High levels of the amino acid arginine and low levels of the product citrulline in the cerebrospinal fluid of Alzheimer's patients could mean that there is a decrease in the enzymes that metabolize this amino acid. One such enzyme is neuronal nitric oxide synthase (nNOS). In this study, neuronal nitric oxide synthase (nNOS), sourced from bovine brain was extracted and concentrated using two methods of precipitation: poly (ethylene glycol) 20 000 (PEG) and ammonium sulphate [(NH₄)₂S0₄). These two techniques gave no increase in yield nor fold purification and hence were abandoned in favour of ion exchange chromatography by DEAE-Sepharose. The enzyme was then successfully purified by anion-exchange and after dialysis produced a 38% yield and three fold purification and yielded the highest specific activity of 2.27 U/mg. Neuronal nitric oxide synthase (nNOS) was a heterodimeric protein with a total molecular mass of ± 225 kDa (95 and 130 kDa monomers). The temperature and pH optima of the enzyme were 40⁰C and 6.5, respectively. The kinetic parameters (KM and Vmax) of nNOS were 70 μM and 0.332 μmol.min⁻¹, respectively. Moreover neuronal nitric oxide synthase (nNOS) was relatively stable at 40⁰C (t½ = 3 h). It was also confirmed that β-amyloid peptides inhibited nNOS when bound to the enzyme and that nNOS behaved as a catalyst in fibril formation through association-dissociation between enzyme and β-amyloid peptide. It was further shown that Aβ₁₇₋₂₈ inhibited nNOS the most with a Ki of 1.92 μM and also had the highest Stern-Volmer value (Ksv) of 0.11 μM⁻¹ indicating tight binding affinity to nNOS and easier accessibility to fluor molecules during binding. Congo red, turbidity, thioflavin-T assays and transmission electron microscopy were successfully used to detect and visualize the presence of fibrils by studying the process of fibrillogenesis. Computerized molecular modeling successfully studied protein dynamics and conformational changes of nNOS. These results correlated with resonance energy transfer (FRET) results which revealed the distance of tryptophan residues from the arginine bound at enzyme active site. Both the aforementioned techniques revealed that in the natural state of the enzyme with arginine bound at the active site, the tryptophan residues (TRP₆₂₅ and TRP₇₂₁) were positioned at the surface of the enzyme 28 Å away from the active site. When the amyloid peptide (Aβ₁₇₋₂₈) was bound to the active site, these same two amino acids moved 14 Å closer to the active site. A five residue hydrophobic fragment Aβ₁₇₋₂₁ [Leu₁₇ - Val₁₈ - Phe₁₉ - Phe₂₀ - Ala₁] within Aβ₁₇₋₂₈ was shown by computer modeling to be critical to the binding of the peptide to the active site of nNOS.

The start of the amyloidogenic pathway in Alzheimer’s disease (AD) begins with the deposition of the Aβ₁₋₄₂ peptide surrounded by astrocytes. High levels of arginine and low amounts of neuronal nitric oxide synthase (nNOS) are associated with AD. These astrocytes store reserve arginine that is eventually metabolized by nNOS, within the vicinity of the Aβ₁₋₄₂ peptide. We propose the existence of an association vs. dissociation equilibrium between Aβ and nNOS such that nNOS is an amyloidogenic catalyst for fibrils. When Aβ binds to nNOS, it inhibits the activity of the enzyme (association phase). However when the amyloid peptide dissociates into a form that can no longer bind, later deduced as a fibril, the activity is restored. Thus, the interaction of Aβ with nNOS could serve to regulate the interaction between nNOS and arginine by restoring activity of the enzyme but at the same time promoting fibrillogenesis. Given this event occurring with the neuron, both nNOS and amyloid can serve as a biomarker for the early onset of AD. The enzyme nNOS catalyzed the formation of fibrils in the presence of Aβ peptides, while Ag nps were shown to reverse the fibril formation from Aβ peptides more so than Au and curcumin either through electrostatic or π-π stacking (aromatic) influences. Our studies have shown that the fragments of Aβ₁₋₄₂ i.e. the pentapeptide (Aβ₁₇₋₂₁) and the three glycine zipper peptides (Aβ₂₅₋₂₉, Aβ₂₉₋₃₃, Aβ₃₃₋₃₇) and the full length glycine zipper stretch (Aβ₂₅₋₃₇) all inhibited nNOS activity to varying degrees. The peptides Aβ₁₇₋₂₁ and Aβ₂₉₋₃₃ with their respective Ki values of 5.1 μM and 7.5 μM inhibited the enzyme the most. The Ki values for reversed sequenced peptides (Aβ₁₇₋₂₁r and Aβ₂₉₋₃₃r) were two fold greater than that of the original peptides while the Ki values for the polar forms (Aβ₁₇₋₂₁p and Aβ₂₉₋₃₃p) were between 3-4 fold greater than that of the original peptides. It was also found that Ag nps (Ki = 0.12 