Le déclin des performances motrices du sujet âgé est associé à un risque accru de morbimortalitéet représente une problématique majeure pour nos sociétés vieillissantes. Son origine est le plus souvent multifactorielle et nous nous sommes plus particulièrement intéressés au rôle des facteurs de risque vasculaire à partir des données longitudinales et transversales de la cohorte dijonnaise de l’étude des 3 Cités. Les performances motrices ont été évaluées à travers la mesure de la vitesse de marche sur 6 mètres chez des sujets âgés de 65 à 85 ans à l'inclusiondans l'étude.Nous avons ainsi observé que l’hypertension artérielle à l’inclusion dans l’étude était associée à une vitesse de marche plus lente et à un déclin de la vitesse de marche plus important au cours du suivi. Parmi les participants ayant eu une IRM cérébrale à l’inclusion, nous avons observé une relation entre la vitesse de marche et les volumes sous-corticaux de substance grise cérébrale, en particulier le volume du noyau caudé. Une vitesse de marche plus lente à l'inclusion était associée à un risque accru de mortalité toutes causes 5 ans plus tard, avec une association plus forte pour la mortalité cardiovasculaire.Ces résultats sont en faveur d’une contribution cérébrovasculaire au déclin des fonctions motrices du sujet âgé, et participent à une meilleure compréhension de ce processus. / Motor decline in the elderly is associated with an increased risk of morbidity and mortality, and represents a major issue for our ageing societies. Its etiology is usually multifactorial, and, in this work, we specifically addressed the contribution of vascular risk factors, based on crosssectional and longitudinal data from the Dijon center of the Three-City study. Motor function was assessed through measures of walking speed over 6 meters in participants aged 65 to 85 years old.We observed that baseline hypertension was associated with lower walking speed at baseline and greater motor decline over follow-up. Among participants with a baseline brain MRI, we observed a relationship between walking speed and the volume of brain subcortical gray matter structures, particularly the volume of the caudate nucleus. Slower walking speed at baseline was associated with an increased risk of all-cause death over 5 years of follow-up; this association was stronger for cardiovascular deaths.These results support the hypothesis of a contribution of vascular risk factors to motor decline in the elderly and contribute to improve our understanding of this process.

Diversos estudos demonstram que o estresse infantil, incluindo situações de perda dos pais, negligência e abusos, representa um forte fator de risco para o desenvolvimento de transtornos de ansiedade, sendo de especial interesse para este trabalho, o transtorno do pânico. Modelos de estresse neonatal em animais de laboratório, que se baseiam na ruptura da relação mãe-filhote, como a separação materna e a privação materna, têm sido amplamente utilizados para avaliar as consequências desse estressor sobre a expressão de comportamentos defensivos associados à ansiedade na vida adulta. No entanto, pouco se sabe sobre seus efeitos em modelos animais de ataques de pânico, mais especificamente aqueles que associam esta condição emocional à resposta defensiva de fuga em animais. Diante disso, o objetivo inicial do presente trabalho foi o de estender as investigações dos efeitos do estresse neonatal sobre o comportamento de fuga de ratos adultos (após 60 dias de nascimento) observado no labirinto em T elevado (LTE), pela estimulação elétrica da substância cinzenta periaquedutal (SCPD) e durante a exposição a um ambiente em hipóxia (7% O2). Para efeitos comparativos, esses animais também foram testados em modelos animais associados à ansiedade generalizada e a depressão. Observamos que ratos Wistar submetidos à separação materna (3h/dia, do 2º ao 21º dia pós-nascimento) não diferiram de animais controles nos parâmetros comportamentais analisados nos modelos de pânico (fuga no LTE e pela estimulação elétrica da SCPD), nos de ansiedade (resposta de esquiva no LTE e o beber punido no teste de conflito de Vogel) ou no de depressão (tempo gasto em imobilidade no teste do nado forçado). Já em ratos privados da mãe (por 24h no 11º dia pós- nascimento), embora este estressor não tenha alterada a resposta de fuga no LTE, ele aumentou a expressão deste comportamento durante a exposição à hipóxia, sugestivo de um efeito panicogênico. Ainda empregando a privação materna, observamos que a administração intraperitoneal de um inibidor da síntese de serotonina, a pclorofenilalanina metil éster (p-CPA - 100mg/Kg/dia, por 4 dias antes dos testes comportamentais) facilitou a expressão do comportamento de fuga durante o teste da hipóxia nos animais controle, de maneira semelhante ao efeito obtido somente com a privação materna. Porém este tratamento não potencializou a fuga promovida pela privação materna. Já os níveis plasmáticos de corticosterona foram aumentados pela exposição à hipóxia, independentemente dos animais terem sido previamente privados da mãe ou terem recebido o pCPA antes do teste. Por fim, também observamos, através de uma análise por Western Blotting, que nem a privação materna ou a exposição à hipóxia altera a concentração de receptores serotonérgicos do tipo 5-HT1A na SCPD ou na amígdala. Em suma, nossos resultados mostram que a privação materna promove uma facilitação da resposta de fuga na hipóxia, sugerindo uma relação entre esse estresse neonatal e o desencadeamento de ataques de pânico de um subtipo específico, o pânico respiratório. Contudo, no que diz respeito ao envolvimento da neurotransmissão serotonérgica, mais estudos são necessários para entender sua participação nessa resposta. / Early life stress (ELS), including parental loss due to death, neglect or abuse, represents a major risk factor for the late development of psychiatric disorders, such as