The role of the NG2 proteoglycan in migration and characterization of the interaction with the intracellular binding partner, Syntenin

NG2 is a transmembrane proteoglycan with two N-terminal LNS domains and a C-terminal PDZ-binding motif. It is expressed in the developing and adult CNS by oligodendroglial precursor cells and subpopulations of perisynaptic glia and elsewhere by many immature cell types. In order to elucidate the functions of the protein and the heterogenous cell population which expresses it, we undertook to identify and characterise interaction partners of the molecule. The presence of the C-terminal PDZ recognition site in NG2 suggested PDZ-domain proteins as intracellular binding partners. In this work, interaction between the PDZ protein Syntenin and NG2 has been characterised. Syntenin is known to be involved in plasma membrane dynamics, metastasis and adhesion. Syntenin may thus link NG2 to the cytoskeleton, mediating migration of developing oligodendrocytes to axonal tracts prior to myelination, as well as process movement of NG2+ perisynaptic glia. NG2 is involved in cell spreading and polyclonal antibodies against NG2 inhibit the migration of immature glia and cell lines expressing the molecule. In this work we have characterised the segments of the extracellular portion of NG2 that are involved in migration. We found that the extracellular region immediately preceding the transmembrane segment is most important for cell motility. As part of this thesis, biochemical approaches to identify a trans-binding ligand interacting with the extracellular part of NG2 was also explored.

Analysis of the Slow Food movement impact on the farmers and rural areas’ sustainable development

The evaluation of the farmers’ communities’ approach to the Slow Food vision, their perception of the Slow Food role in supporting their activity and their appreciation and expectations from participating in the event of Mother Earth were studied. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was adopted in an agro-food sector context. A survey was conducted, 120 questionnaires from farmers attending the Mother Earth in Turin in 2010 were collected. The descriptive statistical analysis showed that both Slow Food membership and participation to Mother Earth Meeting were much appreciated for the support provided to their business and the contribution to a more sustainable and fair development. A positive social, environmental and psychological impact on farmers also resulted. Results showed also an interesting perspective on the possible universality of the Slow Food and Mother Earth values. Farmers declared that Slow Food is supporting them by preserving the biodiversity and orienting them to the use of local resources and reducing the chemical inputs. Many farmers mentioned the language/culture and administration/bureaucratic issues as an obstacle to be a member in the movement and to participate to the event. Participation to Mother Earth gives an opportunity to exchange information with other farmers’ communities and to participate to seminars and debates, helpful for their business development. The absolute majority of positive answers associated to the farmers’ willingness to relate to Slow Food and participate to the next Mother Earth editions negatively influenced the UTAUT model results. A factor analysis showed that the variables associated to the UTAUT model constructs Performance Expectancy and Effort Expectancy were consistent, able to explain the construct variability, and their measurement reliable. Their inclusion in a simplest Technology Acceptance Model could be considered in future researches.

From inverted pendulum to N-link chain: inertial sensors-based assessment of movement kinematics and dynamics for functional evaluation and rehabilitation

Despite several clinical tests that have been developed to qualitatively describe complex motor tasks by functional testing, these methods often depend on clinicians' interpretation, experience and training, which make the assessment results inconsistent, without the precision required to objectively assess the effect of the rehabilitative intervention. A more detailed characterization is required to fully capture the various aspects of motor control and performance during complex movements of lower and upper limbs. The need for cost-effective and clinically applicable instrumented tests would enable quantitative assessment of performance on a subject-specific basis, overcoming the limitations due to the lack of objectiveness related to individual judgment, and possibly disclosing subtle alterations that are not clearly visible to the observer. Postural motion measurements at additional locations, such as lower and upper limbs and trunk, may be necessary in order to obtain information about the inter-segmental coordination during different functional tests involved in clinical practice. With these considerations in mind, this Thesis aims: i) to suggest a novel quantitative assessment tool for the kinematics and dynamics evaluation of a multi-link kinematic chain during several functional motor tasks (i.e. squat, sit-to-stand, postural sway), using one single-axis accelerometer per segment, ii) to present a novel quantitative technique for the upper limb joint kinematics estimation, considering a 3-link kinematic chain during the Fugl-Meyer Motor Assessment and using one inertial measurement unit per segment. The suggested methods could have several positive feedbacks from clinical practice. The use of objective biomechanical measurements, provided by inertial sensor-based technique, may help clinicians to: i) objectively track changes in motor ability, ii) provide timely feedback about the effectiveness of administered rehabilitation interventions, iii) enable intervention strategies to be modified or changed if found to be ineffective, and iv) speed up the experimental sessions when several subjects are asked to perform different functional tests.

