A decaying factor accounts for contained activity in neuronal networks with no need of hierarchical or modular organization

The mechanisms responsible for containing activity in systems represented by networks are crucial in various phenomena, for example, in diseases such as epilepsy that affect the neuronal networks and for information dissemination in social networks. The first models to account for contained activity included triggering and inhibition processes, but they cannot be applied to social networks where inhibition is clearly absent. A recent model showed that contained activity can be achieved with no need of inhibition processes provided that the network is subdivided into modules (communities). In this paper, we introduce a new concept inspired in the Hebbian theory, through which containment of activity is achieved by incorporating a dynamics based on a decaying activity in a random walk mechanism preferential to the node activity. Upon selecting the decay coefficient within a proper range, we observed sustained activity in all the networks tested, namely, random, Barabasi-Albert and geographical networks. The generality of this finding was confirmed by showing that modularity is no longer needed if the dynamics based on the integrate-and-fire dynamics incorporated the decay factor. Taken together, these results provide a proof of principle that persistent, restrained network activation might occur in the absence of any particular topological structure. This may be the reason why neuronal activity does not spread out to the entire neuronal network, even when no special topological organization exists.

Impact of benign childhood epilepsy with centrotemporal spikes (BECTS) on school performance

BECTS represents the vast majority of childhood focal epilepsy. Owing to the age peculiarity of children who suffer from this disease, i.e., school-going age of between 6 and 9 years, the condition is often referred to as a school disorder by parents and teachers. Objective: The aim of this study was to evaluate the academic performance of children with BED'S, according to the clinical and electroencephalographic ILAE criteria, and compare the results of neuropsychological tests of language and attention to the frequency of epileptic discharges. Methods: The performances of 40 school children with BED'S were evaluated by applying a school performance test (SBT), neuropsychological tests (WISC and Trail-Making), and language tests (Illinois Test Psycholinguistic Abilities - ITPA - and Staggered Spondaic Word - SSW). The same tests were applied in the control group. Results: Children with BED'S, when compared to those in the control group, showed lower scores in academic performance (SPT), digits and similarities subtests of WISC, auditory processing subtest of SSW, and ITPA - representational and automatic level. The study showed that epileptic discharges did not influence the results. Conclusion: Children with BED'S scored significantly lower scores in tests on academic performance, when compared with those in the control group probably due to executive dysfunction. (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Behavioral and EEG effects of GABAergic manipulation of the nigro-tectal pathway in the Wistar audiogenic rat (WAR) strain II: An EEG wavelet analysis and retrograde neuronal tracer approach

The role of the substantia nigra pars reticulata (SNPr) and superior colliculus (SC) network in rat strains susceptible to audiogenic seizures still remain underexplored in epileptology. In a previous study from our laboratory, the GABAergic drugs bicuculline (BIC) and muscimol (MUS) were microinjected into the deep layers of either the anterior SC (aSC) or the posterior SC (pSC) in animals of the Wistar audiogenic rat (WAR) strain submitted to acoustic stimulation, in which simultaneous electroencephalographic (EEG) recording of the aSC, pSC, SNPr and striatum was performed. Only MUS microinjected into the pSC blocked audiogenic seizures. In the present study, we expanded upon these previous results using the retrograde tracer Fluorogold (FG) microinjected into the aSC and pSC in conjunction with quantitative EEG analysis (wavelet transform), in the search for mechanisms associated with the susceptibility of this inbred strain to acoustic stimulation. Our hypothesis was that the WAR strain would have different connectivity between specific subareas of the superior colliculus and the SNPr when compared with resistant Wistar animals and that these connections would lead to altered behavior of this network during audiogenic seizures. Wavelet analysis showed that the only treatment with an anticonvulsant effect was MUS microinjected into the pSC region, and this treatment induced a sustained oscillation in the theta band only in the SNPr and in the pSC. These data suggest that in WAR animals, there are at least two subcortical loops and that the one involved in audiogenic seizure susceptibility appears to be the pSC-SNPr circuit. We also found that WARs presented an increase in the number of FG + projections from the posterior SNPr to both the aSC and pSC (primarily to the pSC), with both acting as proconvulsant nuclei when compared with Wistar rats. We concluded that these two different subcortical loops within the basal ganglia are probably a consequence of the WAR genetic background. (C) 2012 Elsevier Inc. All rights reserved.