anxiety disorders. Animal models of ELS that are based on the disruption of mother-infant relationship, such as the repeated maternal separation or maternal deprivation, have been extensively used for the investigation of the longterm effects of these stressors on the expression of defensive behaviors associated with anxiety. However, little is known about their effects on animal models of panic attacks, more specifically in those that associate this emotional condition with escape behavior in animals. Therefore, the aim of the present study was to extend the investigation on the long-term consequences of neonatal stress on the escape response of adult rats (60 days after birth) evoked by the elevated T maze (ETM), electrical stimulation of the dorsal periaqueductal gray (DPAG) or hypoxia (7% O2). For comparative reasons, these animals were also tested in animal models of anxiety and depression. The results showed that the repeated maternal separation of male Wistar (3 hours/day from day 2 to 21 after birth) did not affect the behavioral indexes measured in the panic (escape in the ETM or after DPAG electrical stimulation), anxiety (ETM inhibitory avoidance or punished licking in the Vogel conflict test) or depression (time in immobility in the forced swimming test) models. On the other hand, rats submitted to maternal deprivation (24 hs in the 11th day after birth), although not differing from the control animals on escape expression in the ETM, showed a pronounced escape response during hypoxia, indicating a panicogenic-like response. Also, using this maternal deprivation protocol, we observed that systemic administration of a 5-HT synthesis inhibitor, p-chlrophenilalanine metylester (p-CPA - 100mg/Kg/day, for 4 days before the behavioral tests), facilitated escape expression during hypoxia in non-deprived animals to a level observed in non-pharmacologically treated deprived animals. We also observed that plasma corticosterone levels were increased 30 minutes after hypoxia exposure, independently of the previous condition of the animals (deprivation or drug treatment). Finally, we observed that the number of 5-HT1A receptors in the DPAG or amygdala, measured by Western Blotting, was not affect by previous maternal deprivation or exposure to hypoxia. Taken together, our results show that a single maternal deprivation episode facilitates the expression of escape behavior during hypoxia, suggesting a relationship between this ELS with the observation of a specific subtype of panic attack, the respiratory panic. Further studies are required in order to clarify the 5- HT involvement on these responses.

A substância cinzenta periaquedutal dorsal (dPAG) e o hipotálamo medial (MH) são duas estruturas encefálicas que estão envolvidas na elaboração de estados aversivos e expressão de respostas defensivas. A estimulação elétrica da dPAG ou do MH produz uma série de respostas comportamentais que se assemelham às respostas defensivas induzidas pela presença de um predador. Esses mesmos comportamentos podem ser eliciados com a microinjeção local de agonistas glutamatérgicos nessas estruturas, indicando o envolvimento de aminoácidos excitatórios na expressão das respostas defensivas incondicionadas. Apesar disso, a participação destas estruturas no medo condicionado ainda é pouco conhecida. Assim, o objetivo deste estudo foi avaliar o envolvimento da mediação glutamatérgica da dPAG e de núcleos do MH núcleo anterior (AH) e núcleo pré-mamilar dorsal (PMd) na expressão do medo condicionado à luz. Para isso, foram avaliados os efeitos de agonistas e antagonistas glutamatérgicos (AMPA/Cainato e NMDA) administrados nessas estruturas no teste do sobressalto potencializado pelo medo (SPM) e na medida de congelamento condicionado. Ratos Wistar machos com cânulas-guias implantadas na dPAG, AH ou PMd foram submetidos ao condicionamento aversivo (pareamentos luz+choque). Vinte e quatro horas depois, esses animais receberam injeções intra-dPAG, AH ou PMd de NMDA ou ácido caínico (agonistas NMDA e AMPA/Cainato, respectivamente) ou AP7 ou NBQX (antagonistas NMDA e AMPA/Cainato, respectivamente) e foram submetidos ao teste do SPM. A resposta de congelamento condicionado foi avaliada na mesma sessão. Eventuais alterações motoras foram avaliadas no teste do campo aberto. A administração dos agonistas glutamatérgicos na dPAG promoveu efeitos pró-aversivos no SPM e congelamento condicionado. NBQX sozinho não produziu nenhum efeito significativo, ao passo que o AP7 diminuiu somente o congelamento condicionado. Entretanto, ambos os antagonistas bloquearam os efeitos dos respectivos agonistas. Já a administração dos agonistas e antagonistas glutamatérgicos no AH e PMd, em doses que não afetaram a atividade motora, não produziu efeitos significativos na resposta de congelamento condicionado e SPM. Os presentes resultados sugerem a participação de aminoácidos excitatórios da dPAG, mas não do MH, na expressão do medo condicionado à luz. / The dorsal periaqueductal gray matter (dPAG) and the medial hypothalamus (MH) are two brain structures that are involved in the elaboration of aversive states and expression of defensive responses. Electrical stimulation of the dPAG or MH produces a series of behavioral responses that resemble those defensive responses triggered in the presence of a predator. These same behaviors can be elicited with the local microinjection of glutamate agonists into these structures, indicating the involvement of excitatory amino acids in the expression of unconditioned fear responses. Nevertheless, the involvement of these structures in fear conditioning is still unknown. The objective of this study was to evaluate the involvement of glutamatergic mediation of the dPAG and MH nuclei anterior nucleus (AH) and dorsal pre-mammillary nucleus (PMd) in the expression of conditioned fear to the light. Thus, we evaluated the effects of glutamatergic agonists and antagonists (AMPA/Kainate and NMDA) administered into these structures in fear potentiated startle (FPS) and conditioned freezing responses to the light. Male Wistar rats with guide-cannulae implanted in the dPAG, AH or PMd were subjected to aversive conditioning (light+shock pairings). Twenty-four hours later, the animals were injected intra-dPAG, AH or PMd with NMDA or kainic acid (NMDA and AMPA/Kainate agonists, respectively) or AP7 or NBQX (NMDA and AMPA/Kainate antagonists, respectively) and were subjected to the FPS test. The conditioned freezing response was measured in the same session. Potential motor effects were evaluated with the open-field test. The administration of glutamate agonists into the dPAG promoted pro-aversive effects in the FPS and conditioned freezing. NBQX produced no significant effect per se, whereas AP7 only decreased conditioned freezing. Both antagonists blocked the effects of the respective agonist. On the other hand, the administration of glutamatergic agonists and antagonists into AH and PMd, in doses that did not affect motor activity, produced no significant effects on conditioned fear responses. The present results suggest the involvement of mechanisms mediated by excitatory amino acids of the dPAG, but not of the MH, in the expression of conditioned fear responses to light.

A substância cinzenta periaquedutal dorsal (dPAG) e o hipotálamo medial (MH) são duas estruturas encefálicas que estão envolvidas na elaboração de estados aversivos e expressão de respostas defensivas. A estimulação elétrica da dPAG ou do MH produz uma série de respostas comportamentais que se assemelham às respostas defensivas induzidas pela presença de um predador. Esses mesmos comportamentos podem ser eliciados com a microinjeção local de agonistas glutamatérgicos nessas estruturas, indicando o envolvimento de aminoácidos excitatórios na expressão das respostas defensivas incondicionadas. Apesar disso, a participação destas estruturas no medo condicionado ainda é pouco conhecida. Assim, o objetivo deste estudo foi avaliar o envolvimento da mediação glutamatérgica da dPAG e de núcleos do MH núcleo anterior (AH) e núcleo pré-mamilar dorsal (PMd) na expressão do medo condicionado à luz. Para isso, foram avaliados os efeitos de agonistas e antagonistas glutamatérgicos (AMPA/Cainato e NMDA) administrados nessas estruturas no teste do sobressalto potencializado pelo medo (SPM) e na medida de congelamento condicionado. Ratos Wistar machos com cânulas-guias implantadas na dPAG, AH ou PMd foram submetidos ao condicionamento aversivo (pareamentos luz+choque). Vinte e quatro horas depois, esses animais receberam injeções intra-dPAG, AH ou PMd de NMDA ou ácido caínico (agonistas NMDA e AMPA/Cainato, respectivamente) ou AP7 ou NBQX (antagonistas NMDA e AMPA/Cainato, respectivamente) e foram submetidos ao teste do SPM. A resposta de congelamento condicionado foi avaliada na mesma sessão. Eventuais alterações motoras foram avaliadas no teste do campo aberto. A administração dos agonistas glutamatérgicos na dPAG promoveu efeitos pró-aversivos no SPM e congelamento condicionado. NBQX sozinho não produziu nenhum efeito significativo, ao passo que o AP7 diminuiu somente o congelamento condicionado. Entretanto, ambos os antagonistas bloquearam os efeitos dos respectivos agonistas. Já a administração dos agonistas e antagonistas glutamatérgicos no AH e PMd, em doses que não afetaram a atividade motora, não produziu efeitos significativos na resposta de congelamento condicionado e SPM. Os presentes resultados sugerem a participação de aminoácidos excitatórios da dPAG, mas não do MH, na expressão do medo condicionado à luz. / The dorsal periaqueductal gray matter (dPAG) and the medial hypothalamus (MH) are two brain structures that are involved in the elaboration of aversive states and expression of defensive responses. Electrical stimulation of the dPAG or MH produces a series of behavioral responses that resemble those defensive responses triggered in the presence of a predator. These same behaviors can be elicited with the local microinjection of glutamate agonists into these structures, indicating the involvement of excitatory amino acids in the expression of unconditioned fear responses. Nevertheless, the involvement of these structures in fear conditioning is still unknown. The objective of this study was to evaluate the involvement of glutamatergic mediation of the dPAG and MH nuclei anterior nucleus (AH) and dorsal pre-mammillary nucleus (PMd) in the expression of conditioned fear to the light. Thus, we evaluated the effects of glutamatergic agonists and antagonists (AMPA/Kainate and NMDA) administered into these structures in fear potentiated startle (FPS) and conditioned freezing responses to the light. Male Wistar rats with guide-cannulae implanted in the dPAG, AH or PMd were subjected to aversive conditioning (light+shock pairings). Twenty-four hours later, the animals were injected intra-dPAG, AH or PMd with NMDA or kainic acid (NMDA and AMPA/Kainate agonists, respectively) or AP7 or NBQX (NMDA and AMPA/Kainate antagonists, respectively) and were subjected to the FPS test. The conditioned freezing response was measured in the same session. Potential motor effects were evaluated with the open-field test. The administration of glutamate agonists into the dPAG promoted pro-aversive effects in the FPS and conditioned freezing. NBQX produced no significant effect per se, whereas AP7 only decreased conditioned freezing. Both antagonists blocked the effects of the respective agonist. On the other hand, the administration of glutamatergic agonists and antagonists into AH and PMd, in doses that did not affect motor activity, produced no significant effects on conditioned fear responses. The present results suggest the involvement of mechanisms mediated by excitatory amino acids of the dPAG, but not of the MH, in the expression of conditioned fear responses to light.

