Inspection of the published research shows that sex differences in cognition in the general population have been widely cited with the direction of the advantage depending on the domain being examined. The most prevalent claims are that men are better than women at visuospatial and mathematical tasks whereas women have superior verbal skills and perform better than men on tasks assessing episodic memory. There is also some evidence that women are more accurate than men at identifying facial expressions of emotion. A more in-depth examination of the literature, however, reveals that evidence of such differences is not as conclusive as would at first appear. Not only is the direction and magnitude of sex differences dependent on the cognitive domain but also on the individual tasks. Some visuospatial tasks show no difference (e.g. figure copying) whist men have been shown to be better than women at confrontation naming (a verbal task). Alzheimer’s disease is a heterogeneous illness that affects the elderly. It manifests with deficits in cognitive abilities and behavioural difficulties. It has been suggested that some of the behavioural issues may arise from difficulties with recognising facial emotion expressions. There have been claims that AD affects men and women differently: women have been reported as being more likely to develop AD and showing a greater dementia severity than men with equivalent neuropathology. Despite this, research into sex differences in cognition in AD is scarce, and conflicting. This research was concerned with the effect of sex on the cognitive abilities of AD patients. The relative performance of men and women with AD was compared to that of elderly controls. The study focused on the verbal, visuospatial and facial emotion recognition domains. Data was collected and analysed from 70 AD patients (33 male, 37 female), 62 elderly controls (31 male, 31 female) and 80 young adults (40 male, 40 female). Results showed those with AD demonstrate cognitive deficits compared to elderly controls in verbal and visuospatial tasks but not in the recognition of facial emotions. There were no significant sex differences in either the young adults or the healthy elderly controls but sex differences favouring men emerged in the AD group for figure copying and recall and for confrontation naming. Given that elderly men and women perform equivalently for these tasks, this represents a deterioration in women’s cognitive abilities, relative to men’s. Further evidence of such an adverse effect of AD was apparent in other tasks, too: for most verbal and visuospatial tasks, either an effect favouring women in the elderly is reversed or a male advantage increases in magnitude. There is no evidence of sex differences in facial emotion recognition for any group. This suggests that the lack of published findings reporting on sex differences in this domain is due to the difficulty in getting null findings accepted for publication. The scarcity of research examining sex differences in other domains is also likely to be due to this bias.

Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Apart from its primary function in the synaptic hydrolysis of acetylcholine, acetylcholinesterase (AChE) has been shown through in vitro demonstrations to be able to promote various non-cholinergic functions, including cell adhesion and neurite outgrowth, differentiation, and amyloidosis. AChE was also shown to bind to mouse laminin-111 in vitro by an electrostatic mechanism. Previous results suggest that the site on AChE recognised by certain monoclonal antibodies (MAbs) might be critical for differentiation. These MAbs were found to inhibit both laminin binding and cell adhesion in neuroblastoma cells. In this study, the structure and characteristics of this site were investigated, using the AChE-laminin interaction as a template as well as a detailed epitope analysis of the MAbs. The interaction sites of AChE and laminin were investigated using phage display, modelling and docking, synthetic peptides, enzyme linked immunosorbent assays (ELISAs) and conformational interaction site mapping. Docking of AChE with the single-chain variable fragments (scFvs) produced from the phage display showed the major recognition motifs to be the 90Arg-Glu-Leu-Ser-Glu-Asp motif, the 