Att utvärdera samband mellan subjektivt skattad smärta och transmittorsubstanser med magnetresonansspektroskopi Bakgrund: Smärta är en komplex upplevelse, som involverar olika delar av hjärnan. Regionen anterior cingulate cortex (ACC) är kopplad till upplevelsen av smärta och delas in i ett flertal mindre regioner, till exempel den pregenuala regionen (pgACC) och dorsala regionen (dACC). För att studera olika metaboliter och transmittorsubstanser kan magnetresonansspektroskopi (MRS) användas. MRS och sekvensen MEGA-PRESS kan mäta specifika transmittorsubstanser såsom Gamma-AminoButyric Acid (GABA) och glutamin-glutamat (Glx).  Motiv: Det finns kunskapsluckor kring hur individens subjektiva smärtupplevelse i relation till transmittorsubstanser objektivt kan mätas och utvärderas.  Syfte: Att med MRS och MEGA-PRESS undersöka GABA+ och Glx-nivåer i hjärnområdena pgACC och dACC samt undersöka samband mellan smärtkänslighet och GABA+ och Glx i pgACC och dACC.  Metod: En kvantitativ, experimentell pilotstudie genomfördes med tio friska deltagare. Initialt skannades deltagarna i MRT och smärtstimulerades, sedan skattade de den upplevda smärtan med hjälp av Numeric Rating Scale. MRS och tekniken MEGA-PRESS användes för att mäta transmittorsubstansnivåerna.   Resultat: Studien visade att det fanns en statistiskt signifikant negativ korrelation mellan skattad smärtintensitet och uppmätta nivåer av GABA+ i pgACC (Spearman´s rho = -0,67; p = 0,04). Det fanns även ett statistiskt signifikant positivt samband mellan skattad smärtintensitet och uppmätta nivåer av Glx i dACC (Spearman´s rho =0,73; p=0,02). Vidare fanns signifikant skillnad i Glx mellan pgACC och dACC och en icke signifikant skillnad i GABA+.  Konklusion: Sammanfattningsvis visar resultatet att MRS och MEGA-PRESS kan kvantifiera transmittorsubstanser vid utvärdering av smärtkänslighet och att det finns en positiv korrelation mellan Glx och skattad smärtintensitet, samt en negativ korrelation mellan GABA+ och skattad smärtintensitet. Detta kan ge fördjupad insikt i individens smärtupplevelse och kan främja den individuella behandlingen. Genom att ta hänsyn till sambandet mellan smärta och transmittorsubstanser kan det bidra till ökad förståelse kring individens smärtupplevelse. / To evaluate the relation between subjectively estimated pain and neurotransmitters using magnetic resonance spectroscopy  Background: Pain is a complex experience that involves different parts of the brain. The region anterior cingulate cortex (ACC) is connected to the experience of pain and can be divided into several smaller areas, such as the pregenual region (pgACC) and the dorsal region (dACC). To study different metabolites and neurotransmitters, magnetic resonance spectroscopy (MRS) can be used. MRS and the sequence (MEGA-PRESS) can measure specific neurotransmitters such as Gamma-AminoButyric Acid (GABA) and glutamin-glutamate (Glx).  Motive: There are knowledge gaps about how the individual's subjective pain experience in relation to neurotransmitters can be objectively measured and evaluated.  Aim: Using MRS and MEGA-PRESS to examine levels of GABA+ and Glx in the brain regions pgACC and dACC and to examine the relationship between pain sensitivity and GABA+ and Glx in pgACC and dACC.  Methods: A quantitative, experimental pilot study was conducted which included ten healthy participants. The participants were initially scanned in the MRI and subjected to pain-stimulation, thereafter the participants rated the perceived pain using Numeric Rating Scale. MRS and the sequence MEGA-PRESS were used to quantify the neurotransmitters of interest.  Result: There was a significant, negative correlation between rated pain intensity and measured GABA+ levels in pgACC (Spearman´s rho = -0,67; p = 0,04). There was also a significant, positive correlation between rated pain intensity and measured levels of Glx in dACC (Spearman´s rho =0,73; p=0,02). Furthermore, there was a significant difference in Glx between pgACC and dACC as well as a non-significant difference in GABA+ between regions.  Conclusion: In summary, the result shows that MRS and MEGA-PRESS can quantify neurotransmitters when evaluating pain sensitivity and that there is a positive correlation between Glx and estimated pain intensity, and also a negative correlation between GABA+ and estimated pain intensity. This can provide a deeper insight into the individual’s pain experience and promote individual treatment. Further research regarding the meaning of the different brain regions when measuring neurotransmitters is recommended.