Texture analysis of high resolution MRI allows discrimination between febrile and afebrile initial precipitating injury in mesial temporal sclerosis

A computational pipeline combining texture analysis and pattern classification algorithms was developed for investigating associations between high-resolution MRI features and histological data. This methodology was tested in the study of dentate gyrus images of sclerotic hippocampi resected from refractory epilepsy patients. Images were acquired using a simple surface coil in a 3.0T MRI scanner. All specimens were subsequently submitted to histological semiquantitative evaluation. The computational pipeline was applied for classifying pixels according to: a) dentate gyrus histological parameters and b) patients' febrile or afebrile initial precipitating insult history. The pipeline results for febrile and afebrile patients achieved 70% classification accuracy, with 78% sensitivity and 80% specificity [area under the reader observer characteristics (ROC) curve: 0.89]. The analysis of the histological data alone was not sufficient to achieve significant power to separate febrile and afebrile groups. Interesting enough, the results from our approach did not show significant correlation with histological parameters (which per se were not enough to classify patient groups). These results showed the potential of adding computational texture analysis together with classification methods for detecting subtle MRI signal differences, a method sufficient to provide good clinical classification. A wide range of applications of this pipeline can also be used in other areas of medical imaging. Magn Reson Med, 2012. (c) 2012 Wiley Periodicals, Inc.

On the relationship between neurocysticercosis and mesial temporal lobe epilepsy associated with hippocampal sclerosis: coincidence or a pathogenic relationship?

Neurocysticercosis (NCC) and mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) are two common worldwide forms of focal epilepsy. In regions where NCC is endemic, both diseases can be observed in the same patient. There is recent and growing evidence suggesting that NCC might contribute to or even cause MTLE-HS. In this article, we review the literature regarding NCC and temporal lobe epilepsy, specifically addressing the relationship between NCC and MTLE-HS. In addition, we review some scenarios where NCC seems to emerge as a causative agent or contributor to the development of MTLE-HS in some patients. This association is important because it may have an impact on the evaluation and treatment of a sizable proportion of patients with epilepsy. Insights from these clinical observations might also contribute to the understanding of the neurobiology of both NCC and MTLE-HS. We hope that our review might shed some light on this interesting interplay between two of the most common worldwide conditions associated with human focal epilepsy.

A fragment-based approach for the in silico prediction of blood-brain barrier permeation

Blood-brain barrier (BBB) permeation is an essential property for drugs that act in the central nervous system (CNS) for the treatment of human diseases, such as epilepsy, depression, Alzheimer's disease, Parkinson disease, schizophrenia, among others. In the present work, quantitative structure-property relationship (QSPR) studies were conducted for the development and validation of in silico models for the prediction of BBB permeation. The data set used has substantial chemical diversity and a relatively wide distribution of property values. The generated QSPR models showed good statistical parameters and were successfully employed for the prediction of a test set containing 48 compounds. The predictive models presented herein are useful in the identification, selection and design of new drug candidates having improved pharmacokinetic properties.

Innovative analytical methods for Central Nervous System Drug analysis in biological fluids

During recent years a consistent number of central nervous system (CNS) drugs have been approved and introduced on the market for the treatment of many psychiatric and neurological disorders, including psychosis, depression, Parkinson disease and epilepsy. Despite the great advancements obtained in the treatment of CNS diseases/disorders, partial response to therapy or treatment failure are frequent, at least in part due to poor compliance, but also genetic variability in the metabolism of psychotropic agents or polypharmacy, which may lead to sub-therapeutic or toxic plasma levels of the drugs, and finally inefficacy of the treatment or adverse/toxic effects. With the aim of improving the treatment, reducing toxic/side effects and patient hospitalisation, Therapeutic Drug Monitoring (TDM) is certainly useful, allowing for a personalisation of the therapy. Reliable analytical methods are required to determine the plasma levels of psychotropic drugs, which are often present at low concentrations (tens or hundreds of nanograms per millilitre). The present PhD Thesis has focused on the development of analytical methods for the determination of CNS drugs in biological fluids, including antidepressants (sertraline and duloxetine), antipsychotics (aripiprazole), antiepileptics (vigabatrin and topiramate) and antiparkinsons (pramipexole). Innovative methods based on liquid chromatography or capillary electrophoresis coupled to diode-array or laser-induced fluorescence detectors have been developed, together with the suitable sample pre-treatment for interference removal and fluorescent labelling in case of LIF detection. All methods have been validated according to official guidelines and applied to the analysis of real samples obtained from patients, resulting suitable for the TDM of psychotropic drugs.