Made available in DSpace on 2016-06-02T19:22:13Z (GMT). No. of bitstreams: 1 6764.pdf: 3884512 bytes, checksum: bdca3c9f3391c512a817c23fee8ef734 (MD5) Previous issue date: 2015-03-20 / Universidade Federal de Minas Gerais / The pain is an universal experience, and frequently follows anxiety and depression cases. Some specific drugs used in depression and anxiety treatment are also used for the relief of pain. There are evidences showing that exposure to threatening situations can result in pain inhibition. In this way, studies involving pain and anxiety use animal models as tools for potential therapeutic agents screening as well as for enhance the knowledge about the neurobiology of emotions. This study investigated the following effects: acute and chronic fluoxetine treatment; microinjections of 5-HT1A and 5HT2C receptors agonists intraperiaqueductal gray matter (PAG), and the administration combined of these drugs on antinociception induced by the open arms (OAA) of the elevated plus maze (EPM). Furthermore, we investigated the effects of fluoxetine chronic treatment on serotonin, 5- HIAA, 5-HT1A and 5HT2C receptors levels within PAG. Our results showed that: (I) fluoxetine acute treatment (20 mg/kg) was able to increase the OAA; (II) fluoxetine chronic treatment (21 days) (20 mg/kg) also enhances the OAA, and decreased the number of writhes on animal confined in the enclosed arm, featuring an analgesic effect; (III) the administration of 8-OH-DPAT (5-HT1A agonist) intra-PAG did not change the number of writhes in animals confined in the arms of the EPM; (IV) the infusions of mCPP and MK- 212 (5HT2C agonists) intra-PAG increased the OAA. (V) The blockade of 5HT2C receptors located in the PAG by SB 242080 injection (5HT2C antagonist) was able to completely reverse the OAA; (VI) the combined administration of fluoxetine (acute treatment) and 8- OH-DPAT intra-PAG also blocked completely the OAA; (VII) the combined administration of fluoxetine (acute treatment) and MK-212 intra-PAG reversed the increase of OAA observed with MK-212 injection; (VII) combined administration of fluoxetine (chronic treatment) and 8-OH-DPAT intra-SCP once more blocked OAA; (IX) the fluoxetine (chronic treatment) + MK-212 intra-PAG, impairs the OAA increase observed with isolated MK-212 injection; (X) fluoxetine chronic treatment was not capable to change the serotonin, 13 5-HIAA levels, and serotonin turnover in the PAG (XI) fluoxetine chronic treatment promoted up-regulation of 5-HT1A and 5HT2C receptors within PAG. These findings suggest that OAA is médiated by 5-HT2C receptors located in the PAG. Furthermore, fluoxetine was capable to interact with this serotonergic receptor promoting functional (acute treatment) and quantitative (chronic treatment) changes on 5-HT1A and 5HT2C receptors within PAG. / A dor é uma experiência universal, e frequentemente acompanha quadros de ansiedade e depressão. Alguns tipos específicos de fármacos utilizados no tratamento da depressão e ansiedade são também empregados como analgésicos. Há evidências mostrando que a exposição a situações ameaçadoras podem resultar em inibição da dor. Desta forma, pesquisas que envolvem dor e ansiedade frequentemente empregam modelos animais como instrumentos para a seleção de potenciais agentes terapêuticos, e para investigações acerca da neurobiologia das emoções. Diante destas evidências, esse estudo investigou os efeitos: do tratamento agudo e crônico de fluoxetina; tratamento intra-substância cinzenta periaquedutal (SCP) com agonistas serotoninérgicos 5-HT1A e 5HT2C e administração combinada destes fármacos sobre a antinocicepção induzida pelo confinamento ao braço aberto (BA) do labirinto em cruz elevado (LCE). Além disso, investigamos os efeitos do tratamento crônico com fluoxetina sobre os níveis de serotonina, 5-HIAA e de receptores 5- HT1A e 5HT2C da SCP. Nossos resultados demonstraram que: (I) o tratamento agudo com fluoxetina, na dose de 20 mg/kg, foi capaz de aumentar a antinocicepção induzida pelos BA s do LCE; (II) o tratamento crônico (21 dias) com fluoxetina (20 mg/kg) aumentou a antinocicepção induzida pelo ambiente aversivo, e diminuiu o número de contorções dos animais confinados no braço fechado, o que caracteriza um efeito analgésico; (III) a administração intra-SCP do agonista dos receptores 5-HT1A (8-OHDPAT); não alterou o número de contorções nos animais confinados nos braços do LCE; (IV) as infusões intra- SCP de agonistas dos receptores 5HT2C (mCPP e MK-212), acentuaram a antinocicepção nos animais confinados no BA; (V) o bloqueio dos receptores 5HT2C localizados na SCP, através de injeções do antagonista SB 242080, foi capaz de reverter completamente a antinocicepção induzida pelo BA do LCE; (VI) a administração combinada de fluoxetina (aguda) e 8-OH-DPAT intra-SCP, bloqueou a antinocicepção induzida pelo confinamento ao 11 BA; (VII) a administração combinada de fluoxetina (aguda) e MK-212 intra-SCP reverteu o aumento da antinocicepção observada com a injeção isolada de MK-212; (VIII) a administração combinada de fluoxetina (crônica) e 8-OH-DPAT intra-SCP bloqueou a antinocicepção induzida pelo confinamento ao BA; (IX) o tratamento combinado com fluoxetina (crônica) e MK-212 intra-SCP prejudicou o aumento da antinocicepção observada com a injeção isolada de MK-212; (X) o tratamento crônico com fluoxetina não foi capaz de alterar os níveis de serotonina, 5-HIAA e turnover da serotonina na SCP; (XI) o tratamento crônico com fluoxetina promoveu um aumento nos níveis de receptores 5-HT1A e 5HT2C localizados na SCP. Estes achados sugerem que a antinocicepção induzida pelos BA s do LCE é médiada pelos receptores 5-HT2C localizados na SCP. Além disso, a fluoxetina é capaz de interagir com este subtipo de receptor serotoninérgico promovendo alterações funcionais (tratamento agudo) e quantitativas (tratamento crônico) sobre os receptores 5-HT1A e 5HT2C localizados na SCP.