Les modèles kainate et pentylènetétrazole représentent deux modèles d’épilepsie du lobe temporal dont les conséquences à long terme sont différentes. Le premier est un modèle classique d’épileptogénèse avec crises récurrentes spontanées tandis que le second se limite aux crises aigües. Nous avons d’abord caractérisé les différents changements survenant dans les circuits excitateurs et inhibiteurs de l’hippocampe adulte de rats ayant subi des crises à l’âge immature. Ensuite, ayant observé dans le modèle fébrile une différence du pronostic lié au genre, nous avons voulu savoir si cette différence était aussi présente dans des modèles utilisant des neurotoxines. L’étude électrophysiologique a démontré que les rats KA et PTZ, mâles comme femelles, présentaient une hyperactivité des récepteurs NMDA au niveau des cellules pyramidales du CA1, CA3 et DG. Les modifications anatomiques sous-tendant cette hyperexcitabilité ont été étudiées et les résultats ont montré une perte sélective des interneurones GABAergiques contenant la parvalbumine dans les couches O/A du CA1 des mâles KA et PTZ. Chez les femelles, seul le DG était légèrement affecté pour les PTZ tandis que les KA présentaient, en plus du DG, des pertes importantes au niveau de la couche O/A. Les évaluations cognitives ont démontré que seuls les rats PTZ accusaient un déficit spatial puisque les rats KA présentaient un apprentissage comparable aux rats normaux. Cependant, encore une fois, cette différence n’était présente que chez les mâles. Ainsi, nos résultats confirment qu’il y a des différences liées au genre dans les conséquences des convulsions lorsqu’elles surviennent chez l’animal immature. / Kainate and pentylenetetrazole models represent two animal models of temporal lobe epilepsy in which long-term consequences differ. The first model is a classical model of epileptogenesis with spontaneous recurrent seizures while the second one is limited to acute seizures. We wanted to characterize the difference in changes which occur in excitatory and inhibitory systems of the hippocampus of adult males and females having suffered an episode of status epilepticus during the immature stage of life. Besides having noticed a difference between genders in the febrile model, our second objective was to see if this difference was also present in models using neurotoxins. Electrophysiology recordings indicated that KA and PTZ rats (both male and female) showed a hyperactivity of NMDA receptors in CA1, CA3 and DG pyramidal cells. Anatomical modifications causing hyperactivity were studied and results show a selective loss of specific GABA interneurons PV in the O/A layer of CA1 region of the hippocampus in KA and PTZ male rats. However in female rats, only the DG layer was slightly affected in PTZ while female KA presented losses in both DG and O/A layers. Cognitive evaluation indicated that only PTZ rats showed a spatial impairment since KA rats had a similar learning pattern as controls. However, once again, that difference was observed only in males and not in females. In summary, our results confirmed that there is a difference between genders regarding brain damages after having suffered an episode of status epilepticus during the immature stage.