40Pro-Pro-Met-Gly sequence, and the 59Val-Val-Asp-Ala-Thr-Thr (human) motif. Mouse AChE was found to interact with the basic structures Val2718-Arg-Lys-Arg- Leu2722; Tyr2738-Tyr2739, Tyr2789-Ile-Lys-Arg-Lys2793; and Val2817-Glu-Arg-Lys2820, on the 1 G4 domain of laminin. ELISAs using synthetic peptides confirmed the involvement of the AG-73 site (2719-2729). This site overlaps with laminin’s heparin-binding site. Docking showed the major component of the interaction site on AChE to be the acidic Arg90-Glu-Leu-Ser-Glu-Asp95 (omega loop), and also involving the Pro40-Pro-Val42, Arg46 (linked to Glu94 by a salt bridge) and the hexapeptide Asp61 Ala-Thr-Thr-Phe-Gln66. Epitope analysis showed the MAb’s major recognition site to be the sequence Pro40-Pro- Met-Gly-Pro-Arg-Arg-Phe48 (human AChE). The MAbs also reacted with the prolinerich sequences Pro78-Gly-Phe-Glu-Gly-Thr-Glu84 and Pro88-Asn-Arg-Glu-Leu-Ser-Glu- Asp95. These results define the interaction sites involved in the AChE-laminin interaction and suggest that the interaction plays a role in cell adhesion. Despite the in vitro demonstrations of the importance of AChE’s non-classical functions, the AChE knockout survives. Results from this study suggest the possibility of functional redundancy between AChE and other molecules in early development. Using these in vitro findings that AChE is able to bind laminin-111, information on the interaction sites, as well as results from the monoclonal antibody (MAb) epitope analysis, the idea of redundancy was investigated. Docking and bioinformatics techniques were used to investigate structurally similar molecules that have comparable spatiotemporal expression patterns in the embryonic nervous system. AChE has been shown to be involved in the pathogenesis of Alzheimer’s disease, thus molecules associated with brain function and neurodegeneration were also investigated. Molecules with which AChE could be possibly redundant are syndecans, glypicans, perlecan, neuroligins and the low-density lipoprotein receptors and their variants. AChE was observed to dock with growth arrest-specific protein 6 (Gas6) as well as apolipoprotein E3 (ApoE-3) at the same site as the laminin interaction. The AChE interaction site was shown to resemble the apolipoprotein-binding site on the low density lipoprotein receptor, and related molecules, including the low density lipoprotein receptor-related molecule (LRP) and the sortilin-related receptor (SORL1). These molecules, along with apoE, are associated with Alzheimer’s disease. Resemblances to the triggering receptor on myeloid cells (TREM1) were also suggested; this is interesting as AChE has been implicated in both haematopoiesis and haematopoietic cancers. Coimmunoprecipitation results, applied to investigate alternative ligands for AChE, confirmed the AChE-laminin interaction in neuroblastoma cells, and also suggested the existence of other binding partners. In conclusion, characterisation of the AChE-laminin interaction sites and investigation of structurally similar sites in other molecules suggests a role for AChE in the stabilization of the basement membrane of developing neural cells and provides a feasible explanation for the survival of the knockout mouse. Furthermore, the demonstrated similarity of the AChE interaction site to sites on molecules, notably the low density lipoprotein receptor family and SORL1 and their apolipoprotein ligands that are implicated in the pathology of Alzheimer’s disease, as well as the possible link to haematopoietic differentiation and cancers, warrants further investigation. / AFRIKAANSE OPSOMMING: Talle in vitro studies wys dat die ensiem asetielcholienesterase (AChE), behalwe vir sy klassieke rol in die hidrolise van asetielcholien (ACh), ‘n aantal nie-cholinerge rolle vertolk insluitend in sel adhesie, in die uitgroei van neurieten, in differensiering, asook in amyloidosis. Dit is vooraf gewys dat AChE, met behulp van elektrostatiese meganismes, in vitro met muis laminin-111 kan bind. Dit word verneem dat die area op AChE wat herken word deur monoklonale teenliggaampies (MAbs), moontlik ‘n kritiese area is met betrekking tot differensiasie. Dieselfde MAbs is gevind om beide die laminin-interaksie, sowel as sel adhesie van neuroblastoma selle, te inhibeer. In hierdie projek word die struktuur en