Quantitative interactions between the A-type K+ current and inositol trisphosphate receptors regulate intraneuronal Ca2+ waves and synaptic plasticity

Key points center dot Active calcium signal propagation occurs when an initial calcium trigger elicits calcium release through endoplasmic reticulum (ER) receptors. A high concentration of the calcium trigger in thin-calibre dendrites would suppress release of calcium through hippocampal inositol trisphosphate receptors (InsP3Rs). center dot Could the high-density expression of A-type K+ channels in thin-calibre dendrites be a mechanism for inhibiting this suppression, thereby restoring the utility of the ER as a substrate for active calcium propagation? center dot Quantitative analyses involving experimentally constrained models reveal a bell-shaped dependence of calcium released through InsP3Rs on the A-type K+ channel density, during the propagation of a calcium wave. center dot A-type K+ channels regulated the relative contribution of ER calcium to the induction of synaptic plasticity in the presence of model metabotropic glutamate receptors. center dot These results identify a novel form of interaction between active dendrites and the ER membrane and suggest that A-type K+ channels are ideally placed for inhibiting the suppression of InsP3Rs in thin-calibre dendrites. Abstract The A-type potassium current has been implicated in the regulation of several physiological processes. Here, we explore a role for the A-type potassium current in regulating the release of calcium through inositol trisphosphate receptors (InsP3R) that reside on the endoplasmic reticulum (ER) of hippocampal pyramidal neurons. To do this, we constructed morphologically realistic, conductance-based models equipped with kinetic schemes that govern several calcium signalling modules and pathways, and constrained the distributions and properties of constitutive components by experimental measurements from these neurons. Employing these models, we establish a bell-shaped dependence of calcium release through InsP3Rs on the density ofA-type potassium channels, during the propagation of an intraneuronal calcium wave initiated through established protocols. Exploring the sensitivities of calcium wave initiation and propagation to several underlying parameters, we found that ER calcium release critically depends on dendritic diameter and that wave initiation occurred at branch points as a consequence of a high surface area to volume ratio of oblique dendrites. Furthermore, analogous to the role ofA-type potassium channels in regulating spike latency, we found that an increase in the density ofA-type potassium channels led to increases in the latency and the temporal spread of a propagating calcium wave. Next, we incorporated kinetic models for the metabotropic glutamate receptor (mGluR) signalling components and a calcium-controlled plasticity rule into our model and demonstrate thatthe presence of mGluRs induced a leftward shift in a BienenstockCooperMunro-like synaptic plasticity profile. Finally, we show that the A-type potassium current could regulate the relative contribution of ER calcium to synaptic plasticity induced either through 900 pulses of various stimulus frequencies or through theta burst stimulation. Our results establish a novel form of interaction between active dendrites and the ER membrane, uncovering a powerful mechanism that could regulate biophysical/biochemical signal integration and steer the spatiotemporal spread of signalling microdomains through changes in dendritic excitability.

海马环路中的组合突触可塑性与大鼠情绪研究

海马在某些类型的学习和记忆中起着关键的作用，而突触可塑性（synaptic plasticity）为学习和记忆的模型提供了理论基础。在海马环路中，分布着各种类型的可塑性，包括突触特异的Hebbian形式的可塑性，如长时程增强（long-term potentiation，LTP）和长时程抑制（long-term depression，LTD）；稳态可塑性（homeostatic plasticity），如突触缩放（synaptic scaling）。稳态可塑性是一种整体的调控过程，它可以调节神经元甚至神经网络的平衡；而Hebbian可塑性则是突触特异的，即每个突触进行单独调控的过程。 越来越多的研究提示稳态可塑性和Hebbian可塑性之间存在着空间间隙（spatial gap），那么，如何使得神经元可以通过Hebbian可塑性的过程来维持细胞整体的兴奋性就变得尤为重要。一些报道揭示了LTP和LTD可以在同一突触通路中同时被激活，因此，我们提出组合突触可塑性的概念，即LTP和LTD的组合，它在赋予系统灵活性的同时又可以降低噪音维持系统的稳定性。基于此，本文将围绕这个问题而开展实验工作。 通过对海马CA1区锥体神经元的微小兴奋性突触后电流（miniature excitatory synaptic current, mEPSC）进行测定分析，我们发现mEPSC的幅度分布符合双峰正态分布（double-peak normal distribution）。Theta节律刺激（theta burst stimuli, TBS）诱导后，mEPSC的幅度分布发生改变，呈现右移趋势。随后，采用干扰肽Pep-A2特异地阻断LTP而不影响LTD，我们发现Pep-A2不影响基础状态下mEPSC的幅度分布。在干扰肽Pep-A2存在下，TBS诱导对基础状态下mEPSC的幅度分布也没有影响。结果为揭示LTP和LTD的组合可塑性提供了初步的证据，对进一步理解记忆的编码过程提供了一定的基础。社交隔离可以引起实验大鼠产生焦虑样和抑郁样的行为，而性经历可以改变动物的情绪状态，降低焦虑样和抑郁样的反应。然而，性经历后进行社交隔离对大鼠情绪的影响并没有报道。在这部分工作中，雄性大鼠经历一周的社交活动（male-male paired housing）或者性活动（male-female paired housing），随后进行一段时间的隔离（1天，2天或者7天）。我们发现，经历过性活动的大鼠，无论隔离与否都表现出相似的情绪反应，包括焦虑样和抑郁样行为以及超声波（ultrasonic vocalizations，USVs）发放；而未经历过性活动的大鼠，其情绪反应随着隔离时间的不同而不同。这一现象提示我们，先前的性经历可以对抗实验动物对环境应激事件，如社交隔离的反应。