Movement Analysis by means of inertial sensors: from bench to bedside

in the everyday clinical practice. Having this in mind, the choice of a simple setup would not be enough because, even if the setup is quick and simple, the instrumental assessment would still be in addition to the daily routine. The will to overcome this limit has led to the idea of instrumenting already existing and widely used functional tests. In this way the sensor based assessment becomes an integral part of the clinical assessment. Reliable and validated signal processing methods have been successfully implemented in Personal Health Systems based on smartphone technology. At the end of this research project there is evidence that such solution can really and easily used in clinical practice in both supervised and unsupervised settings. Smartphone based solution, together or in place of dedicated wearable sensing units, can truly become a pervasive and low-cost means for providing suitable testing solutions for quantitative movement analysis with a clear clinical value, ultimately providing enhanced balance and mobility support to an aging population.

Mechanical microcontacts of powder particles studied with the quartz crystal microbalance

Within this work, a particle-polymer surface system is studied with respect to the particle-surface interactions. The latter are governed by micromechanics and are an important aspect for a wide range of industrial applications. Here, a new methodology is developed for understanding the adhesion process and measure the relevant forces, based on the quartz crystal microbalance, QCM. rnThe potential of the QCM technique for studying particle-surface interactions and reflect the adhesion process is evaluated by carrying out experiments with a custom-made setup, consisting of the QCM with a 160 nm thick film of polystyrene (PS) spin-coated onto the quartz and of glass particles, of different diameters (5-20µm), deposited onto the polymer surface. Shifts in the QCM resonance frequency are monitored as a function of the oscillation amplitude. The induced frequency shifts of the 3rd overtone are found to decrease or increase, depending on the particle-surface coupling type and the applied oscillation (frequency and amplitude). For strong coupling the 3rd harmonic decreased, corresponding to an “added mass” on the quartz surface. However, positive frequency shifts are observed in some cases and are attributed to weak-coupling between particle and surface. Higher overtones, i.e. the 5th and 7th, were utilized in order to derive additional information about the interactions taking place. For small particles, the shift for specific overtones can increase after annealing, while for large particle diameters annealing causes a negative frequency shift. The lower overtones correspond to a generally strong-coupling regime with mainly negative frequency shifts observed, while the 7th appears to be sensitive to the contact break-down and the recorded shifts are positive.rnDuring oscillation, the motion of the particles and the induced frequency shift of the QCM are governed by a balance between inertial forces and contact forces. The adherence of the particles can be increased by annealing the PS film at 150°C, which led to the formation of a PS meniscus. For the interpretation, the Hertz, Johnson-Kendall-Roberts, Derjaguin-Müller-Toporov and the Mindlin theory of partial slip are considered. The Mindlin approach is utilized to describe partial slip. When partial slip takes place induced by an oscillating load, a part of the contact ruptures. This results in a decrease of the effective contact stiffness. Additionally, there are long-term memory effects due to the consolidation which along with the QCM vibrations induce a coupling increase. However, the latter can also break the contact, lead to detachment and even surface damage and deformation due to inertia. For strong coupling the particles appear to move with the vibrations and simply act as added effective mass leading to a decrease of the resonance frequency, in agreement with the Sauerbrey equation that is commonly used to calculate the added mass on a QCM). When the system enters the weak-coupling regime the particles are not able to follow the fast movement of the QCM surface. Hence, they effectively act as adding a “spring” with an additional coupling constant and increase the resonance frequency. The frequency shift, however, is not a unique function of the coupling constant. Furthermore, the critical oscillation amplitude is determined, above which particle detach. No movement is detected at much lower amplitudes, while for intermediate values, lateral particle displacement is observed. rnIn order to validate the QCM results and study the particle effects on the surface, atomic force microscopy, AFM, is additionally utilized, to image surfaces and measure surface forces. By studying the surface of the polymer film after excitation and particle removal, AFM imaging helped in detecting three different meniscus types for the contact area: the “full contact”, the “asymmetrical” and a third one including a “homocentric smaller meniscus”. The different meniscus forms result in varying bond intensity between particles and polymer film, which could explain the deviation between number of particles per surface area measured by imaging and the values provided by the QCM - frequency shift analysis. The asymmetric and the homocentric contact types are suggested to be responsible for the positive frequency shifts observed for all three measured overtones, i.e. for the weak-coupling regime, while the “full contact” type resulted in a negative frequency shift, by effectively contributing to the mass increase of the quartz..rnThe interplay between inertia and contact forces for the particle-surface system leads to strong- or weak-coupling, with the particle affecting in three mentioned ways the polymer surface. This is manifested in the frequency shifts of the QCM system harmonics which are used to differentiate between the two interaction types and reflect the overall state of adhesion for particles of different size.rn