eienskappe van die betrokke kritiese areas ondersoek deur die AChE-laminin interaksie te gebruik as sjabloon. ‘n Gedetailleerde analise van die teenliggaam epitoop het ook geskied. Met behulp van faag vertoon, modellering en hegting, sintetiese peptiede, ensiem-gekoppelde immunosorbent toetse (ELISAs) en konformasie interaksie area kartering, is die betrokke interaksie areas bestudeer. Hegting van enkel-ketting varierende fragment (scFv) volgordes, verkry vanaf die vaag vertoon, aan AChE dui dat die hoof herkennings motiewe die 90Arg-Glu-Leu-Ser-Glu-Asp motief, die 40Pro-Pro- Met-Gly volgorde, en die 59Val-Val-Asp-Ala-Thr-Thr (mens) motief is. ‘n Interaksie tussen muis AChE en die 1 G4 domein van laminin is gevind. Die interaksie betrek die basiese structure: Val2718-Arg-Lys-Arg-Leu2722; Tyr2738-Tyr2739, Tyr2789-Ile-Lys-Arg- Lys2793; en Val2817-Glu-Arg-Lys2820. Die betrokkenheid van die AG-73 (2719-2729) area by hierdie interaksie is bevestig met ELISA eksperimente wat sintetiese peptiede inkorporeer. Die AG-73 area oorvleuel die heparin interaksie area op laminin. Hegtings eksperimente wys dat die hoof komponent van die interaksie area op AChE die suur volgorde Arg90-Glu-Leu-Ser-Glu-Asp95 op die omega-lus is. Die interaksie betrek ook die Pro40-Pro-Val42, Arg46 (gekoppel aan Glu94 deur ‘n sout-brug) en die heksapeptied Asp61 Ala-Thr-Thr-Phe-Gln66 motiewe. Analise van die MAb epitoop wys die hoof erkennings area as volgorde Pro40-Pro-Met-Gly-Pro-Arg-Arg-Phe48 (mens AChE). Die MAbs blyk ook gunstig te wees teenoor prolien-ryke volgordes soos Pro78-Gly-Phe-Glu-Gly-Thr-Glu84 en Pro88-Asn-Arg-Glu-Leu-Ser-Glu-Asp95. Die areas betrokke by die AChElaminin interaksie is dus gedefinieer en ‘n moontlike rol vir hierdie interaksie in sel adhesie word voorgestel. Die noodsaaklikheid van AChE se nie-klassieke funksies word bevraagteken na die oorlewing van die AChE uitklop-muis. Resultate hier dui op die moontlikheid van funksionele oortolligheid as verduideliking hiervan, spesifiek met betrekking tot molekules betrokke in vroëe ontwikkeling asook in die proses van neurale agteruitgang. Deur gebruik te maak van die in vitro demonstrasies van die AChE-laminin interaksie, informasie verkry ten opsigte van die betrokke interaksie areas, asook resultate verkry vanaf die monoklonale teenliggaam (MAb) epitoop analise, word die idee van funksionele oortolligheid ondersoek. Hegtings en bioinformatika tegnieke is gebruik om molekules met soortgelyke strukture en uitdrukkings patrone in die embrioniese senuweestelses te ondersoek. Ko-immuno presipitasie tegnieke is gebruik om so moontlike alternatiewe ligande vir AChE te ondersoek. Moontlike funksionele oortolligheid van AChE met die volgende molekules is gevind: syndecan; glypican; perlecan; neuroligin; asook die lae-digtheid lipoproteien (LDL) reseptore en hul variante. Hegting van AChE met ’growth arrest-specific’ proteien 6 (Gas6) en die apolipoproteien E3 (apoE3) is gedemonstreer en gevind om dieselfde area as die laminin interaksie te betrek. Die betrokke interaksie area op AChE het ooreenstemminge met die apolipoproteien interaksie area op die LDL reseptor asook met verwante molekules soos die lae-digtheids lipoproteien reseptor-geassosieerde molekuul (LRP) en die sortilingeassosieerde reseptor (SORL1). Hierdie molekules, insluitend apoE, speel beduidende rolle in die patologie van Alzheimer se siekte. Ooreenkomste tussen AChE en die verwekkings reseptor op myeloïde selle (TREM1) is ook voorgestel, die interaksie is van belang siende dat AChE voorheen geassosieer is met beide haematopoiesis en haematopoietiese kankers. Ko-immuno presipitasie resultate bevestig die AChE-laminin interaksie en dui op die moontlike teenwoordigheid van alternatiewe ligande vir AChE in vivo. In konklusie, karakterisering van die AChE-laminin interaksie areas, gepaard met identifisering van struktureel ooreenstemmende areas in ander molekules, dui op ‘n rol vir AChE in die stabilisering van die basale membraan en verskaf dus ‘n geldige verduideliking vir die oorlewing van die AChE uitklop-muis. Die ooreenstemming van die AChE interaksie area met areas op ander molekules (spesifiek geassosieer met Alzheimer se siekte), asook die moontlike assosiasie van AChE met haematopoietiese differensiering en kanker, lê die grondslag vir verdere ondersoeke.