Role of BDNF secretion and signaling in the activity-dependent refinement of synaptic connections

Neuronal networks exhibit diverse types of plasticity, including the activity-dependent regulation of synaptic functions and refinement of synaptic connections. In addition, continuous generation of new neurons in the “adult” brain (adult neurogenesis) represents a powerful form of structural plasticity establishing new connections and possibly implementing pre-existing neuronal circuits (Kempermann et al, 2000; Ming and Song, 2005). Neurotrophins, a family of neuronal growth factors, are crucially involved in the modulation of activity-dependent neuronal plasticity. The first evidence for the physiological importance of this role evolved from the observations that the local administration of neurotrophins has dramatic effects on the activity-dependent refinement of synaptic connections in the visual cortex (McAllister et al, 1999; Berardi et al, 2000; Thoenen, 1995). Moreover, the local availability of critical amounts of neurotrophins appears to be relevant for the ability of hippocampal neurons to undergo long-term potentiation (LTP) of the synaptic transmission (Lu, 2004; Aicardi et al, 2004). To achieve a comprehensive understanding of the modulatory role of neurotrophins in integrated neuronal systems, informations on the mechanisms about local neurotrophins synthesis and secretion as well as ditribution of their cognate receptors are of crucial importance. In the first part of this doctoral thesis I have used electrophysiological approaches and real-time imaging tecniques to investigate additional features about the regulation of neurotrophins secretion, namely the capability of the neurotrophin brain-derived neurotrophic factor (BDNF) to undergo synaptic recycling. In cortical and hippocampal slices as well as in dissociated cell cultures, neuronal activity rapidly enhances the neuronal expression and secretion of BDNF which is subsequently taken up by neurons themselves but also by perineuronal astrocytes, through the selective activation of BDNF receptors. Moreover, internalized BDNF becomes part of the releasable source of the neurotrophin, which is promptly recruited for activity-dependent recycling. Thus, we described for the first time that neurons and astrocytes contain an endocytic compartment competent for BDNF recycling, suggesting a specialized form of bidirectional communication between neurons and glia. The mechanism of BDNF recycling is reminiscent of that for neurotransmitters and identifies BDNF as a new modulator implicated in neuro- and glio-transmission. In the second part of this doctoral thesis I addressed the role of BDNF signaling in adult hippocampal neurogenesis. I have generated a transgenic mouse model to specifically investigate the influence of BDNF signaling on the generation, differentiation, survival and connectivity of newborn neurons into the adult hippocampal network. I demonstrated that the survival of newborn neurons critically depends on the activation of the BDNF receptor TrkB. The TrkB-dependent decision regarding life or death in these newborn neurons takes place right at the transition point of their morphological and functional maturation Before newborn neurons start to die, they exhibit a drastic reduction in dendritic complexity and spine density compared to wild-type newborn neurons, indicating that this receptor is required for the connectivity of newborn neurons. Both the failure to become integrated and subsequent dying lead to impaired LTP. Finally, mice lacking a functional TrkB in the restricted population of newborn neurons show behavioral deficits, namely increased anxiety-like behavior. These data suggest that the integration and establishment of proper connections by newly generated neurons into the pre-existing network are relevant features for regulating the emotional state of the animal.