Les progrès dans le domaine de la neuroimagerie cérébrale ont permis une certaine compréhension des maladies mentales comme la schizophrénie. Cependant, peu de résultats sont cohérents et ils sont souvent contradictoires, ce qui rend difficile de tirer des conclusions concrètes par rapport à la maladie. Plusieurs facteurs jouent un rôle dans les résultats divergents et convergents : Les différentes techniques d'imagerie et les analyses, le nombre de patients inclus dans les études, l'âge des patients, l'âge de l’'apparition de la maladie, les critères de diagnostic, les effets du traitement antipsychotique, le statut social, ainsi que les comorbidités, font partie de ces facteurs. Bien que les différences cérébrales entre femmes et hommes « normaux » sont bien établies, ce n’est que ces dernières années que des études en neuroimagerie de la schizophrénie ont abordé les différences homme-femme comme une explication potentielle des résultats discordants de l’imagerie cérébrale. L'objectif de cette thèse est de comprendre le rôle du sexe (genre féminin et masculin) dans les anomalies anatomiques observées dans la schizophrénie; ceci, en réalisant des études qui contrôlent, autant que possible, l'effet de différentes variables confondantes et en utilisant des analyses d’IRM automatisées chez des patients et des sujets sains de même âge et du même sexe. Une brève revue globale des résultats actuels dans le domaine de la schizophrénie ainsi que des résultats liés aux différences entre les sexes dans la schizophrénie vont être présentés. La première étude visait à étudier l'influence des différences de sexe sur des mesures de la gyrification corticale de la schizophrénie. Étant donné que la schizophrénie est une maladie dont les «symptômes cliniques » ont un impact négatif sur la qualité de vie des patients qui en souffrent, nous avons exploré la relation entre la gyrification corticale et les différents symptômes de la schizophrénie chez les hommes et les femmes atteints de ce trouble psychiatrique. Le rôle du sexe sur la gyrification corticale et son association aux symptômes a été à peine étudié chez les patients atteints de schizophrénie ; c’est pour cette raison que, nous croyons que cette étude est d’une importante valeur. Dans cette première étude, des images 3T T1 ont été acquises auprès de 48 patients atteints de schizophrénie (24 hommes [SZ-M] et 24 femmes [SZ-F]) et 48 volontaires sains (24 hommes [NC-M] et 24 femmes [NC-F]), appariés en fonction de l'âge et du sexe. Des mesures d’indice de gyrification (IG) pour chaque hémisphère et les quatre lobes cérébraux (frontaux, temporal, pariétal, et occipital) ont été effectuées en utilisant le pipeline de CIVET, lequel est entièrement automatisé. Plusieurs résultats intéressants ont émergé: les patients avaient des valeurs inférieures importantes de l’IG global par rapport aux témoins; SZ-M avaient des valeurs d'IG hémisphériques significativement inférieurs par rapport à NC-M, cela n'a pas été observé dans les groupes de femmes. Aucune différence entre les sexes dans les valeurs de diminution de l’IG avec l'âge n’a été observés chez les témoins sains par contre, une diminution de la valeur de l’IG avec l’âge chez les patients était plus importante chez les patients homme que les patients femmes. Une détérioration plus progressive dans l'hémisphère droit dans les deux groupes de patients a été observée, tout comme des réductions significatives des valeurs d’IG en relation avec la durée de la maladie chez SZ-M, mais pas chez SZ-F. Dans les groupes de patients, on observe des diminutions des valeurs d’IG dans les lobes frontaux bilatéraux et, le lobe occipital droit; le groupe SZ-M a montré une valeur d’IG significativement plus élevée par rapport à NC-M dans le lobe temporal droit; SZ-F a montré des valeurs d’IG significativement plus faibles dans les lobes bilatéraux frontaux, temporaux, pariétaux et le lobe occipital droit, par rapport à NC-F. Aucune corrélation significative n'a été trouvée entre les valeurs de l'IG et le profil de la symptomatologique dans les deux groupes de patients. Etant donné que l’IG reflète, en partie, des altérations dans le développement et la connectivité cérébrale, la diminution de l’IG observée chez les patients est en accord avec le modèle de développement neurobiologique de disconnectivité dans la schizophrénie. De plus, nous soulignons l'importance de l'âge ainsi que la durée de la maladie lorsque nous comparons les hommes et les femmes atteints de schizophrénie. Cependant, nous n'avons pas observé de corrélation significative n'a été trouvée entre les valeurs de l'IG et les symptômes, ce qui est d'un