The ZNF9 gene on chromosome 3 encodes the cellular nucleic acid binding protein (CNBP), a ubiquitously expressed, 177 amino acid (≈19.5kDa) protein that is highly conserved among vertebrates. The function of the protein is largely unknown, however an expansion in the first intron of the protein results in myotonic dystrophy type 2 (DM2), a multisystemic disease featuring cardiac arrhythmia, muscle wasting, cataracts, and a range of neuropathologies. Remarkably, we recently discovered that CNBP is involved in regulating the activity of β-secretase, the enzyme that produces the first cleavage event in the generation of the amyloid-β peptide (Aβ). The progressive fibrillization and deposition of Aβ is widely believed to be the primary causal factor in the development of Alzheimer’s disease (AD), and AD-like pathology in individuals with Down syndrome (DS). DS provides a unique model for evaluating how these factors change in the aged brain as compared to young brain, and how such changes affect the proportion of DS patients with AD. In the AD brain, both BACE1 and BACE2 increased from an early stage of disease; in DS brains, BACE1 significantly decreased (p<0.04) with age, whereas BACE2 was unchanged, even though the gene for BACE2 is located within the DS obligate region of chromosome 21. BACE1 and BACE2 activity levels were highly correlated in this series (r2 = 0.95), indicating that there may be a higher degree of shared regulation than previously believed. This implicates regulators of BACE as potentially critical for the development of AD, and our data suggests that CNBP may be one such regulator. In AD, CNBP increases early in the disease process, a change that does not occur in the normal aging process or in DS. CNBP and BACE protein levels were correlated in these cases (p<0.001), while there was no relationship between CNBP and age, or CNBP and Aβ, in either the human or mouse brain, indicating that CNBP does not increase as a consequence of normal aging. Thirty day overexpression of CNBP following adeno-associated viral delivery in murine gastrocnemius muscle resulted in an increase in BACE1 protein (p<0.01) and a consequential increase in Aβ production (p<0.01). Other experiments indicated that CNBP overexpression did not affect the half-life of BACE1 mRNA or protein, but resulted in an increase in BACE1 translation. These data indicate that CNBP is an important regulator of β-secretase, and may play an important role in the onset and progression of AD.

The multi-cultural demographics of those who are diagnosed with Alzheimer’s disease should be closely examined. From a designer’s standpoint, its cultural traits can foster positive behaviors that lead to better quality of life for patients and caregivers. A patient-centered approach in design was explored in order to shape community-based care that empowers (1) individuality in care services, (2) interpersonal connection in caregiver–patient activities, and (3) a communal culture of being valued via humanitarian approaches.

This critical synopsis of prior work by Clive Beggs is submitted in support of a PhD by published work. The work focuses on venous and cerebrospinal fluid (CSF) anomalies associated with multiple sclerosis (MS) and other neurological diseases. MS is characterized by focal inflammatory lesions, which are often venocentric. Recently a vascular syndrome, chronic cerebrospinal venous insufficiency (CCSVI) has been linked with MS. This syndrome, which is characterized by constricted cerebral venous outflow, has become mired in controversy, with various studies producing conflicting findings, with the result that the science associated with CCSVI has become obscured. Clive Beggs work seeks to bring clarity to the debate surrounding CCSVI by characterizing physiological changes associated with constricted cerebral venous outflow. The work submitted here involves collaborative studies with Robert Zivadinov (University of Buffalo), Paolo Zamboni (University of Ferrara), and Chih- Ping Chung (National Yang Ming University of Medicine). The key findings of these studies are: (i) MS patients, diagnosed with CCSVI, exhibit greatly increased hydraulic resistance of the cerebral venous drainage system; (ii) MS patients experience loss of the small cerebral veins; (iii) MS patients exhibit reduced CSF bulk flow, consistent with mild venous hypertension; (iv) MS patients exhibit increased CSF pulsatility in the Aqueduct of Sylvius, which appears to be linked with mild venous hypertension associated with CCSVI; and (v) jugular venous reflux is associated with white matter and parenchymal volumetric changes in Alzheimer’s patients. Collectively, these findings suggest that extracranial venous anomalies are associated with changes in the intracranial physiology.