Rapporto tra struttura e funzione della cistatina B e dei suoi mutanti in relazione all'epilessia mioclonica progressiva di tipo 1 (EPM1)

This work shows for the first time that native CSTB polymerizes on addition of Cu2+ and DnaK (Hsp70). Cysteines are involved in the polymerization process and in particular at least one cysteine is necessary. We propose that Cu2+ interacts with the thiol group of cysteine and oxidize it. The oxidized cysteine modifies the CSTB structure allowing interaction with DnaK/Hsp70 to occur. Thus, Cu2+ binding to CSTB exposes a site for DnaK and such interaction allows the polymerization of CSTB. The polymers generated from native CSTB monomers, are DTT sensitive and they may represent physiological polymers. Denatured CSTB does not require Cu2+ and polymerizes simply on addition of DnaK. The polymers generated from denatured CSTB do not respond to DTT. They have characteristics similar to those of the CSTB toxic aggregates described in vivo in eukaryotic cells following CSTB over-expression. Interaction between CSTB and Hsp70 is shown by IP experiments. The interaction occurs with WT CSTB and not with the cys mutant. This suggests that disulphur bonds are involved. Methal-cathalyzed oxidation of proteins involves reduction of the metal ion(s) bound to the protein itself and oxidation of neighboring ammino acid residues resulting in structural modification and de-stabilization of the molecule. In this work we propose that the cysteine thyol residue of CSTB in the presence of Cu2+ is oxidized, and cathalyzes the formation of disulphide bonds with Hsp70, that, once bound to CSTB, mediates its polymerization. In vivo this molecular mechanism of CSTB polymerization could be regulated by redox environment through the cysteine residue. This may imply that CSTB physiological polymers have a specific cellular function, different from that of the protease inhibitor known for the CSTB monomer. This hypothesis is interesting in relation to Progressive Myoclonus Epilepsy of type 1 (EPM1). This pathology is usually caused by mutations in the CSTB gene. CSTB is a ubiquitous protein, but EPM1 patients have problems only in the central nervous system. Maybe physiological CSTB polymers have a specific function altered in people affected by EPM1.

Wavelet analysis of heart rate variability related to nocturnal frontal lobe epilepsy seizures

Introduction: Nocturnal frontal lobe epilepsy (NFLE) is a distinct syndrome of partial epilepsy whose clinical features comprise a spectrum of paroxysmal motor manifestations of variable duration and complexity, arising from sleep. Cardiovascular changes during NFLE seizures have previously been observed, however the extent of these modifications and their relationship with seizure onset has not been analyzed in detail. Objective: Aim of present study is to evaluate NFLE seizure related changes in heart rate (HR) and in sympathetic/parasympathetic balance through wavelet analysis of HR variability (HRV). Methods: We evaluated the whole night digitally recorded video-polysomnography (VPSG) of 9 patients diagnosed with NFLE with no history of cardiac disorders and normal cardiac examinations. Events with features of NFLE seizures were selected independently by three examiners and included in the study only if a consensus was reached. Heart rate was evaluated by measuring the interval between two consecutive R-waves of QRS complexes (RRi). RRi series were digitally calculated for a period of 20 minutes, including the seizures and resampled at 10 Hz using cubic spline interpolation. A multiresolution analysis was performed (Daubechies-16 form), and the squared level specific amplitude coefficients were summed across appropriate decomposition levels in order to compute total band powers in bands of interest (LF: 0.039062 - 0.156248, HF: 0.156248 - 0.624992). A general linear model was then applied to estimate changes in RRi, LF and HF powers during three different period (Basal) (30 sec, at least 30 sec before seizure onset, during which no movements occurred and autonomic conditions resulted stationary); pre-seizure period (preSP) (10 sec preceding seizure onset) and seizure period (SP) corresponding to the clinical manifestations. For one of the patients (patient 9) three seizures associated with ictal asystole were recorded, hence he was treated separately. Results: Group analysis performed on 8 patients (41 seizures) showed that RRi remained unchanged during the preSP, while a significant tachycardia was observed in the SP. A significant increase in the LF component was instead observed during both the preSP and the SP (p<0.001) while HF component decreased only in the SP (p<0.001). For patient 9 during the preSP and in the first part of SP a significant tachycardia was observed associated with an increased sympathetic activity (increased LF absolute values and LF%). In the second part of the SP a progressive decrease in HR that gradually exceeded basal values occurred before IA. Bradycardia was associated with an increase in parasympathetic activity (increased HF absolute values and HF%) contrasted by a further increase in LF until the occurrence of IA. Conclusions: These data suggest that changes in autonomic balance toward a sympathetic prevalence always preceded clinical seizure onset in NFLE, even when HR changes were not yet evident, confirming that wavelet analysis is a sensitive technique to detect sudden variations of autonomic balance occurring during transient phenomena. Finally we demonstrated that epileptic asystole is associated with a parasympathetic hypertonus counteracted by a marked sympathetic activation.