μM) inhibited the activity of nNOS the most compared to Au nps; (Ki = 0.15 μM) and curcumin (Ki = 0.25 μM). At 298K, all the ligands bound at a single site on the enzyme (n=1) and a single Trp residue (θ =1), (later identified as Trp678) was made available on the enzyme surface for quenching by the ligands. Increasing the temperature from 298K-313K, increased the value of Ksv and pointed to a dynamic quenching mechanism for Aβ peptides, nps and curcumin interaction with nNOS. The positive signs for entropy and enthalpy for all Aβ peptides nps and curcumin pointed to hydrophobic–hydrophobic interaction with the enzyme. The fact that Kd increased with temperature emphasized the endothermic nature of the binding reaction and the requirement of thermal energy to aid in diffusion of the ligand to the active site. It was concluded that the binding reaction between the ligands and nNOS was non-spontaneous and endothermic at low temperatures (+ΔG) but spontaneous at high temperatures (-ΔG). The two amino acids Tyr706 and Trp678 moved from their original positions, subject to ligand binding. Trp678 moved a minimum distance of 5 Å toward the heme while Tyr706 moved a maximum distance of 14 Å away from the heme. AutoDock 4.2 was a valuable tool in monitoring the distance of Trp678 within the enzyme interior and fluorescence resonance energy transfer (FRET) was efficient in monitoring the distance moved by Trp residues on the enzyme surface.

Les patients atteints de la MA souffrent d'altérations métaboliques et synaptiques précoces. Via la glycolyse et le cycle de Krebs, le métabolisme du glucose permet la production d'ATP, essentielle à l'activité et la plasticité synaptique. Contrairement aux neurones, les astrocytes utilisent majoritairement la glycolyse pour métaboliser le glucose. En plus de la production d'énergie, la glycolyse fournit les précurseurs indispensables à la synthèse de biomolécules comme la L-sérine. Cet acide aminé est produit à partir du glucose par la déviation du 3-phosphoglycérate (3PG), un intermédiaire glycolytique, via l'enzyme 3-phosphoglycérate déshydrogénase (PHGDH), exprimée spécifiquement dans les astrocytes. La L-sérine est le précurseur de la D-sérine, le principal co-agoniste des NMDAR nécessaires à l'activité et la plasticité synaptique.Nous avons utilisé des souris 3xTg-AD, un modèle développant une MA progressive, afin d'étudier si une altération de la production de L-/D-sérine pouvait contribuer à des déficits synaptiques.A 6 mois, lorsque les souris 3xTg-AD ne possèdent pas encore de plaques amyloïdes dans l'hippocampe, nous avons observé in vivo une diminution du métabolisme du glucose, de la concentration de L-sérine et des déficits synaptiques (LTP). L'expression locale de la PHGDH est aussi altérée. L'application de D-sérine restaure complètement les déficits de LTP chez les souris 3xTg-AD.Ces données supportent l'hypothèse qu'un déficit de production de L-sérine par les astrocytes médié par une diminution du flux glycolytique serait responsable de l'altération synaptique observée dans l'hippocampe des souris 3xTg-AD. / An early alteration of both cerebral glucose metabolism and synaptic activity has been consistently described in Alzheimer's disease (AD) patients. Metabolism of glucose via glycolysis and the citric acid cycle produces ATP that is essential for synaptic activity and plasticity. In the brain, glucose is predominantly processed glycolytically into astrocytes and not by neurons. Beyond ATP production, a major function of aerobic glycolysis is to provide precursors to support macromolecular synthesis. L-serine, generated from glucose through diversion of the glycolytic intermediate 3-phosphoglycerate (3PG) into the phosphorylated pathway, is only produced in astrocytes by 3-phosphoglycerate dehydrogenase (PHGDH), selectively expressed in those glial cells. L-serine is the precursor of D-serine, the main co-agonist of synaptic NMDAR, required for synaptic activity and plasticity. We used 3xTg-AD mice, which develop a progressive pathology, to investigate whether a defective production of L-/D-serine contributes to early synaptic deficits in AD. We found that 3xTg-AD mice display early in vivo alterations of glucose metabolism, synaptic deficits (LTP) in the CA1 region and also lower concentration of L-serine. The local expression of PHGDH was significantly altered. Exogenous D-serine completely rescued LTP in 3xTg-AD mice. These data support the hypothesis that a deficit of L-serine synthesis by astrocytes likely mediated by a decreased glycolytic flux may be responsible for the synaptic alteration mediated by NMDAR in the hippocampus of 3xTg-AD mice.