Primary motor cortex involvement in initial learning during visuomotor adaptation

Human motor behaviour is continually modified on the basis of errors between desired and actual movement outcomes. It is emerging that the role played by the primary motor cortex (M1) in this process is contingent upon a variety of factors, including the nature of the task being performed, and the stage of learning. Here we used repetitive TMS to test the hypothesis that M1 is intimately involved in the initial phase of sensorimotor adaptation. Inhibitory theta burst stimulation was applied to M1 prior to a task requiring modification of torques generated about the elbow/forearm complex in response to rotations of a visual feedback display. Participants were first exposed to a 30° clockwise (CW) rotation (Block A), then a 60° counterclockwise rotation (Block B), followed immediately by a second block of 30° CW rotation (A2). In the STIM condition, participants received 20s of continuous theta burst stimulation (cTBS) prior to the initial A Block. In the conventional (CON) condition, no stimulation was applied. The overt characteristics of performance in the two conditions were essentially equivalent with respect to the errors exhibited upon exposure to a new variant of the task. There were however, profound differences between the conditions in the latency of response preparation, and the excitability of corticospinal projections from M1, which accompanied phases of de-adaptation and re-adaptation (during Blocks B and A2). Upon subsequent exposure to the A rotation 24h later, the rate of re-adaptation was lower in the stimulation condition than that present in the conventional condition. These results support the assertion that primary motor cortex assumes a key role in a network that mediates adaptation to visuomotor perturbation, and emphasise that it is engaged functionally during the early phase of learning.

Contribution of primary motor cortex to compensatory balance reactions

Background: Rapid compensatory arm reactions represent important response strategies following an unexpected loss of balance. While it has been assumed that early corrective actions arise largely from sub-cortical networks, recent findings have prompted speculation about the potential role of cortical involvement. To test the idea that cortical motor regions are involved in early compensatory arm reactions, we used continuous theta burst stimulation (cTBS) to temporarily suppress the hand area of primary motor cortex (M1) in participants prior to evoking upper limb balance reactions in response to whole body perturbation. We hypothesized that following cTBS to the M1 hand area evoked EMG responses in the stimulated hand would be diminished. To isolate balance reactions to the upper limb participants were seated in an elevated tilt-chair while holding a stable handle with both hands. The chair was held vertical by a magnet and was triggered to fall backward unpredictably. To regain balance, participants used the handle to restore upright stability as quickly as possible with both hands. Muscle activity was recorded from proximal and distal muscles of both upper limbs.

Results: Our results revealed an impact of cTBS on the amplitude of the EMG responses in the stimulated hand muscles often manifest as inhibition in the stimulated hand. The change in EMG amplitude was specific to the target hand muscles and occasionally their homologous pairs on the non-stimulated hand with no consistent effects on the remaining more proximal arm muscles.

Conclusions: Present findings offer support for cortical contributions to the control of early compensatory arm reactions following whole-body perturbation.

