Dans un contexte de performance sportive, de réhabilitation ou de santé, les étirements sont couramment utilisés dans le but de préparer le système neuromusculaire à l’exercice subséquent. Si la littérature montre majoritairement que les étirements altèrent de façon aigue la performance musculaire et/ou fonctionnelle, il existe toutefois des études dont les résultats diffèrent, suggérant l’influence d’un certain nombre de facteurs sur la variabilité des réponses du système neuromusculaire. Pour une meilleure compréhension de cette variabilité et des mécanismes impliqués, cette thèse avait pour objectif d’examiner l’influence de différents paramètres sur le système neuromusculaire : la durée d’étirement, le groupe musculaire et la modalité d’étirement. Au travers de quatre études, il a été montré que les étirements statiques pouvaient altérer la production de force maximale et les propriétés neuromusculaires indépendamment de la durée d’étirement. Cependant, il est apparu que ces modulations étaient spécifiques au muscle, et plus précisément à la raideur relative du système musculo-tendineux. Indépendamment de la durée d’étirement, les étirements statiques ne seraient pas efficaces pour préparer le système neuromusculaire à une activité musculaire subséquente, et notamment pour des muscles raides. Plus particulièrement, les étirements dynamiques ne paraissent pas plus efficaces. Même si les effets néfastes ont été diminués comparativement aux étirements statiques, ils ne favoriseraient pas davantage la production de force ni la commande nerveuse. Toutefois, il est intéressant de noter qu’une durée courte d’étirements dynamiques peut réduire la résistance passive à l’étirement, et donc augmenter potentiellement l’amplitude articulaire maximale, sans affecter les capacités de production de force. Finalement, les étirements dynamiques pourraient être envisagés comme une activité musculaire dynamique, qui compense partiellement les effets néfastes de l’étirement sur la performance musculaire. D’un point de vue pratique, ceci suggère que ce type d’étirements peut être réalisé avant une performance, mais néanmoins accompagnés d’une activité musculaire de plus haute intensité, afin d’optimiser les effets de l’échauffement musculaire sur le système neuromusculaire. En définitive, la variabilité des réponses du système neuromusculaire serait dépendante de facteurs spécifiques, tels que la modalité d’étirement et la raideur relative du système musculo-tendineux, soulignant l’importance de les prendre en considération dans la pratique. / Stretching is traditionally incorporated into pre-exercise routines in health, rehabilitation and sporting environments to condition the neuromuscular system for exercise. While a large body of evidence reported that stretching may acutely impair the subsequent muscular performance, some conflicting results highlight possible mitigating factors of neuromuscular responses variability. Because the limited data available do not present a clear consensus, the aim of this thesis was to investigate the effects of different factors on neuromuscular responses to stretch: the muscle group, the stretch duration and modality. By means of four studies, it has been shown that static stretching may alter maximal voluntary torque and neuromuscular properties, irrespective of the stretch duration. However, these modulations were dependent on the muscle group, and more specifically on the intrinsic stiffness of the muscle-tendon system. Regardless of the stretch duration, static stretching appears to be not effective, or even detrimental, to prepare the musculotendinous system for subsequent exercises, and especially for stiff muscles. It is also relevant that dynamic stretching was not better than static stretching. Even if stretch-induced impairments were mitigated compared to static stretching, dynamic stretching would not optimize muscle strength capacities and central nervous system. However, a short duration of dynamic stretching may be sufficient to reduce passive resistive torque, and therefore potentially increase maximal range of motion, without affecting muscle strength capacities. Finally, dynamic stretching could be considered as dynamic muscle activity, which would partly counteract deleterious muscle-tendon stretching effects. From a practical point of view, dynamic stretching could be a part of warm-up procedure, but should be associated to stronger contractions to optimize the improvement in muscle strength capacities. In summary, the variability of neuromuscular responses to stretch would be dependent on specific factors, such as stretching modality and relative stiffness of the musculotendinous system, emphasizing the importance of taking it into consideration in practice.