Alzheimer’s disease is a debilitating, progressive neurodegenerative disorder in the elderly, characterized by severe loss of memory and higher cognitive functions. In the hundred years since its discovery, Alzheimer’s disease (AD) has traversed from the status of a ‘rare neurological oddity’ to one of the greatest challenges faced by healthcare and medicine in this millennium. A reported 44 million people currently suffer from AD but only 1 in 4 people have been diagnosed. Although AD has been an area of intense research for almost 50 years now, most studies have focused on the end stage disease. Years of study on the pathological cause underlying AD; have conclusively shown that the accumulation of the sticky peptide, Aβ, is one of the major triggers of AD pathogenesis. However, after the initial Aβ trigger, multiple processes contribute to disease progression, so that by the time a patient is diagnosed on the basis of overt behavioral phenotypes, it is difficult to understand and differentiate between the causative mechanisms and the consequential effects of the disease. It is, perhaps, because of this, that we are still struggling to find therapies for AD which will stop or at the very least slow the course of the disease. In the 2015 report on AD, issued by the Alzheimer’s association, much emphasis has been placed on the early diagnosis of AD and the revision of the diagnostic criteria for AD. According to the new guidelines proposed in 2011, AD has been divided into three stages where the first stage occurs before the appearance of overt behavioral symptoms such as memory loss, whereas by the 1984 guidelines, cognitive disabilities must have already occurred for diagnoses of AD. This proposed preclinical stage of AD has been defined, reflecting the current belief that AD pathogenesis begins almost 20 years before the occurrence of behavioral dysfunction. However, no diagnostic criteria are currently available to establish this stage. Hence, there is a need to understand the early pathogenic mechanisms of AD, which will yield early therapeutic targets as well as early diagnostic markers of AD. One of the earliest documented events in AD pathogenesis is synaptic dysfunction, which is later manifested as loss of dendritic spines. Deficits in long term potentiation (LTP) has been demonstrated in Aβ exposed hippocampal slices as well as in mouse models of AD, much before the appearance of pathological hallmarks such as plaques and tangles as well as overt behavioral phenotypes. While these and other studies indicate clearly that elevated levels of soluble Aβ peptide leads to impairment of synaptic function, the underlying molecular mechanisms are yet to be elucidated. One of the purported mediators of Aβ induced dysfunction is oxidative stress. The Aβ peptide, especially the Aβ42, is a self aggregating peptide with a propensity to form peptidyl radicals. Interaction of the peptidyl radicals with biomolecules leads to the generation of more free radical species via cascading chain reactions. Additionally, Aβ peptide has also been demonstrated to have synaptotoxic effects via its effect on NMDA receptors and calcium influx leading to deregulated reactive oxygen species (ROS) production as well as excitotoxicity. Hence, with a view to understanding Aβ mediated early synaptic dysfunction in AD, we studied early signaling changes in the synaptosomes derived from the cortex of APP/PS1 mice model of AD at various ages. The APP/PS1 model contains a mouse/human chimeric APP gene bearing the KM670/671NL Swedish mutation and the human PS1 gene with an exon 9 deletion. These mice exhibit behavioral deficits from 7 months of age while plaque deposition and gliosis become apparent by 9 months of age. We chose to study both pre-symptomatic ages (1 and 3 months old) as