Estimulacion magnetica trascraneal en el desempeno motor en enfermedades del sistema nervioso central: Revision Sistematica

Introducción: El uso de la estimulación cerebral no invasiva en procesos de rehabilitación es de gran interés, por cuanto con mediación tecnológica se generan nuevas posibilidades de recuperación motora, a partir de la activación de la corteza cerebral. El objetivo del estudio es establecer la evidencia del uso terapéutico de la EMT, relacionado con el desempeño motor de pacientes con enfermedades del sistema nervioso central. Metodología: Se realizó una revisión sistemática de la literatura. Se incluyeron 10 estudios en el análisis cualitativo que incluyó la evaluación de calidad con la escala de Jadad y del riesgo de sesgo con la herramienta Cochrane. Fueron excluidos 1613 estudios. Se aplicó el protocolo del estudio para la extracción, revisión y validez de los estudios incluidos. Resultados: La evidencia disponible muestra resultados positivos del uso terapéutico de la EMT en el desempeño motor en aspectos como la aceleración, la fuerza de pinza y de agarre, la estabilidad y la fuerza muscular, así como una mejor velocidad de la marcha y una disminución en la frecuencia y severidad de los espasmos. Discusión: La EMT puede constituir una estrategia terapéutica para mejorar el desempeño motor en pacientes con ECV, Lesión Medular y enfermedad de Parkinson, que requiere más investigación por la heterogeneidad de los diseños y medidas de descenlace utilizados, así como por la alta variabilidad interindividual que hace complejo estandarizar los protocolos de su uso terapéutico.

Eficacia de la estimulación magnética transcraneal en la disminución de severidad en el trastorno depresivo mayor en monoterapia y coadyuvante comparado con tratamientos farmacológicos. Revisión sistemática y meta-análisis

Resumen Introducción Una posible opción de tratamiento para el manejo del trastorno depresivo mayor (TDM) es la estimulación magnética transcraneal (EMT) que ha mostrado propiedades antidepresivas superiores al placebo con un buen perfil de seguridad. El objetivo del presente trabajo es determinar la reducción en la severidad del TDM y la proporción de eventos adversos (EA) en pacientes con TDM refractario y no refractario, posterior al uso de EMT administrada en monoterapia o tratamiento coadyuvante comparado con terapia farmacológica. Metodología Se planteó una pregunta PICOT de la cual se realizó una búsqueda sistemática de estudios clínicos en las bases de datos Medline, EMBASE y Cochrane. Dos investigadores en forma independiente realizaron la selección de artículos, evaluación de calidad con la herramienta de la colaboración Cochrane y extracción de datos. Se extrajeron datos de eficacia como tasa de respuesta, porcentaje de remisión, calidad de vida, diminución sintomática del trastorno depresivo mayor en la escala de Hamilton y capacidad funcional. Igualmente, proporción de pacientes con EA. Se realizó un meta-análisis de estas variables teniendo en cuenta la heterogeneidad. Resultados La presente revisión sistemática incluyó 26 estudios clínicos aleatorizados de baja calidad metodológica mostrando que la EMT presentó una eficacia superior cuando es usada como coadyuvante a las terapias con que venían siendo tratados los pacientes con TDM refractario y no refractario en los desenlaces de tasa de respuesta y porcentaje de remisión. En el caso de intervenciones farmacológicas específicas, la EMT presento eficacia similar, tanto en terapia coadyuvante como en monoterapia comparado con las intervenciones farmacológicas. En cuanto a seguridad, la EMT presenta un buen perfil de seguridad debido a que en todos los escenarios estudiados los EA fueron no serios y baja frecuencia Conclusiones La evidencia disponible sugiere que la EMT mostró ser efectivo y seguro para el manejo del TDM refractario y no refractario. Sin embargo, la evidencia es débil por lo tanto se necesita mayor investigación clínica que soporte su uso.

Neural basis of visual deficits recovery: visual residual functions and multisensory integration.