Type 1 diabetes affects a person’s life on many levels in terms of quality of life, health, and socioeconomic costs both for the patients but also their families. As of now there is no therapy that targets the underlying mechanism of the disease. Intralymphatic administration of Diamyd® is being evaluated in a phase IIb clinical trial, DIAGNODE-2. The aim was to examine if the intralymphatic administration is feasible for both patients and medical professionals, and to identify any aspects of the procedure that can be improved. This feasibility study is based on interviews and answers received from questionnaires. The medical professionals that were selected were radiologists and study nurses that are involved in the DIAGNODE-2 trial. The radiologists were the prime focus and were thus interviewed through face-to-face/skype or phone and answered a questionnaire. Study nurses, having more contact with the patient, answered a survey in order to gain additional insights into the patient perspective.   The results show that the radiologists has a positive view towards the administration procedure, which was described as easy and safe. According to the study nurses the patients accept the procedure and they agreed that the patients understand the injection procedure once they received the information. In terms of the emotional state of the patients they were a bit nervous, but they became calmer after receiving the first injection. Based on the above-mentioned findings the intralymphatic injection procedure is described as feasible and has the potential to become a part of the standard clinical routine.

La stimulation à haute fréquence (SHF) du noyau sous-thalamique (NST) permet de traiter l'ensemble des symptômes moteurs de la maladie de Parkinson (MP), mais aussi d'atténuer l'apparition les dyskinésies L-Dopa induites, grâce notamment à une réduction massive, voire complète, des prises de L-Dopa chez les patients stimulés. Toutefois, les mécanismes in fine qui sous-tendent l'efficacité thérapeutique de la SHF du NST chez l'homme ne sont pas encore élucidés, tout comme les possibles interactions pouvant exister entre les effets induits par la SHF du NST et ceux (synergiques ou non) d'un traitement à la L-DOPA.<br />Notre travail a porté principalement sur l'animal anesthésié, sain ou hémiparkinsonien, traité de manière chronique ou aiguë à la L-Dopa, et soumis ou non à la SHF du NST. Dans une première partie expérimentale, nous avons analysé chez le rat sain les modifications neurochimiques (variations des contenus en glutamate et en GABA mesurées par microdialyse intracérébrale) induites par la SHF du NST sur des structures situées à distance du NST mais impliquées directement ou indirectement dans les circuits moteurs, comme la region Fr3 du cortex moteur, le colliculus supérieur et le noyau ventro-médian du thalamus.Dans une deuxième partie, nous avons essayé de déterminer si la SHF du NST pouvait modifier la réponse à la L-Dopa (suite à un traitement chronique ou aigu) sur les contenus en dopamine (et ses métabolites DOPAC et HVA), en glutamate et en GABA. Les principaux résultats obtenus mettent en exergue une interaction synergique entre les effets d'une injection unique de L-Dopa et ceux induits par la SHF du NST. En effet, il apparaît que cette stimulation stabilise les taux élevés de dopamine suite au traitement L-Dopa, retardant ainsi son métabolisme. Ces résultats pourraient donc apporter de arguments intéressants concernant les effets bénéfiques de la SHF du NST observés chez les malades parkinsoniens, notamment dans la stabilisation des fluctuations motrices. <br />Les données obtenues au cours de ce travail doctoral apportent de nouveaux arguments pour la compréhension des mécanismes de la SHF du NST, et amènent de nouvelles perspectives justifiant l'intérêt thérapeutique de la SHF dans la maladie de Parkinson.