well as post symptomatic (9 months old) mice. Post nuclear supernatant (PNS) as well as synaptosomes were isolated from the cortex of APP/PS1 and age matched control mice. We assayed the levels of reactive oxygen species (ROS) in the PNS and the synaptosomes of post symptomatic 9 months old APP/PS1 mice and age matched controls. In contrast to reports of enhanced oxidative stress markers in the brains of AD patients, we did not find any increase in the levels of ROS in the PNS of post symptomatic APP/PS1 mice compared to age matched controls. However, synaptosomes from the cortex of these animals exhibited a significant increase in ROS levels in APP/PS1 mice compared to controls. We further found that there was significant increase in the ROS levels in synaptosomes, but not PNS, of very young asymptomatic 1 and 3 months old APP/PS1 mice. This is a first demonstration of synapse specific increase in oxidative stress in AD mice, as young as 1 month of age, indicating that disease specific mechanisms operate at the synapse much before the appearance of any overt cellular or behavioral symptoms. The increase in synaptic ROS levels correlated with a small but significant increase in the levels of Aβ42 in the brains of APP/PS1 mice compared to controls. We also found a concurrent change in the redox status of the cytoskeletal protein, actin, at the synapse. As early as 1 month of age, there was a significant decrease in the protein level of reduced actin indicating that there is an increase in the level of oxidized actin at the synapse. This loss of reduced actin was specific to the fibrillar pool of actin while no significant change was observed in the redox status of the monomeric globular pool of actin. Oxidation of actin has been demonstrated to lead to its depolymerization. Concurrently, we found a significant loss of fibrillar actin in the synaptosomes of APP/PS1 mice. Actin is the major cytoskeletal protein at the synapse. Changes in the globular to fibrillar actin ratio at the synapse at early pre-symptomatic ages in APP/PS1 mice will likely lead to structural and consequent functional changes at the synapse. This could potentially be one of the triggers of synaptic dysfunction in AD. Furthermore, changes in the Akt-mTOR signaling pathway was also observed in the synaptosomes of 1 month old APP/PS1 mice, which is sustained at 9 months. There was a significant loss of the mTOR-pS6K-4EBP1 axis in the synaptosomes, but not PNS, of APP/PS1 mice. We found that loss of Akt signaling, as evinced by loss of Akt phosphorylation, Akt kinase activity as well as loss of phosphorylation of downstream effector GSK3β, potentially underlies the loss of mTOR signaling. Further, the loss of Akt signaling is mediated by synapse specific redox modification of Akt and consequent interaction with the protein phosphatase PP2a. Loss of the Akt-mTOR signaling at the synapse is indicative of deficits in local protein translation. Loss of this essential synaptic function, which plays critical roles in synapse maintenance as well as synaptic plasticity during learning and memory, at an early age, will have long ranging impact on synaptic function such as long term potentiation (LTP) in APP/PS1 mice. Our study is the first demonstration of oxidative stress and consequent signaling changes which occur specifically at the synapse of very young 1 month old APP/PS1 mice. These changes occur much before the appearance of overt phenotype such as plaque deposition and behavioral dysfunction but sustain till the appearance of classical pathological hallmarks. Hence, the study demonstrates that disease progression starts much before previously thought and provides us a critical time window during which therapeutic strategies designed to delay or stop these changes might change the course of AD.