The ability of integrating into a unified percept sensory inputs deriving from different sensory modalities, but related to the same external event, is called multisensory integration and might represent an efficient mechanism of sensory compensation when a sensory modality is damaged by a cortical lesion. This hypothesis has been discussed in the present dissertation. Experiment 1 explored the role of superior colliculus (SC) in multisensory integration, testing patients with collicular lesions, patients with subcortical lesions not involving the SC and healthy control subjects in a multisensory task. The results revealed that patients with collicular lesions, paralleling the evidence of animal studies, demonstrated a loss of multisensory enhancement, in contrast with control subjects, providing the first lesional evidence in humans of the essential role of SC in mediating audio-visual integration. Experiment 2 investigated the role of cortex in mediating multisensory integrative effects, inducing virtual lesions by inhibitory theta-burst stimulation on temporo-parietal cortex, occipital cortex and posterior parietal cortex, demonstrating that only temporo-parietal cortex was causally involved in modulating the integration of audio-visual stimuli at the same spatial location. Given the involvement of the retino-colliculo-extrastriate pathway in mediating audio-visual integration, the functional sparing of this circuit in hemianopic patients is extremely relevant in the perspective of a multisensory-based approach to the recovery of unisensory defects. Experiment 3 demonstrated the spared functional activity of this circuit in a group of hemianopic patients, revealing the presence of implicit recognition of the fearful content of unseen visual stimuli (i.e. affective blindsight), an ability mediated by the retino-colliculo-extrastriate pathway and its connections with amygdala. Finally, Experiment 4 provided evidence that a systematic audio-visual stimulation is effective in inducing long-lasting clinical improvements in patients with visual field defect and revealed that the activity of the spared retino-colliculo-extrastriate pathway is responsible of the observed clinical amelioration, as suggested by the greater improvement observed in patients with cortical lesions limited to the occipital cortex, compared to patients with lesions extending to other cortical areas, found in tasks high demanding in terms of spatial orienting. Overall, the present results indicated that multisensory integration is mediated by the retino-colliculo-extrastriate pathway and that a systematic audio-visual stimulation, activating this spared neural circuit, is able to affect orientation towards the blind field in hemianopic patients and, therefore, might constitute an effective and innovative approach for the rehabilitation of unisensory visual impairments.

Intrazelluläre Lokalisation und synaptische Ausschüttung der Neurotrophine in hippokampalen Neuronen und die Bedeutung von BDNF bei hippokampaler synaptischer Plastizität

Die Mitglieder der Neurotrophin-Familie (NGF, BDNF, NT-3 und NT-4) sind sekretierte Neuropeptide, die eine bedeutende Rolle bei der Entwicklung von Nervenzellen und bei der Modulation der synaptischen Transmission spielen. Wenngleich eine aktivitätsabhängige Sekretion von BDNF bereits gezeigt werden konnte, wurden die subzelluläre Expression und die Ausschüttung der anderen Neurotrophine bislang nur unzureichend charakterisiert. Um die Expression und die Ausschüttung aller Neurotrophine unter identischen Bedingungen untersuchen zu können, wurde in der vorliegenden Arbeit das Expressionsmuster und die synaptische Ausschüttung GFP-markierter Neurotrophine in