Background: Premenstrual dysphoric disorder (PMDD) affects 3–8% of women in fertile ages. Combined oral contraceptives (OCs) are widely used and some users experience adverse mood effects. The cyclicity of PMDD symptoms coincides with increased endogenous levels of allopregnanolone after ovulation. Allopregnanolone enhances the effect of γ-aminobutyric acid (GABA) on the GABAA receptor, the principal inhibitory transmitter system in the brain. The sensitivity to other GABAA receptor agonists than allopregnanolone (i.e. benzodiazepines, alcohol and the 5 β epimer to allopregnanolone, pregnanolone) has been reported to depend on menstrual cycle phase and/or PMDD diagnosis. Isoallopregnanolone, the 3 β epimer to allopregnanolone, has previously been used to verify specific allopregnanolone GABAA receptor effects. Saccadic eye velocity (SEV) is a sensitive and objective measurement of GABAA receptor function. Aims: To study the pharmacological effects, and any effect on gonadotropin release, of intravenous allopregnanolone in healthy women. A second aim was to explore whether allopregnanolone sensitivity differs over the menstrual cycle or during OC use in healthy women, and thirdly in PMDD patients. Methods: Ten women were challenged with a cumulative dose of intravenous allopregnanolone in the follicular phase of the menstrual cycle. The effect on FSH and LH was compared to women exposed to isoallopregnanolone. A single dose of allopregnanolone was administered once in the follicular phase and once in the luteal phase in another ten healthy women and in ten PMDD patients, and additionally in ten women using OCs. Repeated measurements of SEV, subjectively rated sedation and serum concentrations after allopregnanolone injections were performed in all studies. Results: Allopregnanolone dose-dependently reduced SEV and increased subjectively rated sedation. Healthy women had a decreased SEV response in the luteal phase compared to the follicular phase. By contrast, PMDD patients had a decreased SEV response and subjectively rated sedation response to allopregnanolone in the follicular phase compared to the luteal phase. There was no difference in the SEV response to allopregnanolone between women using oral contraceptives and healthy naturally cycling women. Allopregnanolone decreased serum levels of FSH and LH whereas isoallopregnanolone did not affect FSH and LH levels. Conclusion: Intravenous allopregnanolone was safely given and produced a sedative response in terms of SEV and subjectively rated sedation in women. The sensitivity to allopregnanolone was associated with menstrual cycle phase, but in the opposite direction in healthy women compared to PMDD patients. The results suggest mechanisms of physiological tolerance to allopregnanolone across the menstrual cycle in healthy women and support that PMDD patients have a disturbed GABAA receptor function. In addition, one of our studies suggests that allopregnanolone might be involved in the mechanism behind hypothalamic amenorrhea.

Gamma-Amino butyric acid (GABA) is the main inhibitory neurotransmitter in the mammalian central nervous system (CNS) and inhibits the neurotransmission by targeting the ionotropic transmembrane GABAA receptor. Modulators of the GABAA receptor targets the allosteric binding sites and modifies the GABA effect and these sites acts as superior drug targets within psychopharmacology.   Gabather AB has developed the novel compound GT-002 that is known to target the receptor and cause a behavioral effect in rodents. This project characterized the binding of the lead compound GT-002 to GABAA receptor in mammalian brain tissue by development and validation of a radioligand binding assay. In the assay a comparative evaluation was performed using the benzodiazepine (BZ) antagonist Flumazenil (FLU).   All experiments were performed using GABAA receptors originating from porcine and mouse brain tissue membrane, where no significant difference between the mammals was displayed. GT-002 binds with higher affinity and associates faster than FLU to the receptor and implies a two-binding site model. GT-002 displaced FLU and no tested competitive analytes targeting various modulatory sites of the receptor displaced GT-002, implying independent binding of GT-002 and allosterically impacts the BZ binding site.