Expressions- und Funktionsanalysen von "Tetraspan Vesicle Membrane Proteins" in Caenorhabditis elegans

Tetraspan vesicle membrane proteins (TVPs) sind ubiquitäre Komponenten von Transportvesikeln. Bei den Säugetieren unterscheidet man drei Familien, die Physine, Gyrine und SCAMPs (secretory carrier-associated membrane proteins). Ihre Funktion ist weitgehend unbekannt, es wird jedoch vermutet, dass sie eine Rolle bei der Vesikelbildung und der Vesikelrezirkulierung spielen. In Caenorhabditis elegans existiert von jeder Familie jeweils nur ein einziges Polypeptid: für die Physine Synaptophysin (SPH-1), für die Gyrine Synaptogyrin (SNG-1) und für die SCAMPs SCAMP (SCM-1). Ziel der Arbeit war es die Verteilung der C. elegans TVPs zu untersuchen und ihre Funktion unter besonderer Berücksichtigung der vesikelvermittelten synaptischen Kopplung zu bestimmen. Wenn die C. elegans TVPs in humanen Epithelzellen synthetisiert werden, lokalisieren sie in zytoplasmatischen Vesikeln. In Kotransfektionsexperimenten wurde gezeigt, dass sie größtenteils in den gleichen Strukturen enthalten sind. In C. elegans synthetisierte TVP-Reporterkonstrukte können in unterschiedlichen Geweben nachgewiesen werden. Dabei ist SNG-1 fast ausschließlich in Neuronen zu finden. SPH-1 und SCM-1 hingegen weisen komplexe und teilweise überlappende Verteilungsmuster auf. Während für SPH-1 eine starke Fluoreszenz im Pharynx, auf der apikalen Seite der Darmzellen oberhalb des sog. terminal webs und in adluminalen Regionen von exkretorischen Geweben gefunden wurde, war SCM-1 stark in der Muskulatur und den Coelomozyten vertreten. Die Expression von SCM-1 in Pharynx und Darm war deutlich schwächer. Die C. elegans TVPs werden früh in der Entwicklung ab der Gastrulation (SPH-1 und SCM-1) bzw. ab der Neurulation im sog. Komma-Stadium (SNG-1) produziert. Um die Funktion der TVPs in C. elegans zu untersuchen, wurden TVP-Mutanten analysiert. Durch Kombination aller drei TVP-Gen-Mutanten wurden TVP-Dreifachmutanten generiert. Diese wiesen keinen offensichtlichen Defekt im Bewegungsmuster auf, entwickelten sich normal und bildeten ein normales Nervensystem aus. Auch auf unterschiedliche chemische und physikalische Reize in sensorischen Tests reagierten die TVP-Dreifachmutanten in gleicher Weise wie Wildtyptiere. Ebenso zeigen die TVP-Dreifachmutanten elektrophysiologisch unter normalen Bedingungen keine anormalen Reaktionsmuster. In ultrastrukturellen Untersuchungen wurde lediglich eine signifikant erhöhte Anzahl Clathrin-ummantelter Vesikel in cholinergen Synapsen gefunden. Erst unter Stressbedingungen, hervorgerufen durch den GABA-Antagonisten Pentylentetrazol (PTZ), wiesen sowohl die TVP-Dreifach- als auch die TVP-Einzelmutanten eine deutlich erhöhte Krampfbereitschaft auf. Zusammengenommen zeigen die Analysen, dass TVPs zwar für grundlegende neuronale Prozesse nicht notwendig sind, dass sie aber auf der anderen Seite vermutlich an alternativen redundanten Wegen der Neurotransmitterfreisetzung beteiligt sind.