dissoziierten hippokampalen Neuronen mit Hilfe der konfokalen Fluoreszenz-Videomikroskopie zeitaufgelöst untersucht. Zwei Phänotypen konnten unterschieden werden: der distale vesikuläre Expressionstyp mit Neurotrophin-beinhaltenden Vesikeln in distalen Neuriten, und der proximale Expressionstyp mit einer diffusen Neurotrophin-Verteilung in den Neuriten und Neurotrophin-beinhaltenden Vesikeln im Soma des Neurons und in den proximalen Dendriten. Der distale vesikuläre Phänotyp entsprach einer Verteilung des entsprechenden Neurotrophins in die sekretorischen Granula des aktivitätsabhängigen Sekretionsweges, während der proximale Phänotyp den Transport eines Neurotrophins in den konstitutiven Sekretionsweg widerspiegelte. Alle Neurotrophine erreichten in hippokampalen Neuronen prinzipiell beide Sekretionswege. Jedoch gelangten BDNF und NT-3 mit einer größeren Effizienz in den regulierten Sekretionsweg als NT-4 und NGF (BDNF: in 98% aller Zellen, NT-3: 85%, NT-4: 23% und NGF: 46%). Neurotrophine besitzen, wie es für sekretorische Peptide üblich ist, eine Vorläufersequenz, die während der Reifung des Proteins proteolytisch abgespalten wird. Die Fusion dieser Präpro-Sequenz von BDNF mit der Sequenz des maturen NT-4 bewirkte einen effizienteren Transport von NT-4 in die sekretorischen Granula des regulierten Sekretionsweges, und zeigte die große Bedeutung der Präpro-Sequenz für das zelluläre Verteilungsmuster von Neurotrophinen. In Neuronen, in denen die Neurotrophine in den regulierten Sekretionsweg transportiert wurden, konnte eine aktivitätsabhängige Sekretion der Neurotrophine an postsynaptische Strukturen glutamaterger Synapsen beobachtet werden. Die aktivitätsabhängige postsynaptische Ausschüttung der Neurotrophine zeigte eine Heterogenität in der Kinetik der Sekretion (exponentieller Abfall des Neurotrophin-Signals mit Zeitkonstanten von tau = 121 bis 307s). Die Präinkubtion mit dem Protonen-Ionophor Monensin, welcher die Neutralisation des intragranulären pH-Wertes und somit die Solubilisierung der dicht gepackten Proteinstrukturen in den Vesikeln erzwingt, erhöhte die Geschwindigkeit der Neurotrophin-Ausschüttung auf den Wert des unter physiologischen Bedingungen schnellsten Neurotrophins NT-4. Dennoch blieb die Geschwindigkeit der Neurotrophin-Ausschüttung im Vergleich zur Neurotransmitter-Ausschüttung langsam (tau = 13 ± 2 s). Diese Daten belegen eindeutig, dass die Neutralisation der sekretorischen Granula die Geschwindigkeit der Neurotrophin-Ausschüttung kritisch determiniert und die Geschwindigkeit der Neurotrophin-Ausschüttung im Vergleich zur konventionellen Neurotransmitter-Ausschüttung langsam erfolgt. Des Weiteren konnte gezeigt werden, dass das Neurotrophin BDNF effizient in distale vesikuläre Strukturen von CA1 Pyramidenzellen organotypischer Schnittkulturen des Hippokampus sortiert wird. Die basalen elektrischen Eigenschaften von CA1 Pyramidenzellen BDNF-defizienter Mäuse sind vergleichbar zu den Eigenschaften von Wildtyp Mäusen. Sowohl das Eigenpotential der CA1 Pyramidenzellen, die Form der Aktionspotentiale als auch die evozierten Antworten der CA1 Pyramdenzellen auf eine gepaarte präsynaptische Stimulation der Schaffer-Kollateralen zeigten bei BDNF-/- -, BDNF+/- - und BDNF+/+ -Mäusen keine signifikanten Unterschiede. Die Fähigkeit der CA1 Pyramidenzellen auf eine hochfrequente Reizung mit einer Langzeitpotenzierung (LTP) der postsynaptischen Ströme zu reagieren ist jedoch bei den BDNF-defizienten Mäusen beinträchtigt. Eine verminderte Induktion von LTP war in den BDNF-defizienten Mäusen nach tetanischer Stimulation der präsynaptischen Schaffer-Kollateralen und simultaner postsynaptischer Depolarisation der CA1 Pyramidenzelle zu beobachten.