La maladie d'Azheimer (MA) est une pathologie neurodégénérative qui est liée dans ses stades précoces à un dysfonctionnement synaptique et une perte de synapses. De nombreuses données cliniques obtenues chez des patients mais également des données expérimentales obtenues sur des modèles murins de la MA montrent qu'il existe un dimorphisme sexuel s'exprimant par un dépôt de plaques amyloïdes supérieur et une apparition précoce de troubles mnésiques chez les souris femelles par rapport aux souris mâles. Dans ce travail, nous avons étudié les altérations moléculaires et cellulaires de la MA ainsi que les déficits cognitifs associés chez la souris femelle APP/PS1, un modèle murin double transgénique de la MA. En parallèle nous avons étudié les altérations de la transmission et de la plasticité synaptique dans le stratum moleculare, une couche proche du gyrus dentelé (DG) en raison de la forte densité de plaques amyloïdes dans cette région de l'hippocampe.Nous avons mis en évidence la présence de nombreuses plaques amyloïdes dans le DG en quantité supérieure chez les femelles âgées de 6 mois par rapport aux mâles du même âge ainsi qu'une forte activation des cellules gliales astrocytes et microglie. Ces altérations moléculaires et cellulaires s'accompagnent de déficits mnésiques hippocampo-dépendants (test du comportement de peur conditionné et test de la nouvelle localisation spatiale d'un objet) dès l'âge de 4 mois chez les femelles alors que les mâles ne présentent aucun déficit jusqu'à l'âge de 12 mois.Nous avons alors étudié les propriétés électriques des neurones du gyrus dentelé (DG), la transmission et la plasticité de la synapse voie perforante - neurones du gyrus dentelé (synapse PP-DG) chez la souris femelle âgée de 6 mois en comparant les deux génotypes APP/PS1 vs sauvage.Les neurones du DG présentent deux populations distinctes en terme de résistance d'entrée et de patron de décharge de potentiels d'action (PAs). A l'inverse, le potentiel membranaire de repos, la résistance d'entrée, le seuil d'activation et l'amplitude du potentiel d'action ne sont pas modifiés chez la souris APP/PS1 vs la souris sauvage. La fréquence de décharge des potentiels d'action est augmentée chez la souris APP/PS1 sans que la probabilité de décharge en fonction de la pente du pied du potentiel d'action (courbe E-S) soit différente entre la souris APP/PS1 et la souris sauvage. La transmission basale à la synapse PP-DG est modifiée chez la souris APP/PS1 vs la souris sauvage sans altérations du ratio AMPA/NMDA ni de l'index de rectification AMPA. La fréquence des courants miniatures NMDA est augmentée dans les neurones DG de la souris APP/PS1 vs la souris sauvage ce qui suggère le démasquage de synapses silencieuses qui n'expriment peu ou pas de récepteurs AMPA. La potentialisation à long terme (PLT) de l'amplitude des potentiels d'action synchrone est diminuée d'environ 50% chez la souris APP/PS1. La diminution de la PLT observée chez la souris APP/PS1 est en partie liée à des altérations des propriétés intrinsèques des neurones du DG comme le montre le déplacement des courbes E-S induit par la PLT qui traduit une augmentation d'excitabilité de la souris APP/PS1.En conclusion nos résultats montrent un dimorphisme sexuel important avec un dépôt des plaques amyloïdes et une activation neuroinflammatoire des cellules gliales plus précoce chez la souris femelle vs mâle. En parallèle, des déficits importants de la mémoire hippocampale-dépendante sont observés ainsi que des altérations de la transmission et de la plasticité synaptique à la synapse voie perforante - neurones du gyrus dentelé, une synapse clé de l'intégration des informations mnésiques en provenance du cortex enthorhinal. / Azheimer's disease (AD) is a neurodegenerative disease that is linked in its early stage to synaptic dysfunction and loss of synapses. Numerous clinical data obtained from patients but also experimental data obtained on mouse models of AD show that there is a sexual dimorphism evidenced by a higher amyloid plaque deposition and an early onset of memory disorders in female mice compared to male mice.In this work, we investigated the molecular and cellular alterations of AD as well as the associated cognitive deficits in female APP/PS1 mice, a double transgenic murine model of AD. In parallel we studied the alterations of hippocampal synaptic transmission and plasticity in the stratum moleculare, a layer in the vicinity of the dentate gyrus (DG) which specifically displayed a high density of amyloid plaques. We showed the presence of numerous amyloid plaques in the DG in a larger amount in 6 month old females compared to age-matched males as well as a strong activation of astrocyte and microglia glial cells. These molecular and cellular alterations are accompanied by hippocampo-dependent memory deficits (contextual fear conditioning and novel object place recognition task) from the age of 4 months in females whereas males have no deficit until the age of 12 months. We then studied the electrical properties of DG neurons, the transmission and the plasticity of the perforant pathway - DG neurons (PP-DG synapse) in the 6-month old female mouse by comparing the two genotypes APP/PS1 vs wild type (WT).In both genotypes, DG neurons displayed two distinct populations in terms of input resistance and action potential discharge pattern (APs). In contrast, the resting membrane potential, the input resistance, the activation threshold and the amplitude PAs were not modified in APP/PS1 vs WT. The frequency of discharge of APs was increased in APP/PS1 without shift of E-S curve which relates EPSP-slopes to the associated