Study of a wind-wave numerical model and its integration with ocean and oil-spill numerical models

The ability to represent the transport and fate of an oil slick at the sea surface is a formidable task. By using an accurate numerical representation of oil evolution and movement in seawater, the possibility to asses and reduce the oil-spill pollution risk can be greatly improved. The blowing of the wind on the sea surface generates ocean waves, which give rise to transport of pollutants by wave-induced velocities that are known as Stokes’ Drift velocities. The Stokes’ Drift transport associated to a random gravity wave field is a function of the wave Energy Spectra that statistically fully describe it and that can be provided by a wave numerical model. Therefore, in order to perform an accurate numerical simulation of the oil motion in seawater, a coupling of the oil-spill model with a wave forecasting model is needed. In this Thesis work, the coupling of the MEDSLIK-II oil-spill numerical model with the SWAN wind-wave numerical model has been performed and tested. In order to improve the knowledge of the wind-wave model and its numerical performances, a preliminary sensitivity study to different SWAN model configuration has been carried out. The SWAN model results have been compared with the ISPRA directional buoys located at Venezia, Ancona and Monopoli and the best model settings have been detected. Then, high resolution currents provided by a relocatable model (SURF) have been used to force both the wave and the oil-spill models and its coupling with the SWAN model has been tested. The trajectories of four drifters have been simulated by using JONSWAP parametric spectra or SWAN directional-frequency energy output spectra and results have been compared with the real paths traveled by the drifters.

Numerical modelling of fluid-structure interaction with application in hemodynamics

The thesis deals with numerical algorithms for fluid-structure interaction problems with application in blood flow modelling. It starts with a short introduction on the mathematical description of incompressible viscous flow with non-Newtonian viscosity and a moving linear viscoelastic structure. The mathematical model consists of the generalized Navier-Stokes equation used for the description of fluid flow and the generalized string model for structure movement. The arbitrary Lagrangian-Eulerian approach is used in order to take into account moving computational domain. A part of the thesis is devoted to the discussion on the non-Newtonian behaviour of shear-thinning fluids, which is in our case blood, and derivation of two non-Newtonian models frequently used in the blood flow modelling. Further we give a brief overview on recent fluid-structure interaction schemes with discussion about the difficulties arising in numerical modelling of blood flow. Our main contribution lies in numerical and experimental study of a new loosely-coupled partitioned scheme called the kinematic splitting fluid-structure interaction algorithm. We present stability analysis for a coupled problem of non-Newtonian shear-dependent fluids in moving domains with viscoelastic boundaries. Here, we assume both, the nonlinearity in convective as well is diffusive term. We analyse the convergence of proposed numerical scheme for a simplified fluid model of the Oseen type. Moreover, we present series of experiments including numerical error analysis, comparison of hemodynamic parameters for the Newtonian and non-Newtonian fluids and comparison of several physiologically relevant computational geometries in terms of wall displacement and wall shear stress. Numerical analysis and extensive experimental study for several standard geometries confirm reliability and accuracy of the proposed kinematic splitting scheme in order to approximate fluid-structure interaction problems.