La formation des agrégats des peptides et des protéines par l'interaction de feuillets β a de plus en plus attiré l'attention car elle se produit dans de nombreuses maladies humaines généralisées, telles que la sclérose latérale amyotrophique (SLA), la maladie d'Alzheimer (AD), la maladie de Parkinson (PD), les maladies à prions et la maladie de Huntington (HD). La maladie d'Alzheimer est la forme la plus courante de démence qui provoque la perte de la mémoire chez les personnes âgées. En 2013, il y avait 35 millions de personnes souffrant de AD à travers le monde, un chiffre qui devrait doubler d'ici 2050. Etiologiquement ces maladies se manifestent par des dépôts anormaux de protéines, y compris les plaques neuritiques séniles (PNS) et les dégénérescences neurofibrillaires (DNF). L'accumulation extracellulaire d'agrégats insolubles de la protéine β-amyloide (A) conduit à la formation de plaques séniles, tandis que DNF se produisent à l’intérieur des neurones et sont composés par des filaments hélicoidaux appariés de la protéine tau hyperphosphorylée. Les peptides A sont produits en tant que monomères solubles et subissent l'oligomérisation et la formation de fibrilles amyloides par un processus qui n’a pas été complètement clarifié. Il est suggéré que les peptides Aß solubles jouent un rôle important dans la croissance neuronale, la survie et la modulation synaptique, tandis que les oligomères et fibrilles ont des propriétés toxiques. Une nouvelle stratégie thérapeutique vers la prévention ou le traitement de maladies associées à des structures -feuillet et, en particulier, AD, est représentée par la synthèse de mimes de -brins qui peuvent antagoniser la formation ou la reconnaissance de feuillet ß. En fait, dans la maladie d’Alzheimer, le processus d'agrégation des protéines implique une transition de la structure secondaire non ordonnée/α-hélice à une conformation riche en feuillet β, conduisant à la formation de feuillet croisés. Sur la base des quelques données publiées récemment sur des mimes d’épingles  et en particulier des structures macrocycliques de Nowick, comme inhibiteurs de l'agrégation des protéines, nous avons supposé qu’une pré-structuration des molécules peptidomimétiques pourrait augmenter leur affinité pour les peptides A et donc augmenter leur activité inhibitrice de l'agrégation. Notre conception vers un mime d’épingle stable, qui pourrait interagir et éventuellement agir en tant que ligand de feuillets β et inhibiteur de l'agrégation, implique l’assemblage d’une dicétopipérazine bifonctionnelle en tant que scaffold , d’un brin peptidomimétique pour stabiliser la formation de feuillets β et enfin d’une séquence peptidique convenable pour la liaison à la protéine. Ces molécules ont montré une interaction avec le peptide Aβ1-42 ainsi qu’une modulation de la cinétique d’agrégation. / The formation of peptide and protein aggregates through the interaction of β-sheets has increasingly drawn attention since it occurs in many widespread human diseases, such as amyotrophic lateral sclerosis (ALS), Alzheimer’s disease (AD), Parkinson's disease (PD), prion diseases, and Huntington's disease (HD). Alzheimer’s disease is the most common form of dementia that causes memory loss in the elderly. In 2013, 35 million people were afflicted with AD worldwide, a number expected to double by 2050. Etiologically, the most common findings are abnormal protein deposits, including senile neuritic plaques (SNPs) and neurofibrillary tangles (NFTs). The extracellular accumulation of insoluble aggregates of β-amyloid protein (Aβ) leads to the formation of senile plaques, whereas NFTs occur intracellulary and are composed of paired helical filaments of hyperphosphorylated tau protein. Aβ peptides are produced as soluble monomers and undergo oligomerization and amyloid fibril formation via an unclear process. It is suggested that soluble A peptides play an important role in neuronal growth, survival, and synaptic modulation, while the oligomers and fibrils have toxic properties. Mimicking -strands to antagonize -sheet formation or recognition represent a new therapeutic strategy toward the prevention or treatment of diseases associated with -sheet structures such as AD. In this pathology, protein aggregation process involves a secondary structure transition from unordered/α-helix to a β-sheet rich conformation, leading to cross β-sheet structure formation. Based on the few recent published data on β-hairpin mimics, in particular on the macrocyclic structures of Nowick, as inhibitors of protein aggregation, we hypothesized that pre-structuring the peptidomimetic molecules might increase their affinity for Aβ peptides and thus increase their aggregation inhibitory activity. Our design towards a stable β-hairpin mimic (Figure 1), which could interact and eventually act as a β-sheet binder and aggregation inhibitor, involved assembling of a bifunctional diketopiperazine scaffold , a peptidomimetic strand to stabilize the formation of β-sheets and finally a suitable peptide sequence for binding to the aggregating protein. These molecules were shown to interact with the native Aβ1-42 peptide and modulate the kinetics of aggregation.