<p>The formation and retention of distinct membrane domains in the fluidic membrane bilayer is the key process in establishing spatial organization for mediating physiological functions in metazoans. The spectrin-ankyrin network organizes diverse membrane domains including T-tubule and intercalated disc of cardiomyocytes, basolateral membrane of epithelial cells, costameres of striatal muscle, and axon initial segments and nodes of Ranvier in nervous system. This thesis identifies a novel function of 480 kDa ankyrin-G, an alternatively spliced isoform of the ankyrin family, in promoting somatodendritic GABAA receptor synaptogenesis both in vitro and in vivo. In the nervous system, an insertion of a neuronal specific exon (exon 37) occurs in ankyrin-G polypeptide which results in a 480 kDa isoform. 480 kDa ankyrin-G (giant ankyrin-G) has been shown to coordinate formation and maintenance of the axon initial segment (AIS) and nodes of Ranvier. This thesis research began with the discovery that giant ankyrin-G, previously thought to be confined to the axon initial segment, forms developmentally-regulated and cell-type specific somatodendritic "outposts" on the plasma membrane of pyramidal neurons. This somatodendritic 480 kDa ankyrin-G outpost forms micron-scale membrane domains where it associates with canonical AIS binding partners including voltage-gated sodium channel and neurofascin. This thesis further discovered that the giant insert of 480 kDa ankyrin-G interacts with GABARAP, a GABAA receptor-associated protein. Both the interaction with GABARAP and the membrane association through palmitoylation of giant ankyrin-G are required for the formation of somatodendritic GABAergic synapses. This work further found that ankyrin-G associates with extrasynaptic GABAA receptors and stabilizes receptors on the extrasynaptic membrane through opposing endocytosis. This story demonstrates for the first time the existence of giant ankyrin-G somatodendritic outpost as well as its function in directing the formation of GABAergic synapses that provides a rationale for studies linking ankyrin-G genetic variation with psychiatric disease and neurodevelopmental disorders.</p><p>Additional work presented in the Appendix characterized novel ankyrin-G full length transcripts in the heart and kidney with unique domain compositions though alternative splicing. The preliminary work further identified biochemical properties and potential role of an insert C in the C-terminus of ankyrin-G in mediating cytokinesis and cellular migration in mouse fibroblasts. Together, this thesis work expands the knowledge of giant ankyrin-G functions in the nervous system and offers insights into the diversified roles of distinct ankyrin-G peptides acquired from alternative splicing in organizing specific membrane domains and interacting with defined intracellular pathways in different tissues.</p> / Dissertation

Changes in spontaneous spike activities recorded from murine frontal cortex networks grown on substrate-integrated microelectrodes were used to determine the dissociation constant (KB) of three GABAA antagonists. Neuronal networks were treated with fixed concentrations of GABAA antagonists and titrated with muscimol, a GABAA receptor agonist. Muscimol decreased spike activity in a concentration dependent manner with full efficacy (100% spike inhibition) and a 50% inhibitory concentration (IC50) of 0.14 ± 0.05 µM (mean ± SD, n=6). At 10, 20, 40 and 80 µM bicuculline, the muscimol IC50 values were shifted to 4.3 ± 1.8 µM (n=6), 6.8 ± 1.7 µM (n=6), 19.3 ± 3.54 µM (n=10) and 43.5 µM (n=2), respectively (mean ± SD). Muscimol titration in the presence of 10, 20, 40 µM of gabazine resulted in IC50s values of 20.1 (n=2), 37.17 (n=4), and 120.45 (n=2), respectively. In the presence of 20, 80, and 160 µM of TMPP (trimethylolpropane phosphate) the IC50s were 0.86 (n=2), 3.07 (n=3), 6.67 (n=2) µM, respectively. Increasing concentrations of GABAA antagonists shifted agonist log concentration-response curves to the right with identical efficacies, indicating direct competition for the GABAA receptor. A Schild plot analysis with linear regression resulted in slopes of 1.18 ± 0.18, 1.29 ± 0.23 and 1.05 ± 0.03 for bicuculline, gabazine and TMPP, respectively. The potency of antagonists was determined in terms of pA2 values. The pA2 values were 6.63 (gabazine), 6.21 (bicuculline), and 5.4 (TMPP). This suggests that gabazine has a higher binding affinity to the GABAA receptor than bicuculline and TMPP. Hence, using spike rate data obtained from population responses of spontaneously active neuronal networks, it is possible to determine key pharmacological properties of drug-receptor interactions.