This dissertation proposes to combine magnetic resonance imaging (MRI), positron emission tomography (PET) and a neuropsychological test, Mini-Mental State Examination (MMSE), as input to a multidimensional space for the classification of Alzheimer’s disease (AD) and it’s prodromal stages including amnestic MCI (aMCI) and non-amnestic MCI (naMCI). An assessment is provided on the effect of different MRI normalization techniques on the prediction of AD. Statistically significant variables selected for each combination model were used to construct the classification space using support vector machines. To combine MRI and PET, orthogonal partial least squares to latent structures is used as a multivariate analysis to discriminate between AD, early and late MCI (EMCI and LMCI) from cognitively normal (CN)s. In addition, this dissertation proposes a new effective mean indicator (EMI) method for distinguishing stages of AD from CN. EMI utilizes the mean of specific top-ranked measures, determined by incremental error analysis, to achieve optimal separation of AD and CN. For AD vs. CN, the two most discriminative volumetric variables (right hippocampus and left inferior lateral ventricle), when combined with MMSE scores, provided an average accuracy of 92.4% (sensitivity: 84.0%; specificity: 96.1%). MMSE scores were found to improve classification accuracy by 8.2% and 12% for aMCI vs. CN and naMCI vs. CN, respectively. Brain atrophy was almost evenly seen on both sides of the brain for AD subjects, which was different from right side dominance for aMCI and left side dominance for naMCI. Findings suggest that subcortical volume need not be normalized, whereas cortical thickness should be normalized either by intracranial volume or the mean thickness. Furthermore, MRI and PET had comparable predictive power in separating AD from CN. For the EMCI prediction, cortical thickness was found to be the best predictor, even better than using all features together. Validation with an external test set demonstrated that best of feature-selected models for the LMCI group was able to classify 83% of the LMCI subjects. The EMI-based method achieved an accuracy of 92.7% using only MRI features. The performance of the EMI-based method along with its simplicity suggests great potential for its use in clinical trials.

La maladie d’Alzheimer (MA) est la maladie neurodégénérative la plus commune et reste à ce jour incurable. Elle se caractérise par l’accumulation dans le cerveau du peptide neurotoxique bêta-amyloïde (Aβ), par une neuroinflammation et des atteintes neurovasculaires, qui ensemble induisent la mort des neurones et des déficits cognitifs. En raison de leurs activités multiples, les métalloprotéases matricielles (MMPs) émergent comme des acteurs importants dans la MA. Mes travaux ont permis de mieux comprendre l’implication de 3 de ces MMPs dans la MA et soulignent le caractère spécifique et complémentaire de MT1- et MT5-MMP, directement impliquées dans la production d’Aβ, et le rôle de MMP-12 dans la neuroinflammation et dans la perte d’intégrité de la barrière hémato-encéphalique, un système vasculaire particulier qui protège efficacement le cerveau. Mes travaux ouvrent des perspectives dans le développement de nouvelles stratégies thérapeutiques basées sur la modulation de ces MMPs. / Alzheimer's disease (AD) is the most common neurodegenerative disease and remains to this day incurable. It is characterized by the accumulation in the brain of the beta-amyloid (Aß) neurotoxic peptide, by neuroinflammation and neurovascular damage, which together induce neuronal death and cognitive deficits. Because of their multiple activities, matrix metalloproteinases (MMPs) are emerging as important players in AD. My work has provided insight into the involvement of 3 of these MMPs in AD and highlight the specific and complementary nature of MT1- and MT5-MMP, directly involved in the production of Aß, and the role of MMP-12 in neuroinflammation and in the loss of integrity of the blood-brain barrier, a particular vascular system, which effectively protects the brain. My work opens perspectives in the development of new therapeutic strategies based on the modulation of these MMPs.

Alzheimer’s disease (AD) is a complex neurodegenerative disorder, involving metabolic dysfunction, pathogenic aggregation of amyloid beta, and deteriorating cognitive function. Patients exhibit deficiency in omega-3,-6,-9 unsaturated fatty acids (UFAs) in plasma and brain membrane phospholipids, suggesting aberrant fatty acid metabolism influences pathology. Cognitive benefits of omega UFAs in AD remain unknown. Here, I examined effects of a four-month dietary supplementation with UFAs for capacity to alter learning and memory behaviour in an AD mouse model. Cognitive impairment in a fifth generation backcross (N5) C57BL/6Crl X C3H/HeJ TgCRND8 (Tg) mice was compared to control (NonTg) littermates, with respect to both males and females, at six months of age using the Morris Water Maze (MWM). Impairment differed between sexes; female Tg mice were severely impaired, whereas male Tg mice displayed delayed learning. A reduced visual acuity in Tg and NonTg mice, shown by adapted SLAG reflex test, did not impair spatial navigation in cued MWM. A four-month omega-6/-9 UFA oral treatment (75 mg/kg/day) improved learning and memory of Tg mice as compared to vehicle and untreated controls. Omega-3 UFAs, or vehicle alone, did not alter learning and memory of Tg and NonTg mice. Thus, dietary supplementation, particularly when enriched in omega-6/9 UFAs, can affect neural function, and delay conversion from a presymptomatic to symptomatic state in the TgCRND8 mouse model.

