Non-invasive brain stimulation for the management of arterial hypertension

The neural control of the cardiovascular system is a complex process that involves many structures at different levels of nervous system. Several cortical areas are involved in the control of systemic blood pressure, such as the sensorimotor cortex, the medial prefrontal cortex and the insular cortex. Non-invasive brain stimulation techniques - repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) - induce sustained and prolonged functional changes of the human cerebral cortex. rTMS and tDCS has led to positive results in the treatment of some neurological and psychiatric disorders. Because experiments in animals show that cortical modulation can be an effective method to regulate the cardiovascular system, non-invasive brain stimulation might be a novel tool in the therapeutics of human arterial hypertension. We here review the experimental evidence that non-invasive brain stimulation can influence the autonomic nervous system and discuss the hypothesis that focal modulation of cortical excitability by rTMS or tDCS can influence sympathetic outflow and, eventually, blood pressure, thus providing a novel therapeutic tool for human arterial hypertension. (C) 2009 Published by Elsevier Ltd.

0.1T magnetic resonance image in the study of experimental hydrocephalus in rats. Accuracy of the method in the measurements of the ventricular size

PURPOSE: To investigate the accuracy of 1.0T Magnetic Resonance Imaging (MRI) to measure the ventricular size in experimental hydrocephalus in pup rats. METHODS: Wistar rats were subjected to hydrocephalus by intracisternal injection of 20% kaolin (n=13). Ten rats remained uninjected to be used as controls. At the endpoint of experiment animals were submitted to MRI of brain and killed. The ventricular size was assessed using three measures: ventricular ratio (VR), the cortical thickness (Cx) and the ventricles area (VA), performed on photographs of anatomical sections and MRI. RESULTS: The images obtained through MR present enough quality to show the lateral ventricular cavities but not to demonstrate the difference between the cortex and the white matter, as well as the details of the deep structures of the brain. There were no statistically differences between the measures on anatomical sections and MRI of VR and Cx (p=0.9946 and p=0.5992, respectively). There was difference between VA measured on anatomical sections and MRI (p<0.0001). CONCLUSION: The parameters obtained through 1.0T MRI were sufficient in quality to individualize the ventricular cavities and the cerebral cortex, and to calculate the ventricular ratio in hydrocephalus rats when compared to their respective anatomic slice.

Experimental hyperprolinemia induces mild oxidative stress, metabolic changes, and tissue adaptation in rat liver

The present study investigated the effects of chronic hyperprolinemia on oxidative and metabolic status in liver and serum of rats. Wistar rats received daily subcutaneous injections of proline from their 6th to 28th day of life. Twelve hours after the last injection the rats were sacrificed and liver and serum were collected. Results showed that hyperprolinemia induced a significant reduction in total antioxidant potential and thiobarbituric acid-reactive substances. The activities of the antioxidant enzymes catalase and superoxide dismutase were significantly increased after chronic proline administration, while glutathione (GSH) peroxidase activity, dichlorofluorescin oxidation, GSH, sulfhydryl, and carbonyl content remained unaltered. Histological analyses of the liver revealed that proline treatment induced changes of the hepatic microarchitecture and increased the number of inflammatory cells and the glycogen content. Biochemical determination also demonstrated an increase in glycogen concentration, as well as a higher synthesis of glycogen in liver of hyperprolinemic rats. Regarding to hepatic metabolism, it was observed an increase on glucose oxidation and a decrease on lipid synthesis from glucose. However, hepatic lipid content and serum glucose levels were not changed. Proline administration did not alter the aminotransferases activities and serum markers of hepatic injury. Our findings suggest that hyperprolinemia alters the liver homeostasis possibly by induction of a mild degree of oxidative stress and metabolic changes. The hepatic alterations caused by proline probably do not implicate in substantial hepatic tissue damage, but rather demonstrate a process of adaptation of this tissue to oxidative stress. However, the biological significance of these findings requires additional investigation. J. Cell. Biochem. 113: 174183, 2012. (C) 2011 Wiley Periodicals, Inc.