AP firing probability.Basal transmission at the PP-DG synapse was altered in the APP/PS1 mouse vs WT without alterations in the AMPA/NMDA ratio or the AMPA rectification index. The frequency of the NMDA miniature currents was increased in APP/PS1 DG neurons vs WT which suggests the unmasking of silent synapses that express almost no AMPA receptors. The long term potentiation (LTP) of population spike amplitude was decreased by approximately 50% in APP/PS1 mice. The decrease in LTP observed in APP/PS1 was partly related to alterations in the intrinsic properties of DG neurons as evidenced by LTP-induced shifts of E-S curves, which reflects an increased excitability for APP/PS1 mice.In conclusion our results show a prominent sexual dimorphism with much earlier amyloid plaque deposition, neuroinflammatory glial activation in female vs male APP/PS1. In parallel, significant deficits in hippocampal-dependent memory are observed as well as alterations of synaptic transmission and plasticity at the PP-DG synapse, a key synapse of the integration of mnesic informations originated from the entorhinal cortex

The effect of interleukin-1 beta (IL-1β) on the electrical properties of sensory neurons was assessed at comparable levels and exposure times to those found in animal models of neuropathic pain. Experiments involved whole cell current- or voltage-clamp recordings from rat dorsal root ganglion (DRG) neurons in defined medium, neuron enriched cultures. 5-6 days exposure to 100 pM IL-1β produced neuron specific effects. These included an increase in the excitability of medium diameter and small diameter isolectin B4 (IB4)-positive neurons that was comparable to that found after peripheral nerve injury. By contrast, a reduction in excitability was observed in large diameter neurons, while no effect was found in small diameter IB4-negative neurons. Further characterization of changes in medium and small IB4-positive neurons revealed that some, but not all, effects of IL-1β were mediated through its receptor, IL-1RI. Using appropriate voltage protocols and/or ion substitutions, it was found that neuron specific changes in several ionic currents, including alterations in hyperpolarization activated inward current (IH) and decreases in various K+ currents contribute to the increased excitability produced by IL-1β. Overall, these studies revealed that: 1. The effects of long-term exposure of DRG neurons to IL-1β are reflective of the enduring increase in primary afferent excitability reported after peripheral nerve injury. This expands the recognized role of IL-1β in acute inflammatory pain to neuropathic pain. 2. Hyperexcitability in medium neurons exposed to IL-1β likely includes mixed populations of neurons corresponding to nociceptive and non-nociceptive primary afferent fibres and, therefore, has relevance to hyperalgesia and allodynia, respectively. 3. The responsiveness of small IB4-positive neurons, but not IB4-negative, to prolonged IL-1β exposure is consistent with the suggestion that small IB4-negative afferents are involved in inflammatory pain, while small IB4-positive afferents are involved neuropathic pain. 4. The identification of receptor mediated effects and several contributing ionic mechanisms, may have relevance to the development of new therapeutic approaches to neuropathic pain. 5. IL-1β can contribute to increased neuronal excitability by mechanisms that are independent of IL-1RI signalling. This should be taken into account when targeting IL-1β, or more specifically IL-1RI, in the management of neuropathic pain.

Meine Dissertation behandelt verschiedene neue rauschinduzierte Phänomene in anregbaren Neuronenmodellen, insbesondere solche mit FitzHugh-Nagumo Dynamik. Ich beschreibe das Auftreten von vibronischer Resonanz in anregbaren Systemen. Sowohl in einer anregbaren elektronischen Schaltung als auch im FitzHugh-Nagumo Modell zeige ich, daß eine optimale Amplitude einer hochfrequenten externen Kraft die Signalantwort bezüglich eines niederfrequenten Signals verbessert. Weiterhin wird der Einfluß von additivem Rauschen auf das Zusammenwirken von stochastischer und vibronischer Resonanz untersucht. Weiterhin untersuche ich Systeme, die sowohl oszillierende als auch anregbare Eigenschaften beinhalten und dadurch zwei interne Frequenzen aufweisen. Ich zeige, daß in solchen Systemen der Effekt der stochastischen Resonanz deutlich erhöht werden kann, wenn eine zusätzliche hochfrequente Kraft in Resonanz mit den kleinen Oszillationen unterhalb der Anregungsschwelle hinzugenommen wird. Es ist beachtenswert, daß diese Verstärkung der stochastischen Resonanz eine geringere Rauschintensität zum Erreichen des Optimums benötigt als die standartmäßige stochastische Resonanz in anregbaren Systemen. Ich untersuche Frequenzselektivität bei der rauschinduzierten Signalverarbeitung von Signalen unterhalb der Anregungsschwelle in Systemen mit vielen rauschunterstützten stochastischen Attraktoren. Diese neuen Attraktoren mit abweichenden gemittelten Perioden weisen auch unterschiedliche Phasenbeziehungen zwischen den einzelnen Elementen auf. Ich zeige, daß die Signalantwort des gekoppelten Systems unter verschiedenen Rauscheinwirkungen deutlich verbessert oder auch reduziert werden kann durch das Treiben einzelner Elemente in Resonanz mit diesen neuen Resonanzfrequenzen, die mit passenden Phasenbeziehungen korrespondieren. Weiterhin konnte ich einen rauschinduzierten Phasenübergang von einem selbstoszillierenden System zu einem anregbaren System nachweisen. Dieser Übergang erfolgt durch eine rauschinduzierte Stabilisierung eines deterministisch instabilen Fixpunktes der