Les modèles kainate et pentylènetétrazole représentent deux modèles d’épilepsie du lobe temporal dont les conséquences à long terme sont différentes. Le premier est un modèle classique d’épileptogénèse avec crises récurrentes spontanées tandis que le second se limite aux crises aigües. Nous avons d’abord caractérisé les différents changements survenant dans les circuits excitateurs et inhibiteurs de l’hippocampe adulte de rats ayant subi des crises à l’âge immature. Ensuite, ayant observé dans le modèle fébrile une différence du pronostic lié au genre, nous avons voulu savoir si cette différence était aussi présente dans des modèles utilisant des neurotoxines. L’étude électrophysiologique a démontré que les rats KA et PTZ, mâles comme femelles, présentaient une hyperactivité des récepteurs NMDA au niveau des cellules pyramidales du CA1, CA3 et DG. Les modifications anatomiques sous-tendant cette hyperexcitabilité ont été étudiées et les résultats ont montré une perte sélective des interneurones GABAergiques contenant la parvalbumine dans les couches O/A du CA1 des mâles KA et PTZ. Chez les femelles, seul le DG était légèrement affecté pour les PTZ tandis que les KA présentaient, en plus du DG, des pertes importantes au niveau de la couche O/A. Les évaluations cognitives ont démontré que seuls les rats PTZ accusaient un déficit spatial puisque les rats KA présentaient un apprentissage comparable aux rats normaux. Cependant, encore une fois, cette différence n’était présente que chez les mâles. Ainsi, nos résultats confirment qu’il y a des différences liées au genre dans les conséquences des convulsions lorsqu’elles surviennent chez l’animal immature. / Kainate and pentylenetetrazole models represent two animal models of temporal lobe epilepsy in which long-term consequences differ. The first model is a classical model of epileptogenesis with spontaneous recurrent seizures while the second one is limited to acute seizures. We wanted to characterize the difference in changes which occur in excitatory and inhibitory systems of the hippocampus of adult males and females having suffered an episode of status epilepticus during the immature stage of life. Besides having noticed a difference between genders in the febrile model, our second objective was to see if this difference was also present in models using neurotoxins. Electrophysiology recordings indicated that KA and PTZ rats (both male and female) showed a hyperactivity of NMDA receptors in CA1, CA3 and DG pyramidal cells. Anatomical modifications causing hyperactivity were studied and results show a selective loss of specific GABA interneurons PV in the O/A layer of CA1 region of the hippocampus in KA and PTZ male rats. However in female rats, only the DG layer was slightly affected in PTZ while female KA presented losses in both DG and O/A layers. Cognitive evaluation indicated that only PTZ rats showed a spatial impairment since KA rats had a similar learning pattern as controls. However, once again, that difference was observed only in males and not in females. In summary, our results confirmed that there is a difference between genders regarding brain damages after having suffered an episode of status epilepticus during the immature stage.

The fetal lung epithelium secretes fluid into the potential pulmonary air-spaces by actively transporting chloride (Cl¯) into the lung lumen. This Cl¯-driven fluid secretion declines with the progression of lung development. Recent studies demonstrate that the A-type γ-aminobutyric acid receptor (GABAAR), a Cl¯ channel, and glutamic acid decarboxylase (GAD65/67), key GABA-synthesizing enzymes, are expressed in adult pulmonary epithelial cells (ECs), forming an autocrine GABAAR signaling system. My thesis study revealed that GABAAR π- and β2- subunits are expressed in high levels in the fetal rat lung epithelium and decline at birth, consistent with pattern of fluid secretion. Immunohistochemistry showed distinct profiles of expression for GABAAR subunits and GAD65/67. Treatment of alveolar ECs with dexamethasone reduced the GABAAR π-subunit expression. These results suggest that the GABAAR signaling in the fetal pulmonary epithelium is developmentally regulated and the GABAAR expression and GABAAR-mediated Cl¯ secretion in pulmonary ECs may be regulated by glucosteroids.

The fetal lung epithelium secretes fluid into the potential pulmonary air-spaces by actively transporting chloride (Cl¯) into the lung lumen. This Cl¯-driven fluid secretion declines with the progression of lung development. Recent studies demonstrate that the A-type γ-aminobutyric acid receptor (GABAAR), a Cl¯ channel, and glutamic acid decarboxylase (GAD65/67), key GABA-synthesizing enzymes, are expressed in adult pulmonary epithelial cells (ECs), forming an autocrine GABAAR signaling system. My thesis study revealed that GABAAR π- and β2- subunits are expressed in high levels in the fetal rat lung epithelium and decline at birth, consistent with pattern of fluid secretion. Immunohistochemistry showed distinct profiles of expression for GABAAR subunits and GAD65/67. Treatment of alveolar ECs with dexamethasone reduced the GABAAR π-subunit expression. These results suggest that the GABAAR signaling in the fetal pulmonary epithelium is developmentally regulated and the GABAAR expression and GABAAR-mediated Cl¯ secretion in pulmonary ECs may be regulated by glucosteroids.