Permanent anosmia and ageusia after resection of a left temporoinsular low-grade glioma: anatomofunctional considerations

Five percent of the general population has olfactory or gustatory disorders, although most do not complain about it. However, in some cases, these symptoms can be disabling and may affect quality of life. Anosmia was reported as a possible complication following head injury and neurosurgical procedures, particularly after the resection of tumors located in the anterior fossa and the treatment of aneurysms in the anterior circulation. Nonetheless, in all of these situations, olfactory dysfunction could be explained by damage to the peripheral olfactory system. Here, the authors report a case of complete anosmia associated with ageusia following awake resection of a low-grade glioma involving the left temporoinsular region, with no recovery during a follow-up of 3 years. The frontal lobe was not retracted, and the olfactory tract was not visualized during surgery; therefore, postoperative anosmia and ageusia are likely explained by damage to the cortex and central pathways responsible for these senses. The authors suggest that the patient might have had a subclinical right hemianosmia before surgery, which is a common condition. After resection of the central structures critical for smell and taste processing in the left hemisphere, the patient could have finally had bilateral and complete olfactory and gustatory loss. This is the first known report of permanent anosmia and ageusia following glioma surgery. Because these symptoms might have been underestimated, more attention should be devoted to olfaction and taste, especially with regard to possible subclinical preoperative deficit. (http://thejns.org/doi/abs/10.3171/2012.2.JNS111982)

Can neuroimaging be used as a support to diagnosis of borderline personality disorder? An approach based on computational neuroanatomy and machine learning

Several recent studies in literature have identified brain morphological alterations associated to Borderline Personality Disorder (BPD) patients. These findings are reported by studies based on voxel-based-morphometry analysis of structural MRI data, comparing mean gray-matter concentration between groups of BPD patients and healthy controls. On the other hand, mean differences between groups are not informative about the discriminative value of neuroimaging data to predict the group of individual subjects. In this paper, we go beyond mean differences analyses, and explore to what extent individual BPD patients can be differentiated from controls (25 subjects in each group), using a combination of automated-morphometric tools for regional cortical thickness/volumetric estimation and Support Vector Machine classifier. The approach included a feature selection step in order to identify the regions containing most discriminative information. The accuracy of this classifier was evaluated using the leave-one-subject-out procedure. The brain regions indicated as containing relevant information to discriminate groups were the orbitofrontal, rostral anterior cingulate, posterior cingulate, middle temporal cortices, among others. These areas, which are distinctively involved in emotional and affect regulation of BPD patients, were the most informative regions to achieve both sensitivity and specificity values of 80% in SVM classification. The findings suggest that this new methodology can add clinical and potential diagnostic value to neuroimaging of psychiatric disorders. (C) 2012 Elsevier Ltd. All rights reserved.