lokalen Dynamik, während die gesamte Phasenraumstruktur des Systems erhalten bleibt. Die gemeinsame Wirkung von Kopplung und Rauschen führt zu einem neuen Typ von Phasenübergängen und bewirkt eine Stabilisierung des Systems. Das sich daraus ergebende rauschinduziert anregbare Regime zeigt charakteristische Eigenschaften von klassisch anregbaren Systemen, wie stochastische Resonanz und Wellenausbreitung. Dieser rauschinduzierte Phasenübergang ermöglicht dadurch die Übertragung von Signalen durch ansonsten global oszillierende Systeme und die Kontrolle der Signalübertragung durch Veränderung der Rauschintensität. Insbesondere eröffnen diese theoretischen Ergebnisse einen möglichen Mechanismus zur Unterdrückung unerwünschter globaler Oszillationen in neuronalen Netzwerken, welche charakteristisch für abnorme medizinische Zustände, wie z.B. bei der Parkinson′schen Krankheit oder Epilepsie, sind. Die Wirkung von Rauschen würde dann wieder die Anregbarkeit herstellen, die den normalen Zustand der erkrankten Neuronen darstellt. / My thesis is concerned with several new noise-induced phenomena in excitable neural models, especially those with FitzHugh-Nagumo dynamics. In these effects the fluctuations intrinsically present in any complex neural network play a constructive role and improve functionality. I report the occurrence of Vibrational Resonance in excitable systems. Both in an excitable electronic circuit and in the FitzHugh-Nagumo model, I show that an optimal amplitude of high-frequency driving enhances the response of an excitable system to a low-frequency signal. Additionally, the influence of additive noise and the interplay between Stochastic and Vibrational Resonance is analyzed. Further, I study systems which combine both oscillatory and excitable properties, and hence intrinsically possess two internal frequencies. I show that in such a system the effect of Stochastic Resonance can be amplified by an additional high-frequency signal which is in resonance with the oscillatory frequency. This amplification needs much lower noise intensities than for conventional Stochastic Resonance in excitable systems. I study frequency selectivity in noise-induced subthreshold signal processing in a system with many noise-supported stochastic attractors. I show that the response of the coupled elements at different noise levels can be significantly enhanced or reduced by forcing some elements into resonance with these new frequencies which correspond to appropriate phase-relations. A noise-induced phase transition to excitability is reported in oscillatory media with FitzHugh-Nagumo dynamics. This transition takes place via noise-induced stabilization of a deterministically unstable fixed point of the local dynamics, while the overall phase-space structure of the system is maintained. The joint action of coupling and noise leads to a different type of phase transition and results in a stabilization of the system. The resulting noise-induced regime is shown to display properties characteristic of excitable media, such as Stochastic Resonance and wave propagation. This effect thus allows the transmission of signals through an otherwise globally oscillating medium. In particular, these theoretical findings suggest a possible mechanism for suppressing undesirable global oscillations in neural networks (which are usually characteristic of abnormal medical conditions such as Parkinson′s disease or epilepsy), using the action of noise to restore excitability, which is the normal state of neuronal ensembles.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by loss of motor neurons and their supporting cells in the brain, brainstem and spinal cord, resulting in muscle paresis and paralysis including the bulbar (speech, chewing, swallowing) and respiratory muscles. The average age at onset is 55 years, and death due to respiratory failure occurs 2-5 years after symptom onset in ~ 85% of cases. Five to 10% of ALS is familial, and about 20% of familial cases are associated with mutations in the superoxide dismutase 1 (SOD1) gene. To date, 118 SOD1 mutations have been reported worldwide (www alsod.org). All are dominantly inherited, except for the D90A mutation, which is typically recessively inherited. D90A homozygous ALS is associated with long (~14 years) survival, and some atypical symptoms and signs. The reason for this is not known. In contrast, most other SOD1 mutations are associated with average survival, while some are associated with aggressive disease having lower motor neuron predominance and survival less than 12 months. The A4V mutation, which is the most frequently occurring SOD1 mutation in the United States, is an example of the latter. Understanding the pathogenic mechanisms of SOD1 mutants causing widely different disease forms like D90A and A4V is of paramount importance. Overwhelming scientific evidence indicates that mutations in the SOD1 gene are cytotoxic by a “gain of noxious” function, which although not fully understood results in protein aggregation and loss of cell function. This thesis explores different ALS-SOD1 gene mutations in British Columbia (BC), Canada. Two hundred and fifty-three ALS patients were screened for SOD1 mutations, and 12 (4.7%) unrelated patients were found to carry one of 5 different SOD1 mutations: A4V (n=2); G72C (n=1); D76Y (n=1); D90A (n=2); and 113T (n=6). Incomplete penetrance was observed in 3/12 families. Bulbar onset disease was not observed in the SOD1 mutation carriers in this study, but gender distribution was similar to previously reported studies. Age at symptom onset for all patients enrolled, with or without SOD1 mutations, was