Comparison of EEG signals from epilepsy patients with Bump modeling

Background: l’epilessia è una malattia cerebrale che colpisce oggigiorno circa l’1% della popolazione mondiale e causa, a chi ne soffre, convulsioni ricorrenti e improvvise che danneggiano la vita quotidiana del paziente. Le convulsioni sono degli eventi che bloccano istantaneamente la normale attività cerebrale; inoltre differiscono tra i pazienti e, perciò, non esiste un trattamento comune generalizzato. Solitamente, medici neurologi somministrano farmaci, e, in rari casi, l’epilessia è trattata con operazioni neurochirurgiche. Tuttavia, le operazioni hanno effetti positivi nel ridurre le crisi, ma raramente riescono a eliminarle del tutto. Negli ultimi anni, nel campo della ricerca scientifica è stato provato che il segnale EEG contiene informazioni utili per diagnosticare l'arrivo di un attacco epilettico. Inoltre, diversi algoritmi automatici sono stati sviluppati per rilevare automaticamente le crisi epilettiche. Scopo: lo scopo finale di questa ricerca è l'applicabilità e l'affidabilità di un dispositivo automatico portatile in grado di rilevare le convulsioni e utilizzabile come sistema di monitoraggio. L’analisi condotta in questo progetto, è eseguita con tecniche di misure classiche e avanzate, in modo tale da provare tecnicamente l’affidabilità di un tale sistema. La comparazione è stata eseguita sui segnali elettroencefalografici utilizzando due diversi sistemi di acquisizione EEG: il metodo standard utilizzato nelle cliniche e il nuovo dispositivo portatile. Metodi: è necessaria una solida validazione dei segnali EEG registrati con il nuovo dispositivo. I segnali saranno trattati con tecniche classiche e avanzate. Dopo le operazioni di pulizia e allineamento, verrà utilizzato un nuovo metodo di rappresentazione e confronto di segnali : Bump model. In questa tesi il metodo citato verrà ampiamente descritto, testato, validato e adattato alle esigenze del progetto. Questo modello è definito come un approccio economico per la mappatura spazio-frequenziale di wavelet; in particolare, saranno presenti solo gli eventi con un’alta quantità di energia. Risultati: il modello Bump è stato implementato come toolbox su MATLAB dallo sviluppatore F. Vialatte, e migliorato dall’Autore per l’utilizzo di registrazioni EEG da sistemi diversi. Il metodo è validato con segnali artificiali al fine di garantire l’affidabilità, inoltre, è utilizzato su segnali EEG processati e allineati, che contengono eventi epilettici. Questo serve per rilevare la somiglianza dei due sistemi di acquisizione. Conclusioni: i risultati visivi garantiscono la somiglianza tra i due sistemi, questa differenza la si può notare specialmente comparando i grafici di attività background EEG e quelli di artefatti o eventi epilettici. Bump model è uno strumento affidabile per questa applicazione, e potrebbe essere utilizzato anche per lavori futuri (ad esempio utilizzare il metodo di Sincronicità Eventi Stocas- tici SES) o differenti applicazioni, così come le informazioni estratte dai Bump model potrebbero servire come input per misure di sincronicità, dalle quali estrarre utili risultati.

Profilo psicopatologico e qualità della vita in bambini e adolescenti narcolettici: studio caso-controllo

Scopo del nostro lavoro è stato descrivere ed inquadrare gli aspetti psico-comportamentali e la qualità di vita della narcolessia in età evolutiva. Metodi: Abbiamo pertanto disegnato uno studio caso-controllo comprendente 30 pazienti narcolettici, 39 epilettici, e 39 controlli sani, appaiati per sesso e età. Risultati: La nostra popolazione di bambini e adolescenti affetti da narcolessia mostra un aumento delle problematiche internalizzanti. I due gruppi patologici hanno in comune punteggi più elevati rispetto ai controlli per i disturbi d’ansia, le difficoltà attentive e di socializzazione, i disturbi oppositivo-provocatori. Ciò che distingue, invece, i pazienti narcolettici, sono gli aspetti di ritiro e depressione, la tendenza alla somatizzazione, i problemi del pensiero ed i disturbi affettivi. Fattori di rischio psicopatologici per i giovani narcolettici sono risultati essere l’esordio precoce, il ritardo diagnostico, il sonno notturno disturbato, la minor latenza di sonno all’addormentamento, un maggior numero di SOREMP all’MSLT. Dall’altro lato la terapia farmacologica, un maggior numero di sonnellini spontanei e la durata di malattia, sembrano influenzare positivamente l’evoluzione comportamentale. La salute psicosociale dei giovani narcolettici, inoltre, risulta essere peggiore rispetto ai controlli sani, mentre la salute fisica non mostra differenze. I problemi internalizzanti influenzano negativamente tutti gli ambiti della salute di questi ragazzi, mentre la durata di malattia sembra migliorare il funzionamento scolastico. Conclusioni: Il nostro lavoro conferma che i giovani narcolettici presentano un maggior rischio psicopatologico sia rispetto ai controlli sani sia rispetto un’altra patologia neurologica cronica. Se da un lato alcuni aspetti comportamentali possono essere giustificati come una reazione adattativa verso una patologia neurologica invalidante, dall’altro un quadro distimico caratterizzato da ritiro e lamentele somatiche, sembra essere tipico dei bambini ed adolescenti narcolettici.