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Les épilepsies génétiques généralisées (ÉGGs) sont un groupe de syndromes épileptiques hétérogènes qui se manifestent habituellement durant les périodes de l’enfance et de l’adolescence. Les ÉGGs représentent 30% de toutes les épilepsies. Il n’existe présentement aucun remède à l’épilepsie génétique généralisée. Au sein de ce groupe d’épilepsies, les sujets sont le plus souvent dépourvus de lésions cérébrales, ce qui signifie que les facteurs génétiques jouent un rôle important dans l’étiologie de la maladie. Au cours des dernières années, plusieurs gènes impliqués dans des formes familiales d’ÉGG ont été identifiés. La majorité d'entre elles codent pour des canaux ioniques incluant le récepteur-ligand GABAA (RGABAA). De ce groupe, des mutations ont été identifiées dans quatre sous-unités du récepteur GABAA. Dans un premier temps, l’objectif général de cette thèse vise l’évaluation de la composante génétique de notre cohorte d’ÉGG expliquée par les gènes codant pour les sous-unités du récepteur GABAA. Puis, dans un second souffle, le rôle des variants identifiés est défini et analysé afin de mieux cerner leurs impacts dans la pathogénèse de ce phénotype. La première partie du projet consiste en une analyse exhaustive des mutations existantes dans la partie codante des 19 gènes GABRA pour des patients atteints d’ÉGG. En criblant des familles québécoises avec ÉGG, nous avons identifié 22 variants rares incluant 19 faux-sens et 3 non-sens dans 14 sous-unités du RGABAA. En séquençant ces gènes dans une grande cohorte de cas et de contrôles, nous avons établi le profil des variations rares pour ceux-ci. Ces données suggèrent qu’une proportion significative (8%) des patients atteints d’ÉGG ont des variants rares sur les gènes du RGABAA. La deuxième partie porte directement sur certains gènes identifiés lors de la première partie. De ce groupe, cinq nouvelles mutations ont été découvertes dans des gènes déjà associés à l’épilepsie (GABRA1 et GABRG2). Nous avons constaté l’impact de ces mutations dans les mécanismes génétiques de l’épilepsie, en mesurant les effets des variants sur la structure et la fonction du récepteur GABAA. La troisième partie se concentre sur notre hypothèse, voulant que les RGABAA mutants altèrent l’effet du GABA durant le développement du système nerveux central (SNC). L’objectif principal vise à déterminer la contribution relative de chacune des sous-unités mutées dans le développement du SNC. Ainsi, nous avons démontré qu’une telle perte de fonction a un impact significatif sur le développement des synapses GABAergiques et glutamatergiques ainsi que sur la plasticité des circuits corticaux. Nos résultats nous ont permis de préciser comment les mutations dans les gènes GABRA peuvent mener à l’ÉGG. Éventuellement, la caractérisation moléculaire de ces mutations contribuera à l’élaboration de nouveaux outils diagnostiques et facilitera la mise au point de traitements mieux ciblés pour les gens atteints de cette condition neurologique chronique. / Genetic generalized epilepsy (GGE) syndrome is a group of epilepsy disorders that occur early in childhood and adolescence. Genetics generalized epilepsies (GGE) account for approximately 30 % of all epilepsy syndromes. There is currently no cure for GGE. Although patients with GGE typically have no anatomical brain abnormalities, the root cause of these conditions is considered to be genetic in origin. An increasing number of genes predisposing to epilepsy have been identified over the past ten years. It has emerged in many cases that the causative genes for inherited epilepsies code for ion-channels such as the GABAA receptor (GABAAR). Among these genes, mutations in four subunits of the GABAA receptor appear to be an important cause of familial epilepsy. The main aim of the present thesis is to better characterize the genetic component of our GGE cohort explain by GABRA genes and evaluated the critical role of these variants in the pathogenesis of this phenotype. The first part of our project was to investigate the impact of rare variants of GABAAR in GGE, we screened the coding regions of 19 genes encoding for all the known subunits of the GABAAR in unrelated GGE patients, including familial cases. Overall, approximately 8% of our GGE individuals have novel GABRA mutations, including 19 missenses and 3 nonsenses including 1 frameshift mutation. By sequencing those genes in a large cohort of cases and controls, we were able to establish the profile of rare variants for these genes. Our data suggest that a significant proportion of GGE patients share rare variants in GABRA genes. The second part of the work builds on the genes bearing mutations identified in the sequencing analysis. Among this group, five novel mutations have been so far associated to this syndrome (GABRA1 and GABRG2). We characterized the gating properties of GABA-evoked currents and the subcellular localization of the mutated subunits by expressing recombinant GABAA receptors in vitro. The third part of the work aimed to characterize the impact of mutated GABAA receptors on synapse formation and development of neuronal networks. By knocking down these genes in cortical organotypic slices, we provided a better understanding of the specific and distinct neural circuit alterations caused by different GABRA1 mutations and help define the pathophysiology of genetic generalized epilepsy syndromes. We believe that these findings will allow a better understanding of the genetic mechanisms underlying the disease and involve mutations in GABAA receptors in critical mechanisms leading to epilepsy. Eventually, our results could lead to a better diagnosis and counteract the devastating effects of some GGEs early on before this complex condition has had the opportunity to be established.