Les protéines amyloïdes sont impliquées dans de nombreux processus pathologiques de maladies qui restent souvent incurables. Ces protéines solubles dans leur forme native, s’auto- assemblent pour former des oligomères, des fibrilles, des fibres et enfin des agrégats riches en feuillets β. C’est ce processus délétère qui est le point commun entre ces maladies amyloïdes. La protéine amyloïde la plus décrite est le peptide Aβ suspecté de jouer un rôle primordial dans la maladie d’Alzheimer. Récemment, les petits oligomères du peptide Aβ1-42 formés lors des étapes précoces de ce processus ont été décrit comme étant les plus toxiques.Au cours de cette thèse, nous avons donc développé deux méthodes pour pouvoir évaluer l’activité des composés synthétisés sur les étapes précoces de l’oligomérisation et une pour étudier l’affinité du peptide Aβ1-42 pour son ligand. Nous avons également conçu et synthétisé des peptidomimétiques comme ligands du peptide Aβ1-42 capables ainsi de perturber les interactions protéine-protéine du processus d’agrégation du peptide Aβ1-42. L’évaluation de ces composés ainsi que de différents ligands synthétisés au laboratoire a permis une intéressante étude sur la relation entre la structure des composés évalués et leurs activités sur les étapes cruciales du processus d’oligomérisation du peptide Aβ1-42. Des études de viabilité cellulaire, de RMN et de Docking sont en cours pour améliorer notre compréhension du mode d’action de ces composés et du processus d’oligomérisation du peptide Aβ1-42. / Amyloid proteins are involved in many pathological processes of diseases that are often incurable. These soluble proteins in their native form self-assemble to form oligomers, fibrils, fibers and finally aggregates rich in β-sheets. It is this deleterious process which is the common point between these amyloid diseases. The most described amyloid protein is the Aß peptide suspected of playing a key role in Alzheimer's disease. Recently, small peptide Aβ1-42 oligomers formed during the early stages of this process have appeared to be the most toxic species.In this thesis, we have developed two methods to evaluate the activity of different synthesized compounds on the early steps of oligomerization and one method to study the affinity of Aβ1-42 peptide for its ligand. We have also designed and synthesized peptidomimetics as ligands of Aβ1-42 peptide which are able to disrupt protein-protein interactions involved in the aggregation process of Aβ1-42 peptide. Evaluation of these compounds as well as other ligands synthesized in the laboratory allowed an interesting study on the relationship between the structure of the tested compounds and their activities on the critical steps of the oligomerization process of Aβ1-42 peptide. Cell viability studies, NMR and docking are underway to improve our understanding of the mode of action of these compounds and of the oligomerization process of Aβ1-42 peptide.