intérêt particulier et inattendu compte tenu des résultats de la neuroimagerie montrant par exemple certaines corrélations entre les symptômes positifs et certaines anomalies du lobe temporal dans la schizophrénie. Considérant ces résultats, nous avons décidé d'investiguer, dans notre deuxième étude, l'association entre les symptômes et les densités de matière grise (DMG) et de matière blanche (DMB) à la place des mesures de gyrification corticale. Nous avons utilisé la morphométrie basée sur le voxel "Voxel Based Morphometry (VBM8.0 with Diffeomorphic Anatomical Registration (Through Exponentiated Lie Algebra [DARTEL])" et la modélisation linéaire automatique (SPSS21.0 ALM) sur les images 3T T1 MPRAGE acquises auprès de 40 patients atteints de schizophrénie (SZ) et 41 témoins sains (NC). Nous avons trouvé que les patients atteints de schizophrénie avaient une DMG réduite dans le cortex cingulaire antérieur, le cortex temporal médian gauche et une DMG plus élevée dans le cortex cingulaire postérieur gauche par rapport aux sujets sains. Une diminution significative de DMB dans la région fronto-rectal inférieure gauche et la région pariétale postérieure gauche a été observée chez les patients comparés aux sujets sains. Nous avons trouvé des corrélations positives entre les symptômes positifs et la DMG dans l'insula gauche et le noyau caudé droit; et entre les symptômes négatifs et la DMG dans le cortex frontal médian droite et le lobe postérieur de cervelet droit. Nous avons aussi trouvé des corrélations négatives de DMG dans la région pariétale droite (précuneus), le lobe postérieur du cervelet gauche et les symptômes positifs; ainsi qu'entre la DMG du lobe antérieur du cervelet gauche et les symptômes négatifs. En outre, des corrélations positives ont été trouvées entre la DMB dans le cortex frontal médian droit et les symptômes positifs et entre le DMB dans la région frontale supérieure droite et les symptômes négatifs. Des corrélations négatives ont été trouvées entre les symptômes positifs et la DMB dans la région occipitale inférieure droite et le cunéus occipital droit, tandis que des corrélations négatives ont été trouvées entre la DMB et la région frontale supérieure gauche. Il est intéressant de noter que lorsque les symptômes ont été analysés par regroupement, nous avons trouvé que le symptôme de la désorganisation conceptuelle corrélait positivement avec la DMG totale et la DMB totale. L’augmentation de DMG a été associée à une diminution de la gravité des hallucinations et du manque de spontanéité; tandis que l'augmentation de DMB totale a été associée à la diminution de la sévérité de l'hostilité et des idées de grandeur. Une comparaison entre les groupes d'hommes a montré une diminution de la DMG chez les patients schizophrènes, tandis qu’aucune différences n’a été observée dans les groupes de femmes. Nous n’avons trouvé aucune corrélation entre la DMG, la DMB, le liquide cérébro-spinal, le volume total du cerveau, les symptômes individuels et la schizophrénie chez les sujets féminins. Chez les hommes atteints de schizophrénie, on observe des corrélations négatives importantes entre les idées de grandeur et la DMB; des corrélations positives entre la désorientation et la DMB. De plus on observe des corrélations entre et les déficits d'attention et de DMG et DMB. Nos résultats montrent que ces associations sont différentes chez les hommes et les femmes atteints de la schizophrénie. La symptomatologie de schizophrénie est un mélange de déficits cognitifs et socio-affectifs. Dans ce contexte, le but de notre troisième étude est d'étudier chez les patients atteints de la schizophrénie des DMG et DMB et leur relation avec l’acuité mnésique avec des contenus émotionnelles (négatives, positives et neutres) ainsi que étudier l'effet des différences de sexe sur nos résultats. Quarante et un patients droitiers, traités par antipsychotique, souffrant de schizophrénie (SZ) et 40 témoins sains (NC), tous droitiers, ont participé à l’étude. Nous avons utilisé des images de l'International Affective Picture System (IAPS), une banque d'images émotionnelles, et de l’IRM. On observe chez les témoins sains des corrélations entre les valeurs élevées de DMG du cortex pariétal postérieur, du lentiform, du putamen, noyau caudé, le cortex orbitofrontal inférieur gauche et la reconnaissance des images négatives. On observe des corrélations entre la DMG dans la région temporale gauche, fusiforme et la reconnaissance des images positives ; et également dans le cervelet antérieur gauche et l’acuité des images neutres. Chez les patients on observe des valeurs élevées des DMG dans le cortex occipital inférieur gauche et la reconnaissance des images négatives, mais aucune corrélation entre la capacité de reconnaissance des images positives ou neutres. Nous avons observé chez les témoins sains: des relations significatives entre la DMB dans le cortex pariétal postcentral gauche et la capacité de reconnaître des images négatives; dans le cortex temporal inferieur gauche, le cortex pariétal gauche (précuneus), le cortex frontal gauche et la capacité de reconnaissance des images positives; des valeurs de DMB du cortex temporel médian et l’acuité des images neutres. Les patients atteints de schizophrénie ont montré des relations significatives