at surgery (AS, median 31 years, range 10-59) showed a significant negative correlation with DBS outcome at 1 and 3 years. A partition analysis, using DD and AS, clustered subjects into three groups: (1) younger subjects with shorter DD (n = 19, AS < 27, DD ? 17); (2) older subjects with shorter DD (n = 8, DD ? 17, AS ? 27); (3) older subjects with longer DD (n = 17, DD > 17, AS ? 27). Younger patients with short DD benefitted more and faster than older patients, who however continued to improve 10% on average 1 year after DBS implants. Our data suggest that subjects with short DD may expect to achieve a better general outcome than those with longer DD and that AS may influence the time necessary to achieve maximal clinical response.