Ce travail de thèse a permis la caractérisation de deux familles de modulateurs mitochondriaux: les analogues de l’alloprégnanolone et les nouveaux ligands synthétiques de la protéine de translocation mitochondriale ou translocator protein (TSPO) impliquée dans la neurostéroidogenèse. Nos résultats clés ont montré que: i) in vitro, BR297, un analogue de l'alloprégnanolone atténue les déficits bioénergétiques liés à la maladie d'Alzheimer et présente un effet protecteur contre le stress oxydatif, en réduisant les espèces réactives de l'oxygène et la mort dans un modèle cellulaire de la maladie d'Alzheimer, avec une plus grande efficacité comparé à l’allopregnanolone; ii) in vivo, premièrement l’effet protecteur de BR297 a été confirmé dans un modèle de souris transgénique de la maladie d’Alzheimer en atténuant les déficits mitochondriaux,puis deuxièmement, BR297 et BR351 ont démontré des effets neuroprotecteurs sur les dysfonctionnements mitochondriaux liés à l'âge par l'amélioration de bioénergétique cellulaire et des activités des complexes mitochondriaux; et iii) in vitro, les ligands TSPO représentent des molécules prometteuses qui sont capables d'augmenter bioénergétique cellulaire avec des effets comparable ou plus important que des molécules de référence dans un modèle cellulaire de la maladie d'Alzheimer. / This PhD work allowed the characterization of two families of mitochondrial modulators: novel analogues of allopregnanolone, and novel synthetic ligands of translocator protein (TSPO) implicated in the neurosteroidogenesis. Our key findings showed that: i) in vitro, BR297, an analog of allopregnanolone alleviated Alzheimer’s disease-related bioenergetics deficits and exhibited protective effects against oxidative stress by reducing reactive oxygen species and decreasing death in a cellular model of Alzheimer’s disease,with a higher effectiveness compared to allopregnanolone; ii) in vivo, firstly the protective effect of BR297 was confirmed in the transgenic Tg2576 mouse model by alleviating the mitochondrial deficits, secondly BR297and another analog BR351 demonstrated neuroprotective effects on age-related mitochondrial dysfunctions via enhancement of cellular bioenergetics and complex activities; and iii) in vitro, TSPO ligands represent promising molecules which are able to increase cellular bioenergetics with similar/ or higher effects compared to different reference molecules in a cellular model of Alzheimer’s disease.

La maladie d’Alzheimer (MA) est une maladie multifactorielle et à ce jour aucune cause des formes sporadiques de la maladie, qui représente plus de 99% des cas, n’a été mise en évidence. Des données émergentes de la littérature suggèrent l’existence d’un lien entre les dysfonctionnements thyroïdiens et la MA. Dans ce contexte, l’objectif de cette étude était de préciser l’implication de l’hypothyroïdie dans les processus neuropathologiques de la MA. En utilisant un modèle de rats rendus hypothyroïdiens par un traitement au propylthiouracile (PTU), nous avons montré que l’hypothyroïdie favorise la mise en place de lésions caractéristiques de la MA dans l’hippocampe, structure du cerveau précocement altérée dans la maladie et qui joue un rôle crucial dans les processus de mémoire. Une étude d’IRM in vivo a révélé une diminution progressive du volume cérébral des rats hypothyroïdiens. Dans l’hippocampe, l’hypothyroïdie s’accompagne d’une augmentation de la production de peptides amyloïdes, d’une hyperphosphorylation de la protéine Tau et d’une augmentation de la libération de plusieurs cytokines pro-Inflammatoires. Ces lésions, caractéristiques de la MA, sont associées à des troubles de la mémoire spatiale à court et long terme et à une altération de deux voies de signalisation connues pour jouer un rôle important dans les processus de plasticité synaptique et de mémoire : la voie calcique et la voie ERK-MAPK. Afin d’évaluer le potentiel de restauration de ces lésions, une partie des rats hypothyroïdiens a reçu des injections intra-Péritonéales de triiodothyronine (T3), forme active des hormones thyroïdiennes. Nos résultats montrent que l’administration de T3 permet de restaurer les déficits de mémoire spatiale à court terme, mais pas à long terme. En outre, ce même traitement permet de restaurer les niveaux de cytokines pro-Inflammatoires, de peptides amyloïdes ainsi que les voies « calcique » et « ERK-MAPK ». Ces données renforcent l’existence d’un lien entre l’hypothyroïdie et la MA : elles suggèrent que l’hypothyroïdie pourrait représenter un facteur important pouvant impacter le risque de développer des formes sporadiques de la MA. / Alzheimer’s disease (AD) is a multifactorial disease and to date no single cause for the sporadic forms, which accounts for over 99% of the cases, has been established. Converging evidence suggests a possible link between thyroid dysfunctions and AD. The aim of the present study was to explore the possibility that adult hypothyroidism represents an etiopathogenic mechanism of AD. In this context, using a hypothyroid rat model induced by propylthiouracil (PTU) treatment, we report that hypothyroidism is associated with several AD-Associated hallmarks in the hippocampus, a brain structure affected in early stages of AD and which plays a crucial role in memory processes. In vivo MRI revealed a progressive decrease in cerebral volume of hypothyroid-Rats. In the hippocampus, hypothyroidism resulted in Tau hyperphosphorylation, increased levels of amyloid peptide and of several pro-Inflammatory cytokines. These AD-Related pathological hallmarks were associated with impaired short- and long-Term spatial memory and alteration of hippocampal signalling pathways important for synaptic plasticity and memory, including calcium and ERK-MAPK pathways. To test the potential reversion of PTU-Induced lesions, we injected hypothyroid rats with triiodothyronine (T3), the active form of thyroid hormone. Our results show that intraperitoneal injections of T3 restored spatial short-Term, but not long-Term memory in hypothyroid-Treated rat. Furthermore, levels of pro-Inflammatory cytokines, amyloid peptide and of proteins involved in calcium and ERK-MAPK signalling were restored. These data strengthen the link between hypothyroidism and AD, supporting the idea that hypothyroidism may represent an important factor impacting the risk for developing sporadic forms of AD.