O transtorno do pânico (TP) é um transtorno de ansiedade caracterizado por ataques de pânico recorrentes e inesperados, com um prognóstico crônico. Entre as drogas utilizadas no tratamento do TP, os benzodiazepínicos (BZs) de alta potência, como o alprazolam e o clonazepam, apresentam a vantagem de serem eficazes logo no início do tratamento. Assim como outras drogas BZs, tais como o diazepam e o flurazepam, estes compostos também são empregados como ansiolíticos no tratamento de pacientes com transtorno de ansiedade generalizada. O mecanismo da ação primária dessas drogas ocorre pela interação com os sítios de ligação BZs presentes nos receptores do ácido gama-aminobutírico do tipo A (GABAA), facilitando a neutotransmissão GABAérgica. Entretanto, ainda permanecem desconhecidos os substratos neurais envolvidos no efeito panicolítico causado pelos BZs. Dentre os substratos em potencial, a substância cinzenta periaquedutal dorsal (SCPD), uma estrutura mesencefálica criticamente relacionada à fisiopatogênica do TP, apresenta alta densidade de receptores GABAA e de sítios de ligação BZs. Neste trabalho avaliamos o envolvimento do complexo receptor GABAA/BZ presente na SCPD no efeito panicolítico promovido pela administração sistêmica de alprazolam em ratos Wistar. Para isso, empregamos o labirinto em T elevado (LTE), que além da resposta de fuga, que é associada ao pânico, também permite avaliar a resposta de esquiva inibitória, associada à ansiedade. Neste modelo, o alprazolam inibe a expressão da resposta de fuga, indicando efeito panicolítico e inibe a aquisição da esquiva inibitória, sugestivo de efeito ansiolítico. Além do LTE, também empregamos os modelos experimentais da hipóxia e o de Vogel, associados ao pânico e a ansiedade, respectivamente. Os resultados obtidos mostraram que o efeito panicolítico promovido pela administração sistêmica de alprazolam, observado na resposta de fuga do LTE, foi bloqueado pela administração intra-SCPD de flumazenil, antagonista dos sítios de ligação BZs, ou de bicuculina, antagonista dos receptores 10 GABAA. No teste da hipóxia, o efeito panicolítico causado pela administração sistêmica de alprazolam foi inibido, porém não significativamente bloqueado, pela administração intra-SCPD de bicuculina. Já o efeito ansiolítico, observado na resposta de esquiva do LTE e no teste do beber punido de Vogel, não foi bloqueado pela administração intra-SCPD de flumazenil ou de bicuculina. No conjunto, nossos resultados sugerem que o complexo receptor GABAA/BZ da SCPD está envolvido no efeito panicolítico, mas não ansiolítico, promovido pela administração sistêmica de alprazolam. / Panic Disorder (PD) is an anxiety disorder characterized by recurrent and unexpected panic attacks with a chronic prognosis. Among the drugs used to treat PD, highpotency benzodiazepines (BZs), such as alprazolam and clonazepam, have the advantage of causing significant effects early in the treatment. Like others BZs, such as diazepam and flurazepam, these compounds are also used as anxiolytics in the treatment of patients with generalized anxiety disorder. The primary mechanism of action of these drugs is the interaction with BZs binding sites present at gammaaminobutyric acid type A receptors (GABAA), facilitating GABAergic neurotransmission. However, it remains yet unknown the neural substrates involved in the panicolytic-like action caused by BZs. Among the potential substrates, the dorsal periaqueductal gray matter (DPAG), a mesencephalic structure critically associated with the physiopathology of PD, presents a high density of GABAA receptors and of BZs binding sites. In this work, we evaluated the participation of the GABAA/BZ receptor complex present in the DPAG in the panicolytic-like effect caused by systemic administration of alprazolam in Wistar rats. For this, we use the elevated T-maze (ETM), that besides the escape response which is associated with panic, also allows the measurement of inhibitory avoidance