Plusieurs variables biologiques, psychologiques, ainsi que des différences culturelles, ont été mises en cause afin d'expliquer la différence de perception de la douleur existante entre les hommes et les femmes. Il est connu que les hormones gonadiques influencent la réponse nociceptive chez l'animal et chez l'humain. Le cerveau a aussi la capacité de synthétiser ses propres "hormones sexuelles", les neurostéroïdes. L'objectif de cette thèse était: 1) évaluer les facteurs physiologiques et psychologiques influençant de perception de la douleur chez les hommes et les femmes, 2) évaluer l'implication des androgènes et du cortisol sur les symptômes cliniques et la perception de la douleur chez des sujets atteints de fibromyalgie et sains, et 3) évaluer l'implication des hormones gonadiques et de leurs métabolites 3α5α-réduits dans la transmission et la modulation de la douleur chez animaux les mâles et les femelles par l'utilisation de modèles de douleur comportementaux.

No description available.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-18T21:17:40Z No. of bitstreams: 1 DanielaMariaDeSousaMoura_TESE.pdf: 5064072 bytes, checksum: ff797a9a6f4cca34baad638e77a8a3f2 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-30T19:11:36Z (GMT) No. of bitstreams: 1 DanielaMariaDeSousaMoura_TESE.pdf: 5064072 bytes, checksum: ff797a9a6f4cca34baad638e77a8a3f2 (MD5) / Made available in DSpace on 2017-10-30T19:11:36Z (GMT). No. of bitstreams: 1 DanielaMariaDeSousaMoura_TESE.pdf: 5064072 bytes, checksum: ff797a9a6f4cca34baad638e77a8a3f2 (MD5) Previous issue date: 2017-08-30 / As c?lulas granulares do hipocampo s?o um dos poucos tipos de neur?nios gerados no sistema nervoso central de mam?feros adultos. O modelo atual de neurog?nese no hipocampo adulto assume que c?lulas tronco neurais (CTN) geram progenitores com potencial restrito ? gera??o de neur?nios ou astr?citos. Est?mulos ambientais e condi??es patol?gicas podem alterar a progress?o da linhagem, modulando a prolifera??o, diferencia??o, sobreviv?ncia e integra??o sin?ptica dos neur?nios gerados. Por exemplo, a Epilepsia do Lobo Temporal mesial (ELT), a forma mais comum de epilepsia em adultos, est? associada a altera??es na taxa de neurog?nese hipocampal adulta. Neste trabalho, n?s utilizamos dois modelos experimentais de ELT para avaliar os efeitos de um insulto epileptog?nico (i.e., status epilepticus, SE) sobre a linhagem e amadurecimento celular no giro denteado adulto. Atrav?s da t?cnica de fate-mapping utilizando animais Dcx-CreERT2/CAG-CAT-GFP, n?s acompanhamos o destino de c?lulas que apresentavam o promotor do gene doublecortin (DCX) ativado antes ou depois da inje??o intrahipocampal dos agentes convulsivantes ?cido ca?nico ou pilocarpina. Desta forma, pudemos avaliar o efeito destas drogas sobre progenitores e neur?nios imaturos DCX+ gerados antes ou ap?s o tratamento. Em ambos os modelos, foram observados um aumento de neurog?nese e altera??es no posicionamento e morfologia de c?lulas granulares, conforme descri??es pr?vias na literatura. Altera??es neuronais, tais como localiza??o ect?pica e presen?a de dendritos basais, foram observadas tanto em c?lulas geradas antes quanto ap?s a indu??o do SE, embora com frequ?ncias distintas. No entanto, apenas no hipocampo ipsilateral ? inje??o de ?cido ca?nico n?s observamos dispers?o da camada granular e morte neuronal em CA1 e CA3, apesar da atividade parox?stica epil?ptica ocorrer em ambos os hipocampos. Surpreendentemente, o aumento da neurog?nese em animais que receberam ?cido ca?nico foi restrito ao hipocampo contralateral, enquanto no lado ipsilateral foi observado um significativo aumento na gera??o de astr?citos a partir dos progenitores DCX+. Al?m disso, tamb?m observamos neste modelo a presen?a de c?lulas com morfologia e marcadores de CTNs, sugerindo que progenitores DCX+ poderiam regredir para estados mais primitivos na linhagem celular do hipocampo adulto. O aumento da astrogliog?nese no lado ipsilateral ? inje??o de ?cido ca?nico foi associado a uma degenera??o de interneur?nios parvalbumina (PV)+ no hipocampo, sugerindo que a atividade gaba?rgica poderia estar contribuindo para o redirecionamento da linhagem celular. Em conjunto, nossos dados indicam que a linhagem celular no giro denteado n?o ? unidirecional e irrevers?vel, e que o aumento da atividade el?trica neuronal induzida por ?cido ca?nico e pilocarpina t?m efeitos diferentes sobre a diferencia??o celular e destino fenot?pico dos progenitores e neur?nios nessa regi?o. Esses resultados imp?em a necessidade de revermos o modelo atual de neurog?nese hipocampal adulta e tamb?m indicam que diferentes modelos animais de epilepsia produzem altera??es celulares distintas no hipocampo adulto e, portanto, poderiam representar diferentes graus/est?gios da patologia. / The granular cells of the hippocampus are one of the few types of neurons generated in the central nervous system of adult mammals. The current model of neurogenesis in the adult hippocampus assumes that neural stem cells (NSCs) give rise to progenitors restricted to the generation of neurons or astrocytes. Environmental stimuli and pathological conditions can alter the lineage progression, modulating cell proliferation, differentiation, survival and synaptic integration of newly generated neurons. For example, mesial Temporal Lobe Epilepsy (TLE), the most common form of epilepsy in adults, is associated with changes in the rate of adult hippocampal neurogenesis. In this work, we used two experimental TLE models to evaluate the effects of an epileptogenic insult (i.e., status epilepticus, SE) on the cell lineage and neuronal maturation in the adult dentate gyrus. Using Dcx-CreERT2 / CAG-CAT-GFP animals, we fate mapped the fate of cells expressing the doublecortin gene (DCX) either before or after intrahippocampal injection of the convulsive agents kainic acid or pilocarpine. In this way, we could evaluate the effect of these drugs on DCX+ progenitors and immature neurons generated before or after treatment. In both models, we observed an increase in neurogenesis and changes in the positioning and morphology of granular cells, according to previous descriptions in the literature. Neuronal aberrations, such as ectopic localization and presence of basal dendrites, were observed both in cells generated before and after induction of SE, albeit at different frequencies. However, only in the hippocampus ipsilateral to the injection of kainic acid we observed granule cell dispersion and neuronal death in CA1 and CA3, although the paroxysmal epileptic activity occurred in both hippocampi. Surprisingly, the increase in neurogenesis in animals that received kainic acid was restricted to the contralateral hippocampus, whereas on the ipsilateral side a significant increase in astrocyte generation was observed within the DCX+ progenitor lineage. In addition, we also observed the presence of cells with NSC hallmarks, suggesting that DCX+ progenitors could regress to more primitive states in the adult hippocampal cell lineage. The increased astrogliogenesis on the ipsilateral side to the injection of kainic acid was associated with a degeneration of parvalbumin (PV)+ interneurons in the hippocampus, suggesting that GABAergic activity could be contributing to the rerouting of the DCX+ progenitor cell lineage. Taken together, our data indicates that the cell lineage in the dentate gyrus is neither unidirectional nor irreversible, and that the increased neuronal electrical activity induced by kainic acid and pilocarpine have different effects on cell differentiation, as well as on the fate of progenitors and neurons in that region. These results highlight the need to review the current model of adult hippocampal neurogenesis and also indicate that different animal models of epilepsy produce distinct cellular alterations in the adult hippocampus and could therefore represent different degrees / stages of the pathology.