Disrupting frontal eye-field activity impairs memory recall

A large body of research demonstrated that participants preferably look back to the encoding location when retrieving visual information from memory. However, the role of this 'looking back to nothing' is still debated. The goal of the present study was to extend this line of research by examining whether an important area in the cortical representation of the oculomotor system, the frontal eye field (FEF), is involved in memory retrieval. To interfere with the activity of the FEF, we used inhibitory continuous theta burst stimulation (cTBS). Before stimulation was applied, participants encoded a complex scene and performed a short-term (immediately after encoding) or long-term (after 24 h) recall task, just after cTBS over the right FEF or sham stimulation. cTBS did not affect overall performance, but stimulation and statement type (object vs. location) interacted. cTBS over the right FEF tended to impair object recall sensitivity, whereas there was no effect on location recall sensitivity. These findings suggest that the FEF is involved in retrieving object information from scene memory, supporting the hypothesis that the oculomotor system contributes to memory recall.

Glycine-induced long-term potentiation is associated with structural and functional modifications of α-amino-3-hydroxyl-5-methyl-4-isoxazolepropionic acid receptors

Global long-term potentiation (LTP) was induced in organotypic hippocampal slice cultures by a brief application of 10 mM glycine. Glycine-induced LTP was occluded by previous theta burst stimulation-induced potentiation, indicating that both phenomena share similar cellular processes. Glycine-induced LTP was associated with increased [3H]α-amino-3-hydroxyl-5-methyl-4-isoxazolepropionic acid (AMPA) binding in membrane fractions as well as increased amount of a selective spectrin breakdown product generated by calpain-mediated spectrin proteolysis. Antibodies against the C-terminal (C-Ab) and N-terminal (N-Ab) domains of GluR1 subunits were used to evaluate structural changes in AMPA receptor properties resulting from glycine-induced LTP. No quantitative or qualitative changes were observed in Western blots from membrane fractions prepared from glycine-treated slices with C-Ab. In contrast, Western blots stained with N-Ab revealed the formation of a 98-kDa species of GluR1 subunits as well as an increased amount of immunoreactivity after glycine-induced LTP. The amount of spectrin breakdown product was positively correlated with the amount of the 98-kDa species of GluR1 after glycine treatment. Functional modifications of AMPA receptors were evaluated by determining changes in the effect of pressure-applied AMPA on synaptic responses before and after glycine-induced LTP. Glycine treatment produced a significant increase in AMPA receptor function after potentiation that correlated with the degree of potentiation. The results indicate that LTP induction produces calpain activation, truncation of the C-Ab domain of GluR1 subunits of AMPA receptors, and increased AMPA receptor function. They also suggest that insertion of new receptors takes place after LTP induction.

Short-term synaptic enhancement and long-term potentiation in neocortex.

Repetitive stimuli reliably induce long-term potentiation (LTP) of synapses in the upper layers of the granular somatosensory cortex but not the agranular motor cortex of rats. Herein we examine, in these same cortical areas, short-term changes in synaptic strength that occur during the LTP induction period. theta-Burst stimulation produced a strong short-term enhancement of synapses in the granular area but only weak enhancement in the agranular area. The magnitude of enhancement during stimulation was strongly correlated with the magnitude of LTP subsequently expressed. Short-term enhancement was abolished by an antagonist of N-methyl-D-aspartate (NMDA) receptors but remained in the presence of a non-NMDA receptor antagonist. Inhibitory postsynaptic potentials of the granular and agranular areas displayed similar frequency sensitivity, but the frequency sensitivity of NMDA receptor-dependent excitatory postsynaptic potentials differed significantly between areas. We propose that pathway-specific differences in short-term enhancement are due to variations in the frequency dependence of NMDA currents; different capacities for short-term enhancement may explain why repetitive stimulation more readily induces LTP in the somatosensory cortex than in the motor cortex.

Multimodal characterisation of sensorimotor oscillations

The studies in this project have investigated the ongoing neuronal network oscillatory activity found in the sensorimotor cortex using two modalities: magnetoencephalography (MEG) and in vitro slice recordings. The results have established that ongoing sensorimotor oscillations span the mu and beta frequency region both in vitro and in MEG recordings, with distinct frequency profiles for each recorded laminae in vitro, while MI and SI show less difference in humans. In addition, these studies show that connections between MI and SI modulate the ongoing neuronal network activity in these areas. The stimulation studies indicate that specific frequencies of stimulation affect the ongoing activity in the sensorimotor cortex. The continuous theta burst stimulation (cTBS) study demonstrates that cTBS predominantly enhances the power of the local ongoing activity. The stimulation studies in this project show limited comparison between modalities, which is informative of the role of connectivity in these effects. However, independently these studies provide novel information on the mechanisms on sensorimotor oscillatory interaction. The pharmacological studies reveal that GABAergic modulation with zolpidem changes the neuronal oscillatory network activity in both healthy and pathological MI. Zolpidem enhances the power of ongoing oscillatory activity in both sensorimotor laminae and in healthy subjects. In contrast, zolpidem attenuates the “abnormal” beta oscillatory activity in the affected hemisphere in Parkinsonian patients, while restoring the hemispheric beta power ratio and frequency variability and thereby improving motor symptomatology. Finally we show that independent signals from MI laminae can be integrated in silico to resemble the aggregate MEG MI oscillatory signals. This highlights the usefulness of combining these two methods when elucidating neuronal network oscillations in the sensorimotor cortex and any interventions.

Effets de la stimulation magnétique transcrânienne dans la maladie de Parkinson avec déficits cognitifs légers