The reconstruction of skeletal movement: the soft tissue artefact issue

In 3D human movement analysis performed using stereophotogrammetric systems and skin markers, bone pose can only be estimated in an indirect fashion. During a movement, soft tissue deformations make the markers move with respect to the underlying bone generating soft tissue artefact (STA). STA has devastating effects on bone pose estimation and its compensation remains an open question. The aim of this PhD thesis was to contribute to the solution of this crucial issue. Modelling STA using measurable trial-specific variables is a fundamental prerequisite for its removal from marker trajectories. Two STA model architectures are proposed. Initially, a thigh marker-level artefact model is presented. STA was modelled as a linear combination of joint angles involved in the movement. This model was calibrated using ex-vivo and in-vivo STA invasive measures. The considerable number of model parameters led to defining STA approximations. Three definitions were proposed to represent STA as a series of modes: individual marker displacements, marker-cluster geometrical transformations (MCGT), and skin envelope shape variations. Modes were selected using two criteria: one based on modal energy and another on the selection of modes chosen a priori. The MCGT allows to select either rigid or non-rigid STA components. It was also empirically demonstrated that only the rigid component affects joint kinematics, regardless of the non-rigid amplitude. Therefore, a model of thigh and shank STA rigid component at cluster-level was then defined. An acceptable trade-off between STA compensation effectiveness and number of parameters can be obtained, improving joint kinematics accuracy. The obtained results lead to two main potential applications: the proposed models can generate realistic STAs for simulation purposes to compare different skeletal kinematics estimators; and, more importantly, focusing only on the STA rigid component, the model attains a satisfactory STA reconstruction with less parameters, facilitating its incorporation in an pose estimator.

Analysis of cerebral and autonomic response to respiratory events in patients with Sleep Apnea Syndrome

The arousal scoring in Obstructive Sleep Apnea Syndrome (OSAS) is important to clarify the impact of the disease on sleep but the currently applied American Academy of Sleep Medicine (AASM) definition may underestimate the subtle alterations of sleep. The aims of the present study were to evaluate the impact of respiratory events on cortical and autonomic arousal response and to quantify the additional value of cyclic alternating pattern (CAP) and pulse wave amplitude (PWA) for a more accurate detection of respiratory events and sleep alterations in OSAS patients. A retrospective revision of 19 polysomnographic recordings of OSAS patients was carried out. Analysis was focused on quantification of apneas (AP), hypopneas (H) and flow limitation (FL) events, and on investigation of cerebral and autonomic activity. Only 41.1% of FL events analyzed in non rapid eye movement met the AASM rules for the definition of respiratory event-related arousal (RERA), while 75.5% of FL events ended with a CAP A phase. The dual response (EEG-PWA) was the most frequent response for all subtypes of respiratory event with a progressive reduction from AP to H and FL. 87.7% of respiratory events with EEG activation showed also a PWA drop and 53,4% of the respiratory events without EEG activation presented a PWA drop. The relationship between the respiratory events and the arousal response is more complex than that suggested by the international classification. In the estimation of the response to respiratory events, the CAP scoring and PWA analysis can offer more extensive information compared to the AASM rules. Our data confirm also that the application of PWA scoring improves the detection of respiratory events and could reduce the underestimation of OSAS severity compared to AASM arousal.