L’objectif principal de cette thèse est d’évaluer l’impact thérapeutique d’une intervention de stimulation cognitive associée à un programme d’activité physique au stade léger à modéré de la maladie d’Alzheimer. Précisément, il s’agit de détailler les effets respectifs et combinés de ces interventions selon les trois dimensions suivantes : 1) le fonctionnement cognitif général, 2) le fonctionnement exécutif à travers la mise à jour, l’alternance, l’inhibition et la planification, 3) le fonctionnement psychosocial, intégrant l’anxiété et la dépression. L’étude principale de cette thèse a comparé les performances pré- et post-intervention de 67 patients répartis en quatre groupes (i.e., groupe stimulation cognitive, groupe activité physique, groupe stimulation cognitive plus activité physique, groupe contrôle). Les résultats ont montré que, 1) la stimulation cognitive permet l’amélioration du fonctionnement cognitif général et le maintien des capacités d’alternance et de mise à jour, 2) l’activité physique favorise l’amélioration des capacités d’inhibition et le maintien des capacités d’alternance, et 3), l’association de la stimulation cognitive et de l’activité physique permet l’amélioration du fonctionnement cognitif général, l’amélioration des performances d’alternance et d’inhibition et le maintien des capacités de mise à jour. L’ensemble de ces résultats met en évidence le potentiel thérapeutique de la stimulation cognitive et de l’activité physique dans le traitement de la maladie d’Alzheimer. De plus, les données recueillies montrent que les bénéfices des interventions sont d’autant plus importants lorsque le programme intègre les deux formes de prises en charge. Les mécanismes par lesquels s’opèrent les changements dans la cognition des personnes souffrant d’Alzheimer sont discutés à travers le concept de réserve cognitive. L’enjeu des futures recherches réside dans le développement de thérapies visant le maintien du fonctionnement exécutif à travers la stimulation des capacités physiques et cognitives. / The principal objective of this thesis was to evaluate the therapeutic impact of an intervention which combines a cognitive stimulation program and a physical activity program in mild to moderate Alzheimer's disease. Specifically, the objective was to detail the respective and combined effects of these interventions in the three following dimensions, 1) general cognitive functioning, 2) executive functioning with updating, switching, inhibition and planning, 3) psychosocial functioning, including anxiety and depression. The main study of this thesis examines the pre-and post-intervention scores of 67 patients assigned into four groups (i.e., cognitive stimulation, physical activity, cognitive stimulation combined with physical activity, and control). The data showed that, 1) cognitive stimulation improved general cognitive functioning and maintained updating and switching abilities, 2) physical activity improved inhibition and switching abilities, and 3) associate cognitive stimulation and physical activity allowed the improvement of general cognitive functioning, inhibition and switching abilities, and allowed remaining updating abilities. Taken together, these results demonstrate the therapeutic effects of cognitive stimulation and physical activity in Alzheimer's disease treatment. Moreover, the data collected showed that the benefits of the interventions were particularly important when the program included both interventions. Mechanisms of changes in cognition of Alzheimer's patients are discussed through the concept of cognitive reserve. The aim for future researches is to develop programs of cognitive stimulation and physical activities to preserve executive functioning.