Regulation der BDNF-Expression in Endothelzellen

Das Neurotrophin BDNF ist ein protektiver Faktor, der das Wachstum, die Differenzierung und das Überleben neuronaler Zellen fördert. Neben der neuronalen Expression wird BDNF auch peripher exprimiert, so auch in Endothelzellen. Dort stimuliert BDNF die Angiogenese und fördert das Endothelzellüberleben. Eine Regulation der BDNF-Expression unter pathologischen Bedingungen wie Epilepsie, M. Alzheimer, M. Parkinson, Depression und Ischämie ist bereits mehrfach beschrieben worden. Literaturdaten zeigen veränderte BDNF-Expressionen unter pathologischen Bedingungen zeitgleich mit einem erhöhten Spiegel des Tumornekrosefaktors (TNF-a) bzw. einer Aktivierung der Proteinkinase C (PKC). Ob ein erhöhter TNF-a-Spiegel bzw. die Aktivierung der PKC Ursache der veränderten BDNF-Expression ist, ist bisher noch nicht bekannt. In der vorliegenden Arbeit konnte gezeigt werden, dass sowohl TNF-a als auch eine Aktivierung der PKC in peripheren Endothelzellen die BDNF-Expression konzentrations- und zeitabhängig reduziert. Im Fall von TNF-a wird diese Reduktion über den TNF-a-Rezeptor 1 (TNFR1) vermittelt und auf dem Niveau der Transkription reguliert. Weiterhin konnte gezeigt werden, dass BDNF die Angiogenese-Aktivität von humanen Umbilikalvenen-Endothelzellen (HUVEC) in Abhängigkeit der BDNF-Rezeptoren TrkB und p75NTR stimuliert. TNF-a hingegen reduziert die Angiogenese in HUVEC. Bei der Regulation der BDNF-Expression durch den PKC-aktivierenden Phorbolester Phorbol-12-Myristat-13-Acetat (PMA) konnte eine Beteiligung der PKC-Isoformen d gezeigt werden. Die Verminderung der BDNF-Expression durch PKC-Aktivierung konnte durch Inhibitoren der PKC d aufgehoben werden. PMA hatte keine destabilisierende Wirkung auf die BDNF-mRNA. Auch hier wird BDNF durch PMA auf dem Niveau der Transkription reguliert. Weiterhin ist bisher eine pharmakologische Regulation der BDNF-Expression noch nicht näher untersucht worden. Erstmalig konnte eine Wirkung des b1-Adrenorezeptorblockers Nebivolol auf die BDNF-mRNA-Expression beobachtet werden. Nebivolol erhöht die BDNF-Expression in zerebralen Endothelzellen in vitro und im Mäuseherzen in vivo. Hierbei handelt es sich um eine substanzspezifische Wirkung von Nebivolol, die NO-unabhängig verläuft und nicht über den b3-Adrenozeptor vermittelt wird. Teile der klinisch beobachteten protektiven Wirkungen von Nebivolol könnten auf eine erhöhte BDNF-Expression zurückgeführt werden.