Mineral dust mobilisation, transport, and deposition in different climate epochs

Mineral dust is an important component of the Earth's climate system and provides essential nutrientsrnto oceans and rain forests. During atmospheric transport, dust particles directly and indirectly influencernweather and climate. The strength of dust sources and characteristics of the transport, in turn, mightrnbe subject to climatic changes. Earth system models help for a better understanding of these complexrnmechanisms.rnrnThis thesis applies the global climate model ECHAM5/MESSy Atmospheric Chemistry (EMAC) for simulationsrnof the mineral dust cycle under different climatic conditions. The prerequisite for suitable modelrnresults is the determination of the model setup reproducing the most realistic dust cycle in the recentrnclimate. Simulations with this setup are used to gain new insights into properties of the transatlanticrndust transport from Africa to the Americas and adaptations of the model's climate forcing factors allowrnfor investigations of the impact of climatic changes on the dust cycle.rnrnIn the first part, the most appropriate model setup is determined through a number of sensitivity experiments.rnIt uses the dust emission parametrisation from Tegen et al. 2002 and a spectral resolutionrnof T85, corresponding to a horizontal grid spacing of about 155 km. Coarser resolutions are not able tornaccurately reproduce emissions from important source regions such as the Bodele Depression in Chad orrnthe Taklamakan Desert in Central Asia. Furthermore, the representation of ageing and wet deposition ofrndust particles in the model requires a basic sulphur chemical mechanism. This setup is recommended forrnfuture simulations with EMAC focusing on mineral dust.rnrnOne major branch of the global dust cycle is the long-range transport from the world's largest dustrnsource, the Sahara, across the Atlantic Ocean. Seasonal variations of the main transport pathways to thernAmazon Basin in boreal winter and to the Caribbean during summer are well known and understood,rnand corroborated in this thesis. Both Eulerian and Lagrangian methods give estimates on the typicalrntransport times from the source regions to the deposition on the order of nine to ten days. Previously, arnhuge proportion of the dust transported across the Atlantic Ocean has been attributed to emissions fromrnthe Bodele Depression. However, the contribution of this hot spot to the total transport is very low inrnthe present results, although the overall emissions from this region are comparable. Both model resultsrnand data sets analysed earlier, such as satellite products, involve uncertainties and this controversy aboutrndust transport from the Bodele Depression calls for future investigations and clarification.rnrnAforementioned characteristics of the transatlantic dust transport just slightly change in simulationsrnrepresenting climatic conditions of the Little Ice Age in the middle of the last millennium with meanrnnear-surface cooling of 0.5 to 1 K. However, intensification of the West African summer monsoon duringrnthe Little Ice Age is associated with higher dust emissions from North African source regions and wetterrnconditions in the Sahel. Furthermore, the Indian Monsoon and dust emissions from the Arabian Peninsula,rnwhich are affected by this circulation, are intensified during the Little Ice Age, whereas the annual globalrndust budget is similar in both climate epochs. Simulated dust emission fluxes are particularly influencedrnby the surface parameters. Modifications of the model do not affect those in this thesis, to be able tornascribe all differences in the results to changed forcing factors, such as greenhouse gas concentrations.rnDue to meagre comparison data sets, the verification of results presented here is problematic. Deeperrnknowledge about the dust cycle during the Little Ice Age can be obtained by future simulations, based onrnthis work, and additionally using improved reconstructions of surface parameters. Better evaluation ofrnsuch simulations would be possible by refining the temporal resolution of reconstructed dust depositionrnfluxes from existing ice and marine sediment cores.

The Making of a Shiite Bourgeoisie in Lebanon Political Mobilisation, Economic Resources and Formation of a Social Group

The thesis analyses the making of the Shiite middle- and upper/entrepreneurial-class in Lebanon from the 1960s till the present day. The trajectory explores the historical, political and social (internal and external) factors that brought a sub-proletariat to mobilise and become an entrepreneurial bourgeoisie in the span of less than three generations. This work proposes the main theoretical hypothesis to unpack and reveal the trajectory of a very recent social class that through education, diaspora, political and social mobilisation evolved in a few years into a very peculiar bourgeoisie: whereas Christian-Maronite middle class practically produced political formations and benefited from them and from Maronite’s state supremacy (National Pact, 1943) reinforcing the community’s status quo, Shiites built their own bourgeoisie from within, and mobilised their “cadres” (Boltanski) not just to benefit from their renovated presence at the state level, but to oppose to it. The general Social Movement Theory (SMT), as well as a vast amount of the literature on (middle) class formation are therefore largely contradicted, opening up new territories for discussion on how to build a bourgeoisie without the state’s support (Social Mobilisation Theory, Resource Mobilisation Theory) and if, eventually, the middle class always produces democratic movements (the emergence of a social group out of backwardness and isolation into near dominance of a political order). The middle/upper class described here is at once an economic class related to the control of multiple forms of capital, and produced by local, national, and transnational networks related to flows of services, money, and education, and a culturally constructed social location and identity structured by economic as well as other forms of capital in relation to other groups in Lebanon.