Beaucoup de patients atteints de la maladie de Parkinson (MP) peuvent souffrir de troubles cognitifs dès les étapes initiales de la maladie et jusqu’à 80% d’entre eux vont développer une démence. Des altérations fonctionnelles au niveau du cortex préfrontal dorsolatéral (CPFDL), possiblement en relation avec le noyau caudé, seraient à l’origine de certains de ces déficits cognitifs. Des résultats antérieurs de notre groupe ont montré une augmentation de l’activité et de la connectivité dans la boucle cortico-striatale cognitive suite à la stimulation magnétique transcrânienne (SMT) utilisant des paramètres « theta burst » intermittent (iTBS) sur le CPFDL gauche. Pour cette étude, 24 patients atteints de la MP avec des troubles cognitifs ont été séparées en 2 groupes : le groupe iTBS active (N=15) et le groupe sham (stimulation simulée, N=9). Une batterie neuropsychologique détaillée évaluant cinq domaines cognitifs (attention, fonctions exécutives, langage, mémoire et habiletés visuo-spatiales) a été administrée lors des jours 1, 8, 17 et 37. Le protocole iTBS a été appliqué sur le CPFDL gauche durant les jours 2, 4 et 7. Les scores z ont été calculés pour chaque domaine cognitif et pour la cognition globale. Les résultats ont montré une augmentation significative de la cognition globale jusqu’à 10 jours suivant l’iTBS active, particulièrement au niveau de l’attention, des fonctions exécutives et des habiletés visuo-spatiales. Cet effet sur la cognition globale n’est pas répliqué dans le groupe sham. Ces résultats suggèrent donc que l’iTBS peut moduler la performance cognitive chez les patients atteints de MP avec des déficits cognitifs.

The link between visual exploration and neuronal activity: A multi-modal study combining eye tracking, functional magnetic resonance imaging and transcranial magnetic stimulation

In the present multi-modal study we aimed to investigate the role of visual exploration in relation to the neuronal activity and performance during visuospatial processing. To this end, event related functional magnetic resonance imaging er-fMRI was combined with simultaneous eye tracking recording and transcranial magnetic stimulation (TMS). Two groups of twenty healthy subjects each performed an angle discrimination task with different levels of difficulty during er-fMRI. The number of fixations as a measure of visual exploration effort was chosen to predict blood oxygen level-dependent (BOLD) signal changes using the general linear model (GLM). Without TMS, a positive linear relationship between the visual exploration effort and the BOLD signal was found in a bilateral fronto-parietal cortical network, indicating that these regions reflect the increased number of fixations and the higher brain activity due to higher task demands. Furthermore, the relationship found between the number of fixations and the performance demonstrates the relevance of visual exploration for visuospatial task solving. In the TMS group, offline theta bursts TMS (TBS) was applied over the right posterior parietal cortex (PPC) before the fMRI experiment started. Compared to controls, TBS led to a reduced correlation between visual exploration and BOLD signal change in regions of the fronto-parietal network of the right hemisphere, indicating a disruption of the network. In contrast, an increased correlation was found in regions of the left hemisphere, suggesting an intent to compensate functionality of the disturbed areas. TBS led to fewer fixations and faster response time while keeping accuracy at the same level, indicating that subjects explored more than actually needed.

Effets de la stimulation magnétique transcrânienne dans la maladie de Parkinson avec déficits cognitifs légers

Beaucoup de patients atteints de la maladie de Parkinson (MP) peuvent souffrir de troubles cognitifs dès les étapes initiales de la maladie et jusqu’à 80% d’entre eux vont développer une démence. Des altérations fonctionnelles au niveau du cortex préfrontal dorsolatéral (CPFDL), possiblement en relation avec le noyau caudé, seraient à l’origine de certains de ces déficits cognitifs. Des résultats antérieurs de notre groupe ont montré une augmentation de l’activité et de la connectivité dans la boucle cortico-striatale cognitive suite à la stimulation magnétique transcrânienne (SMT) utilisant des paramètres « theta burst » intermittent (iTBS) sur le CPFDL gauche. Pour cette étude, 24 patients atteints de la MP avec des troubles cognitifs ont été séparées en 2 groupes : le groupe iTBS active (N=15) et le groupe sham (stimulation simulée, N=9). Une batterie neuropsychologique détaillée évaluant cinq domaines cognitifs (attention, fonctions exécutives, langage, mémoire et habiletés visuo-spatiales) a été administrée lors des jours 1, 8, 17 et 37. Le protocole iTBS a été appliqué sur le CPFDL gauche durant les jours 2, 4 et 7. Les scores z ont été calculés pour chaque domaine cognitif et pour la cognition globale. Les résultats ont montré une augmentation significative de la cognition globale jusqu’à 10 jours suivant l’iTBS active, particulièrement au niveau de l’attention, des fonctions exécutives et des habiletés visuo-spatiales. Cet effet sur la cognition globale n’est pas répliqué dans le groupe sham. Ces résultats suggèrent donc que l’iTBS peut moduler la performance cognitive chez les patients atteints de MP avec des déficits cognitifs.