Mechanismen der Caveolin-Genregulation in neuralen Zellsystemen

Caveolae sind vesikuläre Invaginationen der eukaryontischen Zellmembran, die bei einer Vielzahl zellbiologischer Prozesse eine bedeutende Rolle spielen. Die strukturellen und funktionellen Hauptbestandteile der Caveolae sind die Caveolin-Proteine, welche von drei homologen Genen (Caveolin-1,-2,-3) kodiert werden. Die Caveoline stellen die Struktur-Organisatoren der Caveolae dar, und regulieren direkt die Aktivität von zahlreichen Caveolae-assoziierten Rezeptorproteinen und Signalmolekülen. Oftmals werden die pleiotropen Effekte der Caveoline über eine Veränderung der Caveolin-Genexpressionsstärke moduliert. In der vorliegenden Arbeit wurden drei unterschiedliche biologische Steuerfaktoren identifiziert, unter deren Kontrolle die Caveolin-Genexpression in neuralen Zellsystemen steht. Bei diesen Faktoren handelt es sich um das Steroidhormon Oestrogen und seine Rezeptoren, den Wachstumsfaktor TGFa und den sekundären Botenstoff zyklisches AMP (cAMP). Oestrogen wirkt über die Aktivierung von Oestrogen-Rezeptoren (ERs) im zentralen Nervensystem in der Regel als neurotropher Faktor. In der vorliegenden Arbeit konnte erstmalig gezeigt werden, daß in humanen Neuroblastom-Zellen (SK-N-MC) die stabile, rekombinante Expression des ERa-Subtyps zu einer drastischen Reduktion der Caveolin-1/-2-Transkription führt, und daß in der Folge die zelluläre Caveolin-Biosynthese eingestellt wird. Eine Analyse des Caveolin-1-Gens ergab, daß einhergehend mit der Inaktivierung der Caveolin-1-Transkription eine Vielzahl der im Promoter enthaltenen CpG-Dinukleotide methyliert vorliegen. Durch pharmakologische Inhibition der nukleären DNA-Methyltransferasen sowie der Histon-Deacetylasen konnte die Caveolin-1-Transkription teilweise wiederhergestellt werden. Diese Befunde lassen auf die Existenz eines DNA-Methylierungs-abhängigen Stilllegungsmechanismus der Caveolin-Genexpression durch ERa schließen. Dagegen führte die Überexpression des ERb-Subtyps in SK-N-MC-Zellen zu keiner Veränderung der Caveolin-1/-2-Expression. Interessanterweise wurde die supprimierende Wirkung des ERa durch die gleichzeitige Überexpression des ERb vollständig aufgehoben. Der mitogene Wachstumsfaktor TGFa wurde als zweites extrazelluläres Signalmolekül identifiziert, welches eine Reduktion der Caveolin-1/-2-Genexpression bewirkt. In primären kortikalen Astrozyten konnte gezeigt werden, daß TGFa seine supprimierende Wirkung auf die Caveolin-1-Expression partiell über die Aktivierung des PI3-Kinase-abhängigen Signalweges vermittelt. Zudem wurde die supprimierende Wirkung von TGFa durch einen Inhibitior der Histon-Deacetylasen relativiert. Daher scheinen sowohl für den ERa als auch für TGFa epigenetische Prozesse bei der Suppression der Caveolin-1-Genexpression eine entscheidende Rolle zu spielen. Intrazellulär wirkte neben der PI3-Kinase auch der Botenstoff cAMP in kortikalen Astrozyten als Suppressor der Caveolin-Genexpression. Es wäre denkbar, daß die Caveolin-Suppression funktioneller Bestandteil des seit langem etablierten Effekts der cAMP-induzierten Astrozyten-Differenzierung ist. Desweiteren wiesen der cAMP- und TGFa-abhängige Signalweg ein überlappendes, Gehirnregion-spezifisches Regulationsprofil der Caveolin-Expression in Astrozyten auf: während in Kortex und Striatum eine Regulation durch cAMP und TGFa erfolgte, blieb diese in Klein- und Zwischenhirn aus. Somit bewirken drei zentrale regulatorische Faktoren der Proliferation und Differenzierung neuraler Zellen eine Reduktion in der Konzentration der pleiotrop funktionellen Caveoline. Zukünftige Studien müssen zeigen, inwieweit die reduzierte Caveolin-Expression für die morphologischen und biochemischen Primärwirkungen dieser Faktoren während der Entwicklung und im Zuge der Tumorgenese mitverantwortlich ist. Außerdem könnten über die Beobachtungen der zellbiologischen Auswirkungen reduzierter Caveolin-Spiegel neue Erkenntnisse über die Funktion dieser Proteine gewonnen werden.

Aktivitätsabhängige Kontrolle der Apoptose in neonatalen kortikalen Neuronen und Etablierung eines Biosensors zur Echtzeitanalyse der Caspase-3-Aktivierung