older than reported in previous studies. On average, patients with SOD1 mutations experience a longer diagnostic delay (22.6 months) compared to patients without mutations (12 months). Two SOD1 patients were originally misdiagnosed including the G72C patient who’s presenting features resembled a proximal myopathy. Neuropathological examination of this patient failed to reveal upper motor neuron disease. The I113T mutation was associated with variable age of onset and survival time, and was found in 2 apparently sporadic cases. The D76Y mutation was also found in an apparently sporadic case. I113T and D76Y are likely influenced by other genetic or environmental factors in some individuals. Two patients were homozygous for the D90A mutation, with clinical features comparable to patients originally described in Scandinavia. Clinical and electrophysiological motor neuron abnormalities were observed in heterozygous relatives of one D90A homozygous patient. The A4V patients were similar to those described in previous studies, although one had significant upper motor neuron disease both clinically and neuropathologically. Clinical neurophysiology is essential in the diagnosis of ALS, and helpful in monitoring disease progression. A number of transcranial magnetic stimulation (TMS) studies may detect early dysfunction of upper motor neurons when imaging techniques lack sensitivity. Peristimulus time histograms (PSTHs), which assess corticospinal function via recording of voluntarily activated single motor units during low intensity TMS of the motor cortex, were used to study 19 ALS patients having 5 different SOD1 mutations (including 8 of the 12 patients identified with SOD1 mutations from BC). Results were compared with idiopathic ALS cases, patients with multiple sclerosis (MS), and healthy controls. Significant differences were found in corticospinal pathophysiology between ALS patients with SOD1 mutations, idiopathic ALS, and MS patients. In addition, different SOD1 mutants were associated with significantly different neurophysiologic abnormalities. D90A homozygous patients show preserved if not exaggerated cortical inhibition and slow central conduction, which may reflect the more benign disease course associated with this mutant. In contrast, A4V patients show cortical hyper-excitability and only slightly delayed central conduction. I113T patients display a spectrum of abnormalities. This suggests mutant specific SOD1 pathology(s) of the corticospinal pathways in ALS.

No description available.

Les mécanismes cellulaires et moléculaires qui sous-tendent la mémoire et l’apprentissage chez les mammifères sont incomplètement compris. Le rythme thêta de l’hippocampe constitue l’état « en ligne » de cette structure qui est cruciale pour la mémoire déclarative. Dans la région CA1 de l’hippocampe, les interneurones inhibiteurs LM/RAD démontrent des oscillations de potentiel membranaire (OPM) intrinsèques qui pourraient se révéler importantes pour la génération du rythme thêta. Des travaux préliminaires ont suggéré que le courant K+ I(A) pourrait être impliqué dans la génération de ces oscillations. Néanmoins, peu de choses sont connues au sujet de l’identité des sous-unités protéiques principales et auxiliaires qui soutiennent le courant I(A) ainsi que l’ampleur de la contribution fonctionnelle de ce courant K+ dans les interneurones. Ainsi, cette thèse de doctorat démontre que le courant I(A) soutient la génération des OPM dans les interneurones LM/RAD et que des protéines Kv4.3 forment des canaux qui contribuent à ce courant. De plus, elle approfondit les connaissances sur les mécanismes qui régissent les interactions entre les sous-unités principales de canaux Kv4.3 et les protéines accessoires KChIP1. Finalement, elle révèle que la protéine KChIP1 module le courant I(A)-Kv4.3 natif et la fréquence de décharge des potentiels d’action dans les interneurones. Nos travaux contribuent à l’avancement des connaissances dans le domaine de la modulation de l’excitabilité des interneurones inhibiteurs de l’hippocampe et permettent ainsi de mieux saisir les mécanismes qui soutiennent la fonction de l’hippocampe et possiblement la mémoire chez les mammifères. / Cellular and molecular mechanisms underlying learning and memory in mammals are incompletely understood. The theta rhythm in the hippocampus constitutes the « on-line » state of this structure which is crucial for declarative memory. In the CA1 hippocampal area, LM/RAD inhibitory interneurons exhibit intrinsic membrane potential oscillations (MPOs) that could be important for the generation of theta rhythm. Preliminary work suggested that K+ current I(A) could be involved in the generation of these oscillations. Nevertheless, little is known about the identity of the principal and auxiliary protein subunits underlying I(A) current and the extent of the functional contribution of this K+ current in hippocampal interneurons. Thus, this Ph.D. thesis shows that I(A) current underlies MPO generation in LM/RAD interneurons and that Kv4.3 proteins form channels that contribute to this current. Also, it deepens the knowledge on the mechanism controlling the interactions between Kv4.3 channel-forming principal subunits and KChIP1 auxiliary proteins. Finally, it reveals that KChIP1 modulates native I(A)-Kv4.3 current and the action potential discharge frequency in interneurons. Our work takes part in advancing the knowledge on the field of modulation of excitability in hippocampal inhibitory interneurons and allows a better understanding of the mechanisms underlying the function of the hippocampus and possibly memory in mammals.