acquisition, which has been related to anxiety. In this model, alprazolam inhibits the expression of escape, indicating a panicolytic-like effect and inhibits the acquisition of inhibitory avoidance, suggestive of an anxiolytic effect. In addition to the ETM, animals were also tested in the hypoxia and Vogel\'s conflict tests, which have been associated with panic and anxiety, respectively. The results showed that the panicolytic-like effect caused by alprazolam in ETM\'s escape response was blocked by intra-DPAG injection of flumazenil, a BZs binding site antagonist, or bicuculline, a GABAA receptor antagonist. In the hypoxia test, the panicolytic-like effect caused by alprazolam was inhibited, but not significantly blocked, by intra-DPAG injection of bicuculline. The anxiolytic effect observed in the 12 ETM\'s avoidance task or in the Vogel\'s conflict test was not blocked by intra-DPAG injection of flumazenil or bicuculline. Taken together, our results suggest that the GABAA/BZ receptor complex located in the DPAG is involved in the panicolytic, but not anxiolytic, effect caused by systemic administration of alprazolam.

Background Obesity is currently one of the major causes of ill health and it is clear that overeatingis the cause of obesity. However, the actions of many endogenous factors that contribute to overeating are still not well understood. Gamma-aminobutyric acid (GABA)-ergic transmission has been shown to be of great importance for food intake regulation. The progesterone metabolite allopregnanolone is a potent positive GABAA receptor modulating steroid (GAMS) and in humans, elevated allopregnanolone levels have been suggested to be involved in increased food intake, and also with overweight and obesity. GABAA receptors that express the α2 and α3 subunits are proposed to be the main subtypes involved in food intake regulation. Therefore, the aims of the work in this thesis were to further investigate the effect of allopregnanolone on food intake, feeding behaviour, possible effects on weight gain and also to characterize a possible antagonist at α2β3γ2and α3β3γ2 GABAA receptors. Methods Allopregnanolone effects on food intake of different food items were recorded in male Wistar rats. Feeding patterns were analyzed. Food preference tests were also conducted and rats were repeatedly exposed to allopregnanolone under different feeding conditions to elucidate possible effects on body weight gain. To deeper investigate GABAA receptor subtypes suggested to be involved in food intake regulation, electrophysiological whole-cell patch-clamp recordings were performed to identify the specificity of the GAMS antagonist UC1020, at human α2β3γ2 and α3β3γ2 GABAA receptors expressed in HEK293-cells. Results Allopregnanolone increased the intake of standard chow, cookies and a high fat diet in male Wistar rats. Preferentially, allopregnanolone increased the rats´intake of the more calorie dense food type. Allopregnanolone reduced feeding latency and prolonged feeding duration. The increased chow intake induced by allopregnanolone was more pronounced at the beginning of the rats´ active period compared to the inactive. Repeated allopregnanolone administration during 5 consecutive days led to an increased body weight gain, more evident in schedule fed rats on a high fat diet. Both obesity prone and obesity resistant rats gained significantly more weight with repeated allopregnanolone exposure and the increased body weight gain correlated with increased food intake. The compound UC1020 was a potent antagonist of GAMS-enhanced GABA evoked currents at human α3β3γ2 GABAA receptors, whereas it had no effect at α2β3γ2 GABAA receptors. Conclusions Our findings indicate that allopregnanolone induced hyperphagia may be one of the endogenous factors involved in weight gain, especially when the diet is energy-rich. The compound UC1020 may prove useful for investigating the involvement of the α2 and α3 GABAA receptor subtypes in GAMS-induced hyperphagia.