Die Apoptose spielt eine entscheidende Rolle während der normalen Entwicklung des zentralen Nervensystems. Elektrische Aktivität und die Versorgung mit trophischen Faktoren sind ausschlaggebend für das Überleben von Neuronen. Um zu untersuchen, welche zellulären Prozesse die aktivitätsabhängige Apoptose in organotypischen Schnittkulturen des neugeborenen Neokortex beeinflussen, wurde in der vorliegenden Arbeit immunzytochemisch das Auftreten aktivierter Caspase-3, nach pharmakologischer Beeinflussung von Ionenkanälen und membranständigen Rezeptoren analysiert. Die Unterdrückung neuronaler Aktivität durch den Natriumionenkanalblocker TTX führte zu einem signifikanten Verlust kortikaler Neuronen. Ein ähnlicher Anstieg der Zahl apoptotischer Neurone konnte durch Applikation von Antagonisten ionotroper Glutamatrezeptoren, GABAA-Rezeptoren oder neuronaler Gap Junctions induziert werden. Jedoch konnte bei einigen Antagonisten die apoptosefördernde Wirkung erst nach längerer Einwirkung beobachtet werden. Im Weiteren wurde eine Methode etabliert, mit deren Hilfe eine Echtzeitanalyse der Apoptose kortikaler Neurone unter dem Entzug trophischer Faktoren in Gegenwart unterschiedlicher extrazellulärer Kaliumkonzentrationen ermöglicht wurde. Dazu wurden dissoziierte kortikale Kulturen mit dem pCaspase3-sensor Vektor transfiziert. Das durch dieses Plasmid codierte fluoreszente Protein wird Caspase-3 abhängig gespalten. In der vorliegenden Arbeit konnte gezeigt werden, dass der Caspase3-sensor spezifisch für die Aktivierung der Caspase-3 ist, und dass die Überlebensfähigkeit der transfizierten Neurone durch das Transfektionsprotokoll nicht beeinflusst wird.

Die Rolle von GABA- und Glyzinrezeptoren während der radialen Migration kortikaler Neurone in der pränatalen Maus

Für die Entwicklung des zerebralen Kortex ist die radiale Migration von Neuronen von elementarer Bedeutung. Für diese radiale Migration sind extrazelluläre Signale, die mit den Neuronen interagieren und eine Umgestaltung des Zytoskeletts vermitteln, notwendig. Zu den extrazellulären Signalen gehört auch der Neurotransmitter GABA, der über Depolarisation der Neurone einen Ca2+-Einstrom vermittelt und dadurch die Modulation der Migration über Ca2+-abhängige Signalwege ermöglicht. Auch von Taurin ist bekannt, dass es die neuronale Migration beeinflusst. Frühere Studien zeigten, dass die Depolarisation von GABAA-Rezeptoren durch GABA zu einem Migrationsstop führt, wohingegen Picrotoxin-sensitive Rezeptoren die Migration von der Ventrikulären Zone in die Intermediäre Zone des pränatalen Kortex vermitteln. Obwohl zu den Picrotoxin-sensitiven Rezeptoren GABAA-, GABAC- und bestimmte Glyzinrezeptoren gehören, wurde die Rolle von GABAC- und Glyzinrezeptoren während der radialen Migration nie überprüft. Ziel dieser Dissertation war deshalb, den Einfluss von GABAC- und Glyzinrezeptoren auf die radiale Migration zu untersuchen. Unter Verwendung von Migrationsanalysen, Fluoreszenzmessungen, molekularbiologischen und histologischen Methoden wurde gezeigt, dass GABAC-Rezeptoren im unteren Bereiche des präfrontalen Kortex exprimiert werden, ihre Aktivierung durch GABA in der Intermediären Zone zu einer Depolarisation führt, dass GABAC-Rezeptoren die Migration fördern und dieser Effekt über den migrationsstoppenden Effekt der GABAA-Rezeptoren dominiert. Durch Aktivierung der Glyzinrezeptoren fördert Taurin die Migration.

Membrane properties and synaptic integration of identified neuronal populations in the developing rodent neocortex