entre de DMB dans le cortex occipito-lingual gauche et la reconnaissance des images négatives ; dans le cortex pariétal angulaire gauche et la reconnaissance des images positives ; et dans le cortex temporal supérieur droit et les images neutres. Les différences de sexe dans la schizophrénie ont été observées : chez les patients de sexe masculin, des corrélations négatives ont été trouvées entre les DMB et la capacité de reconnaître des images négatives et positives. Chez les hommes sains, nous avons trouvé des corrélations positives entre des valeurs totales de DMG et la capacité de reconnaître des images négatives. Nous n’avons pas observé de corrélations dans les groupes de femmes. Ces résultats soutiennent l'hypothèse de l'atrophie fronto-temporale régionale chez les patients schizophrènes. Toutefois, nous notons qu’ils ont des augmentations relatives des valeurs de DMB dans le cortex occipito-pariétal. Nous avançons l'hypothèse que les déficits mnésiques chez les patients sont liés à des perturbations dans la coordination des réseaux cérébraux, ce qui peut être affecté par des déficits structuraux plus évidents chez les patients masculins. Par conséquent, nous préconisons que les futures études devraient utiliser le connectome ou l’approche « réseaux cérébraux » pour étudier l’impact du sexe (genre masculin-féminin) sur les déficits cognitifs et symptomatologiques dans la schizophrénie. Nos résultats globaux soulignent l'importance de la différence entre homme et femme dans la modulation de manifestations cliniques et fonctionnelles de la schizophrénie. Ainsi, nous croyons que le contrôle des covariables comme l'âge, la durée de la maladie et le statut social est insuffisant et que les études futures sur la schizophrénie devraient systématiquement séparer les hommes des femmes, afin de mieux comprendre cette maladie mentale complexe et dévastatrice. / Advances in cerebral neuroimaging techniques have helped our understanding of mental illnesses, such as schizophrenia. Few findings remain consistent and are often contradictory, making it difficult to draw informative conclusions about the disease. Several factors play a role in both diverging and converging results. Imaging technique and analyses, number of patients involved, age of patients, age at onset of the disease, diagnostic criteria, antipsychotic treatment effects, social status, comorbidities, are among some of the reasons. Despite well established cerebral sex differences in healthy population, it is only in recent years that neuroimaging studies in schizophrenia have addressed sex differences as a major possible explanation for discrepant neuroimaging finding. The aim of this thesis is to help understand the role of sex on brain structures in schizophrenia, by conducting studies that control as much as possible for other variables and by using MRI automated analyses for patients and controls matched for age and sex. This work will briefly present findings in schizophrenia in general, and then an extensive review of the literature on sex differences in schizophrenia will be presented. From it, we are able to conclude that sex differences have been reported with rare exception in almost all aspects involved in the life of patients with schizophrenia. Chapters 1. The first study investigated sex differences in cortical gyrification in schizophrenia patients (SZ). In addition, considering that schizophrenia is a disease of “clinical symptoms” that determine the quality of life of patients afflicted by it, we explored the relation between cortical gyrification and symptoms in males and females with schizophrenia. The role of sex on cortical gyrification and its association with symptoms has been scarcely investigated in patients with schizophrenia. In this study, 3T T1 images were acquired from 48 schizophrenia patients (24 males [SZ-M] and 24 females [SZ-F]) and 48 normal controls [NC] (24 males [NC-M] and 24 females [NC-F]) matched for age, sex, and handedness. Gyrification Index (GI) analyses for each hemisphere and four cerebral regions (frontal, temporal, parietal, and occipital) were performed using the fully automated CIVET pipeline. Patients had significant lower values of the overall GI relative to normal controls and SZ-M had significant lower right hemispheric GI values compared to NC-M. This was not observed in either NC-F or in SZ. No gender difference in GI values decreases with age were observed in NC. In patients, GI decreases with age were greater in SZ-M than SZ-F, with a more progressive deterioration in the right hemisphere in both patient groups. Significant GI value reductions in association with duration of illness were observed in SZ-M but not in SZ-F. Patient groups had lower GI in bilateral frontal, temporal, and parietal lobes than controls. SZ-F had significant lower GI values in left frontal, bilateral temporal and left parietal lobe compared to NC-F. No significant correlations were found between GI values and symptom scores in either group of patients. Since GI reflects, in part, alterations in cerebral development and connectivity, the decrease in GI observed in patients is in agreement with the neurodevelopmental model of disconnectivity in schizophrenia, and may explain the worse prognosis and social outcome observed in male patients. Furthermore, we emphasize the importance of age and duration of illness when comparing males and females with schizophrenia. Observed differences between male and female patients may reflect a more diffuse and generalized cortical loss in males. Female patients had cortical loss in specific regions, while preserving cortical gyrification in compensatory regions. Our latter finding -no significant correlation between GI values and symptom scores- was of particular interest and was unexpected in view of neuroimaging findings of correlations between positive symptoms and temporal lobe abnormalities. 