Transcranial magnetic stimulation (TMS) is a widely-used investigative technique in motor cortical evaluation. TMS is now being used in the investigation of fatigue to help partition the effects of central fatigue. Few studies have utilized this technique to evaluate the effects of locomotor exercise and none in conditions of extreme exercise. Therefore, the purpose of this thesis was twofold; first, to answer methodological questions pertaining to the use of TMS in fatigue evaluation, particularly of the quadriceps, and second, to investigate the effects of extreme exercise conditions on the development of central and supraspinal fatigue and corticospinal excitability and inhibition. In Studies 1 and 2, the effect of approaching a target force in different ways before the delivery a TMS pulse and the difference between commonly-employed methods of determining TMS intensity on the selection of optimal TMS intensity were investigated. In Study 3, the effect of one night sleep deprivation on cognitive and exercise performance and central parameters was investigated. The effect of a 110-km ultra-trail on the supraspinal component of central fatigue was evaluated in Study 4. The principal findings from this thesis are that during TMS evaluation during brief voluntary contractions, it is essential to deliver the TMS pulse once the force has stabilized at the target and that a stimulus-response curve at 20% MVC is appropriate for determining optimal TMS intensity in exercise and fatigue studies. Furthermore, while sleep deprivation negatively-impacted cognitive and exercise performance, it did not influence neuromuscular parameters nor result in greater central fatigue. Supraspinal fatigue develops and corticospinal excitability increases during endurance/ultra-endurance running and cycling, while the effects on inhibitory corticospinal mechanisms are equivocal and probably depend on exercise characteristics and TMS intensity

Le but de cette thèse était la recherche de biomarqueurs des troubles de l'humeur (dépression unipolaire et troubles bipolaires). Compte tenu de l'étiologie de ces troubles (hypométabolisme du cortex préfrontal dorso-latéral et déficit de la neurotransmission GABA/glutamatergique), nous avons choisi d'étudier deux biomarqueurs : la performance saccadique et l'excitabilité corticale. Nos résultats montrent que les performances saccadiques (antisaccades) permettent (i) de discriminer les patients présentant des troubles de l'humeur de sujets sains, (ii) d'objectiver l'amélioration thymique des patients suite à un traitement, et (iii) d'évaluer l'effet neuromodulateur à court-terme d'une séance de stimulation magnétique transcrânienne répétée. Concernant les mesures d'excitabilité corticale, aucune différence liée à l'amélioration thymique des patients, ni de différences entre patients et contrôles ne ressortent significativement. Nous avons suggéré que le non-contrôle du « State-Dependency » (i.e., de l'« état neurocognitif » des sujets pendant les stimulations) puisse être l'une des causes de l'absence de résultats, et validé cette hypothèse en manipulant les registres cognitifs et émotionnels des sujets.Le second aspect de notre travail de thèse avait trait à l'étude de l'efficacité de la stimulation magnétique transcrânienne répétée (rTMS) comme alternative thérapeutique non médicamenteuse des troubles de l'humeur. Si la littérature s'accorde sur une efficacité significative mais modérée de la rTMS comme traitement, nos données n'ont pas mis en évidence de supériorité du traitement actif par rapport au traitement placebo dans le cas de la neurostimulation iTBS. Une des raisons de ce manque d'efficacité du traitement actif pourrait être liée à des questions d'ordre méthodologique, comme le choix des paramètres de stimulation. Plus généralement, cette absence de résultats incite à questionner le postulat théorique basant l'étude de la réactivité du CPFDL ou sa neuromodulation sur les propriétés du cortex moteur. Notre expérience, étudiant la réactivité de différentes zones corticales par couplage TMS-EEG, va dans ce sens en montrant que la réactivité du cortex moteur diffère de celle des autres cortex. Le couplage TMS-EEG devrait permettre de mieux comprendre l'impact de la neuromodulation rTMS sur la cible corticale visée, et donc d'adapter les paramètres de stimulations aux aires cérébrales stimulées, permettant à terme de