In my PhD work I concentrated on three elementary questions that are essential to understand the interactions between the different neuronal cell populations in the developing neocortex. The questions regarded the identity of Cajal-Retzius (CR) cells, the ubiquitous expression of glycine receptors in all major cell populations of the immature neocortex, and the role of taurine in the modulation of immature neocortical network activity.rnTo unravel whether CR cells of different ontogenetic origin have divergent functions I investigated the electrophysiological properties of YFP+ (derived from the septum and borders of the pallium) and YFP− CR cells (derived from other neocortical origins). This study demonstrated that the passive and active electrophysiological properties as well as features of GABAergic PSCs and glutamatergic currents are similar between both CR cell populations. These findings suggest that CR cells of different origins most probably support similar functions within the neuronal networks of the early postnatal cerebral cortex.rnTo elucidate whether glycine receptors are expressed in all major cell populations of the developing neocortex I analyzed the functional expression of glycine receptors on subplate (SP) cells. Activation of glycine receptors by glycine, -alanine and taurine elicited membrane responses that could be blocked by the selective glycinergic antagonist strychnine. Pharmacological experiments suggest that SP cells express functional heteromeric glycine receptors that do not contain 1 subunits. The activation of glycine receptors by glycine and taurine induced a membrane depolarization, which mediated excitatory effects. Considering the key role of SP cells in immature cortical networks and the development of thalamocortical connections, this glycinergic excitation may influence the properties of early cortical networks and the formation of cortical circuits.rnIn the third part of my project I demonstrated that tonic taurine application induced a massive increase in the frequency of PSCs. Based on their reversal potential and their pharmacological properties these taurine-induced PSCs are exclusively transmitted via GABAA receptors to the pyramidal neurons, while both GABAA and glycine receptors were implicated in the generation of the presynaptic activity. Accordingly, whole-cell and cell-attached recordings from genetically labeled interneurons revealed the expression of glycine and GABAA receptors, which mediated an excitatory action on these cells. These findings suggest that low taurine concentrations can tonically activate exclusively GABAergic networks. The activity level maintained by this GABAergic activity in the immature nervous system may contribute to network properties and can facilitate the activity dependent formation of adequate synaptic projections.rnIn summary, the results of my studies complemented the knowledge about neuronal interactions in the immature neocortex and improve our understanding of cellular processes that guide neuronal development and thus shape the brain.rn

Histological evidence of delayed ischemic brain tissue damage in the rat double-hemorrhage model

The rat double-SAH model is one of the standard models to simulate delayed cerebral vasospasm (CVS) in humans. However, the proof of delayed ischemic brain damage is missing so far. Our objective was, therefore, to determine histological changes in correlation with the development of symptomatic and perfusion weighted imaging (PWI) proven CVS in this animal model. CVS was induced by injection of autologous blood in the cisterna magna of 22 Sprague-Dawley rats. Histological changes were analyzed on day 3 and day 5. Cerebral blood flow (CBF) was assessed by PWI at 3 tesla magnetic resonance (MR) tomography. Neuronal cell count did not differ between sham operated and SAH rats in the hippocampus and the cerebral cortex on day 3. In contrast, on day 5 after SAH the neuronal cell count was significantly reduced in the hippocampus (p<0.001) and the inner cortical layer (p=0.03). The present investigation provides quantitative data on brain tissue damage in association with delayed CVS for the first time in a rat SAH model. Accordingly, our data suggest that the rat double-SAH model may be suitable to mimic delayed ischemic brain damage due to CVS and to investigate the neuroprotective effects of drugs.

Rapid adaptation of visual search in simulated hemianopia

Patients with homonymous hemianopia have altered visual search patterns, but it is unclear how rapidly this develops and whether it reflects a strategic adaptation to altered perception or plastic changes to tissue damage. To study the temporal dynamics of adaptation alone, we used a gaze-contingent display to simulate left or right hemianopia in 10 healthy individuals as they performed 25 visual search trials. Visual search was slower and less accurate in hemianopic than in full-field viewing. With full-field viewing, there were improvements in search speed, fixation density, and number of fixations over the first 9 trials, then stable performance. With hemianopic viewing, there was a rapid shift of fixation into the blind field over the first 5-7 trials, followed by continuing gradual improvements in completion time, number of fixations, and fixation density over all 25 trials. We conclude that in the first minutes after onset of hemianopia, there is a biphasic pattern of adaptation to altered perception: an early rapid qualitative change that shifts visual search into the blind side, followed by more gradual gains in the efficiency of using this new strategy, a pattern that has parallels in other studies of motor learning.

Sex Differences in Semantic Processing: Event-Related Brain Potentials Distinguish between Lower and Higher Order Semantic Analysis during Word Reading

Behavioral studies suggest that women and men differ in the strategic elaboration of verbally encoded information especially in the absence of external task demand. However, measuring such covert processing requires other than behavioral data. The present study used event-related potentials to compare sexes in lower and higher order semantic processing during the passive reading of semantically related and unrelated word pairs. Women and men showed the same early context effect in the P1-N1 transition period. This finding indicates that the initial lexical-semantic access is similar in men and women. In contrast, sexes differed in higher order semantic processing. Women showed an earlier and longer lasting context effect in the N400 accompanied by larger signal strength in temporal networks similarly recruited by men and women. The results suggest that women spontaneously conduct a deeper semantic analysis. This leads to faster processing of related words in the active neural networks as reflected in a shorter stability of the N400 map in women. Taken together, the findings demonstrate that there is a selective sex difference in the controlled semantic analysis during passive word reading that is not reflected in different functional organization but in the depth of processing.