The sigma-1 receptor (sig-1R) is a unique endoplasmic reticulum (ER) chaperone protein that interacts with a variety of voltage- and ligand-gated ion channels, which are components of an intricate system that regulates neuronal functioning. While there is an extensive body of knowledge pertaining to the sig-1R, many questions remain. The first question this thesis addresses is how the sig-1R modulates the functioning of the N-methyl-D-aspartate receptor (NMDAR). Using a heterologous expression system, I provide evidence that the mechanism of modulation is likely not a direct interaction between sig-1R and NMDAR and that this is not affected by the presence or absence of the membrane-associated guanylate kinases (MAGUK) protein PSD-95. The next question addressed investigates the impact of sig-1R absence on the synaptic physiology and action potential firing of CA1 pyramidal neurons. It was found that there is not a significant difference in these parameters, suggesting a non-essential role of the sig- 1R under normal physiological conditions. The third topic covered in my studies explores the sig-1R KO mouse in the Aβ25-35 infusion model of Alzheimer’s disease (AD). Preliminary results suggest that there is a dysfunction in the action potential characteristics and after- hyperpolarization characteristics of challenged sig-1R KO mice. Overall my results provide the groundwork for future experiments that will lead to a better understanding of the sig-1R and its role in cellular and synaptic physiology.

The thesis was designed to gain insight into how Alzheimer’s disease influences selfhood from first-personal accounts of illness. The focus of the study was narrowed further by concentrating on the autobiographies of individuals diagnosed with Early-Onset Alzheimer’s disease (EOAD). The purpose of this thesis was to analyze the autobiographies of individuals with EOAD with the aim of understanding their selfhood. In this thesis I argue that, Alzheimer’s disease may influence a change in self, however, the self is not lost entirely. This thesis draws on the philosophical conception of narrated self as it allows for one perpetually constructed self, whereby a change in self does not necessarily mean the self is lost entirely. Through an interpretive analysis of six autobiographical accounts of Alzheimer’s, this thesis demonstrates that Alzheimer’s disease influences a loss of sense of self but that autobiography enables individuals with Alzheimer’s to (re)construct self.

Little is known about the specific cognitive impairments that may be the cause of the reported increased crash rate in individuals with early dementia. Though, it is widely accepted that attention, visuospatial and perceptual abilities are central in being able to operate a vehicle safely. This study had three objectives. The first was to clarify the neuropsychological profile, with an emphasis on attention, visuospatial and perceptual abilities, of individuals with early dementia with Lewy bodies (DLB), the next was to examine the driving performances of two groups of individuals with early dementia (i.e., early Alzheimer’s disease, AD, and early DLB) and the last was to examine the degree of association between neuropsychological impairments and driving impairments in hopes of predicting poor driving outcomes. Fifty-six participants were recruited from three groups; 20 individuals diagnosed with early AD, 15 individuals diagnosed with early DLB and 21 healthy age-matched controls. All participants were administered the following neuropsychological tests: the Mini-Mental Status Exam (MMSE), the Dementia Rating Scale (DRS-2), the Boston Naming Test (BNT), the Test of Everyday Attention (TEA), the Visual Object and Space Perception Test (VOSP) and the Useful Field of View (UFOV). Additionally, a simulated driving task was completed, with data being collected through primary measures recorded by the simulator as well as an experimenter based driving assessment using a demerit-point test. Results indicated that individuals with early DLB were found to be most impaired in their visuospatial abilities, selective and divided attention abilities, and were found to have significant cognitive fluctuations. Driving performances confirmed that drivers with early dementia were at greater risk for motor vehicle collisions (MVC) and they were found to commit a significant number of driving errors during the driving simulation. Finally, this study was able to demonstrate that in drivers with early AD, attentional impairments were the strongest predictors of driving impairment, whereas in drivers with early DLB, visuospatial impairments were indicative of driving impairment.