Behavioural analysis of mouse mutants with altered neuronal and glial genes

Im ersten Teil dieser Doktorarbeit beabsichtigte meine Arbeit, die funktionelle Beteiligung des CB1 Rezeptors, einer Hauptkomponente des neuronalen Endocannabinoid-Systems (ECS), an der Ausbildung von verschiedenen Verhaltensphänotypen mit Hilfe von konditionalen Mausmutanten, denen der CB1 Rezeptor auf verschiedenen neuronalen Unterpopulationen fehlt, aufzuschlüsseln und zu untersuchen. Verschiedene Verhaltensmodelle wurden hierzu getestet. Dabei lag der Fokus dieser Arbeit auf der CB1f/f;D1-Cre Mauslinie, welche der CB1 Rezeptor auf den D1 Rezeptor exprimierenden Neuronen des Striatums fehlt. Ich konnte zeigen, dass der Verlust des CB1 Rezeptors auf diesen Neuronen keinen Einfluss auf basale neurologische Funktionen, Gewicht, Bewegung, Exploration, Sozialverhalten, Angst und Stressbewältigung der Tiere hat, jedoch eine Beteiligung an der Entwicklung von Suchtverhalten gegeben ist. Bei Betrachtung des Kokain-induzierten Suchtverhaltens zeigten die konditionalen Mausmutanten eine reduzierte Suchtanfälligkeit sowohl im Vergleich zu Tieren mit einem totalen CB1 Rezeptor Verlust in allen Körperzellen, als auch zu genetisch unveränderten Kontrollmäusen beider Linien.rnDes Weiteren zeigen die Ergebnisse dieser Studie eine große, aber gegensätzliche Beteiligung des ECS bei der Regulation von Exploration in Abhängigkeit des Verlustes des CB1 Rezeptors auf GABAergen Neuronen des Vorderhirns und kortikalen glutamatergen Neuronen, jedoch nicht auf striatalen Neuronen alleine. Zusätzlich war ich in der Lage, die Wichtigkeit des genetischen Hintergrunds von Mauslinien nicht nur auf die Ausbildung von spezifischen Verhaltensphänotypen, sondern auch auf die Genexpression zu zeigen.rnIn dem zweiten Teil dieser Arbeit, in dem ich mich auf die Funktion von Gliazellen konzentrierte, wurden ebenfalls Mausmutanten in verschiedenen Verhaltensmodellen getestet. Ein genetisches Auslöschen des NG2 Glykoproteins in Gliazellen sorgt in den Knock-out Mäusen für ein schlechteres Hörvermögen und ein reduziertes Depressionsverhalten im Vergleich zu ihren Wildtyp-Kontrollmäusen. Interessanterweise zeigten diese Tiere auch eine reduzierte Empfänglichkeit bei chemisch induzierten epileptischen Krämpfen, was eine Rolle des NG2 Glykoproteins bei der Kontrolle der glutamatergen Homöostase vorschlägt, die wahrscheinlich durch Strukturänderungen der Neuron-Glia-Synapse verursacht wird. rn

The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy

An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). A problem-orientated approach was used focussing on both published and practice-based evidence. In part I of the consensus the authors have tabulated the supporting evidence to produce a concise but comprehensive information base, pooling data and experience from 36 institutions in 9 European countries which involves more than 10,000 patients and over 45,000 treatment sessions during a period of more than 280 treatment years. In part II of the consensus the Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) based Motor Development Curves have been expanded to provide a graphical framework on how to treat the motor disorders in children with CP. This graph is named "CP(Graph) Treatment Modalities - Gross Motor Function" and is intended to facilitate communication between parents, therapists and medical doctors concerning (1) achievable motor function, (2) realistic goal-setting and (3) treatment perspectives for children with CP. The updated European consensus 2009 summarises the current understanding regarding an integrated, multidisciplinary treatment approach using Botulinum toxin for the treatment of children with CP.

Eye movement and diffusion tensor imaging analysis of treatment effects in a Niemann-Pick Type C patient

New treatment options for Niemann-Pick Type C (NPC) have recently become available. To assess the efficiency and efficacy of these new treatment markers for disease status and progression are needed. Both the diagnosis and the monitoring of disease progression are challenging and mostly rely on clinical impression and functional testing of horizontal eye movements. Diffusion tensor imaging (DTI) provides information about the microintegrity especially of white matter. We show here in a case report how DTI and measures derived from this imaging method can serve as adjunct quantitative markers for disease management in Niemann-Pick Type C. Two approaches are taken--first, we compare the fractional anisotropy (FA) in the white matter globally between a 29-year-old NPC patient and 18 healthy age-matched controls and show the remarkable difference in FA relatively early in the course of the disease. Second, a voxelwise comparison of FA values reveals where white matter integrity is compromised locally and demonstrate an individualized analysis of FA changes before and after 1year of treatment with Miglustat. This method might be useful in future treatment trials for NPC to assess treatment effects.