traiter plus efficacement les troubles de l'humeur. / The aim of this doctoral thesis was to develop biomarkers for mood disorders (unipolar major depression and bipolar disorders). Considering mood disorders' etiology (Dorso lateral prefrontal cortex hypometabolism and GABA/glutamate neurotransmission deficits), we decided to study two biomarkers: saccadic performance and cortical excitability. Our results showed that saccadic performance (notably Antisaccades) allows (i) discriminating bipolar patients from healthy subjects, (ii) ascertaining patients' mood improvement, and (iii) evaluating the short-term neuromodulation induced by repetitive transcranial magnetic stimulation.Regarding cortical excitability measurements, our results did not reveal any differences neither between patients and healthy subjects, nor between Responders and non Responders to a treatment (Ketamine injection or rTMS). We suggested that the null results could be explained by the lack of control of State-Dependency. This assumption was tested and validated through the manipulation of the subjects' cognitive and emotional states.A second aim of this doctoral thesis was to study the efficacy of rTMS, a non pharmacological therapeutic alternative, as a treatment for mood disorders. Meta-analyses showed that anti depressant effect of rTMS seems to be significant but still moderate. In our experiment, mood improvement did not differ between active and sham rTMS. Basic methodological reasons such as stimulation parameters could explain this lack of efficacy. Overall, one could wonder about the validity of the theoretical postulate of rTMS, drawn upon motor cortex reactivity. This postulate inferred that both cortical reactivity of motor cortex and DLPFC are similar. Using TMS-EEG coupling, we studied the reactivity of these cortices, to TMS pulses, which revealed that motor cortex and DLPFC reactivities should not be assimilated. This result calls into question the relevance of the rTMS theoretical postulate. Coupling TMS and EEG should allow a better understanding of the impact of rTMS neuromodulatory effect over the targeted area, and thus to a better adaption of the stimulation parameters, which could lead to an improvement of rTMS efficacy as a treatment for mood disorders.

INTRODUÇÃO: A obtenção de medidas de excitabilidade cortical mediante a estimulação magnética transcraniana tem surgido nos últimos anos como método de avaliação da integridade funcional do trato cortico-spinal e rede interneuronal no córtex primário motor, abrindo perspectiva de utilizá-la na prática clínica. Alterações nos parâmetros de excitabilidade cortical tem sido relatados na síndrome fibromiálgica e outras síndromes dolorosas, se correlacionando com a gravidade de diferentes componentes dessas síndromes e mudando conforme o tratamento. Entretanto, apesar do seu potencial benefício, existe uma pequena quantidade de estudos disponíveis na literatura que tenham proposto a obtenção de dados de normalidade para esses parâmetros, com casuísticas pequenas, não pareadas por fatores que potencialmente alteraram seus valores. O presente estudo procurou montar uma curva de normalidade de parâmetros de excitabilidade cortical com cálculo de amostra, pareamento por idade e sexo, com estudo dos efeitos da lateralidade hemisférica e dominância, fase do ciclo menstrual e variabilidade inter e intraexaminador. MÉTODOS: Após cálculo amostral, foram convocados voluntários saudáveis do sexo masculino e feminino, pareados por idade. No total, 216 voluntários completaram o estudo. O potencial evocado motor, inibição intracortical e facilitação intracortical foram medidas no músculo primeiro interósseo dorsal após estímulo dos córtices motor primário bilateral. O grupo de 15 mulheres fez a primeira medição do uso de anticoncepcional oral e a segunda medição na fase de descanso do mesmo. A variabilidade interexaminador e intraexaminador foi aferida em 20 voluntários para cada uma das situações. RESULTADOS: A comparação entre os parâmetros de voluntários menores que 50 anos e maiores que 50 anos mostrou diferenças significativas. Foram obtidos os valores de normalidade para menores de 50 anos e maiores de 50 anos (média e desvio padrão): 1.Menores ou igual que 50 anos: LMR: 49 ± 9,39%; PEM 120%: 587,63±779,52 V; MEP 140%: 1413,08±1343,18 V; MEP 120/140%: 3,83±5,39 V; IIC 2ms: 0,40 ±0,44 V; IIC 4ms: 0,61± 0,84 