Synthese 18 F-markierter Liganden zur Visualisierung der GABA-Bindungsstelle des GABA A-Rezeptors mittels PET

γ-Aminobuttersäure (GABA) ist der wichtigste inhibitorische Neurotransmitter im zentralen Nervensystem und bindet vorrangig an ionotrope GABAA-Rezeptoren. Diese sind an fast allen neuronalen Prozessen beteiligt und werden darüber hinaus mit neurologischen Erkrankungen wie Epilepsie, Angstzuständen, Schlafstörungen und Schizophrenie in Verbindung gebracht. Die PET bietet als molekulares bildgebendes Verfahren die Möglichkeit einzelne Stoffwechselvorgänge des GABAergen Systems zu visualisieren und zu quantifizieren. Durch den Einsatz eines 18F-markierten Radioliganden an die GABA-Bindungsstelle könnten so die Rezeptorverfügbarkeit des GABAA-Rezeptors gemessen und die Ausschüttung des Neurotransmitters GABA quantifiziert werden.rn4-(2-Naphthylmethyl)-5-(piperidin-4-yl)isothiazolole und -isoxazolole stellen aufgrund ihrer hohen Affinität gegenüber der GABA-Bindungsstelle und ihrer lipophilen Struktur vielversprechende Leitstrukturen für die Entwicklung eines PET-Tracers zur Visualisierung der GABA-Bindungsstelle dar. Daher wurden zunächst 19F-substituierte Referenzverbindungen synthetisiert, um diese hinsichtlich ihrer Eignung als Radioligand in in vitro-Studien zu evaluieren. Dazu wurde Fluor direkt sowie über eine Fluorethoxygruppe an Position 1 des Naphthalinrings eingeführt. Zusätzlich wurde ein Fluorethylether eines Isothiazolols als Referenz-verbindung synthetisiert. In anschließenden Verdrängungsstudien wurden die Affinitäten der synthetisierten Verbindungen mit [3H]Muscimol an Membranpräparaten aus Rattenhirnen, sowie transfizierten HEK293-Zellen bestimmt. Zusätzlich wurden die entsprechenden Log D-Werte bestimmt. Die Verbindung 5-(piperidin-4-yl)-4-(1-fluornaphth-2-ylmethyl)-isothiazol-3-ol VK5 zeigte in den in vitro-Studien die vielversprechendsten Ergebnisse (IC50 = 10 nM; Log D = 1,7) und wurde im Folgenden in einer dreistufigen Radiosynthese als 18F-Verbindung synthetisiert.rnZu diesem Zweck wurde ein geeigneter Markierungsvorläufer dargestellt und über eine n.c.a. SNAr-Markierung mit [18F]F- umgesetzt. Die Reaktionsparameter wurden hinsichtlich Reaktionszeit, -temperatur, Basenkonzentration und Lösungsmittel optimiert. Die zur Aktivierung einer SNAr ein-geführte Carbonylfunktion wurde in einem zweiten Schritt mit Triethylsilan/Trifluoressigsäure reduziert. Im finalen Schritt wurden zwei Schutzgruppen mit Bortrichlorid in DCM abgespaltet und [18F]VK5 als injektionsfertige Lösung in isotoner NaCl-Lösung erhalten. Es wurden radiochemische Ausbeuten von 0,7-1 % (EOS) nach einer durchschnittlichen Synthesedauer von 275 Minuten erhalten.rnDer Radioligand [18F]VK5 wurde anschließend in Autoradiographie-Versuchen an Hirnschnitten der Ratte hinsichtlich seiner Spezifität für die GABA-Bindungsstelle untersucht. Die unspezifische Bindung wurde durch die Zugabe von GABA bestimmt wonach kein signifikanter Unterschied festgestellt werden konnte. Die hohe unspezifische Bindung kann möglicherweise auf die niedrigen spezifischen Aktivitäten zurückgeführt werden. Diese lagen, bedingt durch die drei Schritte der Radiosynthese, in einem Bereich von 0,1-0,6 GBq/μmol. Die erhaltenen Ergebnisse lassen für zukünftige Versuche noch einige Optimierungsmöglichkeiten offen. Aufgrund der bisher erhaltenen Daten lässt sich daher keine definitive Aussage über die Eignung des Liganden [18F]VK5 als PET-Tracer treffen.rn