Spastin in the human and mouse central nervous system with special reference to its expression in the hippocampus of mouse pilocarpine model of status epilepticus and temporal lobe epilepsy

In the present in situ hybridization and immunocytochemical studies in the mouse central nervous system (CNS), a strong expression of spastin mRNA and protein was found in Purkinje cells and dentate nucleus in the cerebellum, in hippocampal principal cells and hilar neurons, in amygdala, substantia nigra, striatum, in the motor nuclei of the cranial nerves and in different layers of the cerebral cortex except piriform and entorhinal cortices where only neurons in layer II were strongly stained. Spastin protein and mRNA were weakly expressed in most of the thalamic nuclei. In selected human brain regions such as the cerebral cortex, cerebellum, hippocampus, amygdala, substania nigra and striatum, similar results were obtained. Electron microscopy showed spastin immunopositive staining in the cytoplasma, dendrites, axon terminals and nucleus. In the mouse pilocarpine model of status epilepticus and subsequent temporal lobe epilepsy, spastin expression disappeared in hilar neurons as early as at 2h during pilocarpine induced status epilepticus, and never recovered. At 7 days and 2 months after pilocarpine induced status epilepticus, spastin expression was down-regulated in granule cells in the dentate gyrus, but induced expression was found in reactive astrocytes. The demonstration of widespread distribution of spastin in functionally different brain regions in the present study may provide neuroanatomical basis to explain why different neurological, psychological disorders and cognitive impairment occur in patients with spastin mutation. Down-regulation or loss of spastin expression in hilar neurons may be related to their degeneration and may therefore initiate epileptogenetic events, leading to temporal lobe epilepsy.

Rising sound intensity: an intrinsic warning cue activating the amygdala

Human subjects overestimate the change of rising intensity sounds compared with falling intensity sounds. Rising sound intensity has therefore been proposed to be an intrinsic warning cue. In order to test this hypothesis, we presented rising, falling, and constant intensity sounds to healthy humans and gathered psychophysiological and behavioral responses. Brain activity was measured using event-related functional magnetic resonance imaging. We found that rising compared with falling sound intensity facilitates autonomic orienting reflex and phasic alertness to auditory targets. Rising intensity sounds produced neural activity in the amygdala, which was accompanied by activity in intraparietal sulcus, superior temporal sulcus, and temporal plane. Our results indicate that rising sound intensity is an elementary warning cue eliciting adaptive responses by recruiting attentional and physiological resources. Regions involved in cross-modal integration were activated by rising sound intensity, while the right-hemisphere phasic alertness network could not be supported by this study.

Current concepts in the pathogenesis of meningitis caused by Streptococcus pneumoniae

In spite of improved antimicrobial therapy, bacterial meningitis still results in brain damage leading to significant long-term neurological sequelae in a substantial number of survivors, as confirmed by several recent studies. Meningitis caused by Streptococcus pneumoniae is associated with a particularly severe outcome. Experimental studies over the past few years have increased our understanding of the molecular mechanisms underlying the events that ultimately lead to brain damage during meningitis. Necrotic damage to the cerebral cortex is at least partly mediated by ischemia and oxygen radicals and therefore offers a promising target for adjunctive therapeutic intervention. Neuronal apoptosis in the hippocampus may represent the major pathological process responsible for cognitive impairment and learning disabilities in survivors. However, the mechanisms involved in causing this damage remain largely unknown. Anti-inflammatory treatment with corticosteroids aggravates hippocampal damage, thus underlining the potential shortcomings of current adjuvant strategies. In contrast, the combined inhibition of matrix metalloproteinase and tumour necrosis factor-alpha converting enzyme protected both the cortex and hippocampus in experimental meningitis, and may represent a promising new approach to adjunctive therapy. It is the hope that a more refined molecular understanding of the pathogenesis of brain damage during bacterial meningitis will lead to new adjunctive therapies.