V; IIC: 0,56± 0,63 V; FIC 10ms: 1,95 ±1,82 V; FIC 15ms: 1,80±1,73 V; FIC: 1,87±1,64 V. 2. Maiores de 50 anos: LMR: 49,1 ± 9.58%; PEM 120%:467,71±650,61 V; PEM 140%:1172,43±1158,47 V; PEM 120/140%: 4,04±4,27 V; IIC2ms: 0,73± 1,26 V; IIC 4ms: 1,04±1,67 V; IIC:0,81±1,03 V; FIC 10ms:2,46±3,85 V; FIC 15ms: 2,12±3,05 V; FIC: 2,28±3,32 V. Houve semelhança entre homens e mulheres( p>0,3). Os córtices motores direito e esquerdo apresentaram parâmetros semelhantes de excitabilidade cortical (p>0,25) para todas as análises. Assim, os valores para o hemisfério direito e esquerdo e os dados de homens e mulheres foram agrupados. Não houve diferença estatística significativa entre destros e sinistros (p>0,20). A variabilidade inter e intraexaminador é alta para a maior parte dos parâmetros, porém, com alta correlação para o limiar motor em repouso e potenciais evocados motores. A inibição e facilitação cortical tiveram baixa correlação, mas confiabilidade aceitável. Não houve diferença importante entre a quantidade de medidas anormais obtidas entre as fases do ciclo menstrual com ou sem o uso do anticoncepcional oral. CONCLUSÕES: Foram levantados os parâmetros de normalidade para adultos saudáveis acima e abaixo de 50 anos. A idade não tem um efeito linear sobre a excitabilidade cortical. Não há diferenças significativas entre sexo, lateralidade de hemisfério ou dominância sobre parâmetros de excitabilidade cortical. Não há correlação significativa entre as fases de uso de anticoncepcional oral e do seu descanso (período menstrual) com as medidas de excitabilidade cortical / BACKGROUND AND AIMS: Measures of cortical excitability parameters by transcranial magnetic stimulation have gained increasing interest as a way to obtain information on the functional integrity of the cortico-spinal tract and interneuronal networks within the primary motor cortex. Changes in cortical excitability parameters have been reported in fibromyalgia and neuropathic pain syndromes showing correlation with the severity of different symptoms of these pain syndromes, and seeming to change during treatment. Despite its potential use, there is a paucity of normative data for cortical excitability parameters. We aimed to obtain normative data for cortical excitability in healthy volunteers. METHODS: A sample size of men and women were matched according to age. In total 216 healthy volunteers completed the study. Rest motor threshold (RMT), motor evoked potentials (MEP), intracortical inhibition (ICI) and facilitation (ICF) were measured in the first dorsal interosseous muscle for both primary motor cortex A group of 15 women were measured twice, first during use of oral contraceptive and a second measure was obtained when not in use of it (menstruations phase). The inter and intrainvestigator variability was assessed in a sample of 20 healthy volunteers. RESULTS: The comparison between the cortical excitability parameters from volunteers younger than 50 years old and volunteers older than 50 years showed significant differences. Normative data for younger than 50 years and older than 50 years were obtained (mean and standard deviation): 1. Age of 50 years or younger: RMT: 49 ±9.39%; MEP120%: 587.63±779.52 V; MEP140%: 1413.08±1343.18 V; MEP120/140%: 3.83±5.39 V; ICI2ms: 0.40 ±0.44; ICI4ms: 0.61 ±0.84 V; ICI: 0.56±0.63 V; ICF10ms: 1.95 ±1.82 V; ICF15ms: 1.80±1.73 V; ICF: 1.87±1.64 V. 2. Older than 50 years: RMT: 49.1±9.58%; MEP120%: 467.71±650.61 V; MEP140%: 1172.43±1158.47 V; MEP120/140%: 4.04±4.27V; ICI2ms: 0.73± 1.26 V; ICI4ms: 1.04±1.67 V; ICI: 0.81±1.03 V; ICF10ms:2.46±3.85 V; ICF15ms: 2.12±3.05 V; ICF: 2.28±3.32 V. There was similarity between genders (p>0,3.) There was no difference between left and right hemispheres (p>0,25). Consequently data from both hemispheres and genders were grouped. There was no significant statistical difference between handedness. We found a good inter/intrainvestigator correlation for RMT and MEP. ICI and ICF had low correlations but an acceptable reliability. CONCLUSIONS: We reported normative data for cortical excitability in adult individuals younger and older than 50 years old. Age has a non-linear effect on cortical excitability. We found no left-right cortex asymmetries or differences related to gender or handedness. We found no correlation between the phases of contraceptive use and the menstruation phase and the cortical excitability parameters