2. In the second study, we examined the association between symptoms and brain structure using gray (GMD) and white matter (WMD) densities. Voxel-based morphometry (VBM8.0 with Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra [DARTEL]) and Automatic Linear Modeling (SPSS21.0 ALM) were used on 3T T1 MPRAGE images acquired from 40 schizophrenia patients (SZ) and 41 normal controls (NC). We found that SZ had lower GMD in the anterior cingulate cortex and left middle temporal gyrus, and higher GMD in the left posterior cingulate in comparison to NC. SZ had significantly lower WMD in the left inferior fronto-rectal and the left posterior parietal regions in comparison to NC. Significant positive correlations were found between positive symptoms and GMD in the left insula and right caudate, and between negative symptoms and GMD in the right middle frontal and the posterior lobe of the right cerebellum (uvula). Inverse relationships between GMD in the right parietal (precuneus), the left posterior lobe of the cerebellum (uvula) and positive symptoms, and between GMD in the left anterior lobe of the cerebellum and negative symptoms were observed in SZ. In addition, positive correlations were found between WMD in the right middle frontal lobe, and between positive symptoms and WMD in the right superior frontal region with negative symptoms. Negative correlations were found between positive symptoms and WMD in the right inferior occipital and the right occipital cuneus, while negative symptoms correlated negatively with the WMD of the left superior frontal. When symptom clusters were analyzed, conceptual disorganization symptom positively correlated with both total GMD and WMD. While increases in GMD were associated with decreased severity of lack of spontaneity and hallucinations symptom, increases in total WMD were associated with decreased severity of hostility and grandiosity symptoms. Comparison between male subjects revealed decreased GMD in male schizophrenia patients, while no differences were observed between females across groups. No correlations were found in female groups between GMD, WMD, CSF, or total brain volume and individual symptoms. In males with schizophrenia, significant negative correlation between ideas of grandiosity and WMD, a positive correlation between disorientation and WMD, and attention deficits and GMD and WMD were found. The current data suggest region-specific GMD and WMD association with negative and positive symptoms. In addition, it reveals that such associations are different in male and female schizophrenia patients. 3. The third study investigated the relationships of GMD and WMD with memory accuracy for emotionally negative, positive, and neutral pictures in schizophrenia patients relative to normal controls. Schizophrenia is characterized by an amalgam of cognitivo-socio-emotional deficits. The relationship between emotion processing on cognition and neurobiological underpinnings merit more attention than it has received so far. Memory deficits are among the most common deficits in schizophrenia and have a widespread impact on cognition in general. Additionally, consistently with the major theme of the present thesis, we investigated the effect of gender on the observed effect. Forty one, right-handed medicated patients with schizophrenia (SZ) and 40 right-handed normal controls (NC) matched by age and sex were assessed for memory accuracy using negative, positive and neutral pictures taken from the International Affective Picture System (IAPS). Imaging methods and analyses were similar to our second study. Fifteen minutes after presentation of selected IAPS images (incidental encoding), subjects were asked to recognize the previously seen images among other images. We found higher GMD in NC in the right posterior parietal cortex, lentiform, putamen, and caudate, as well as the left inferior orbitofrontal cortex, in relation with the negative images accuracy. NC had higher GMD in the left temporal and fusiform regions in relation with the positive images accuracy, and higher GMD in the left anterior cerebellum in relation with neutral images. Schizophrenia subjects had higher GMD in the left inferior occipital cortex in relation with the negative images accuracy, but GMD was not correlated with positive or neutral images accuracy in this group. WMDs correlations were higher in NC in the left postcentral parietal region for negative images; in the left inferior temporal, left precuneus parietal, and left frontal regions for positive images; and in the left middle temporal region for neutral images. Schizophrenia patients had higher WMD in the left lingual occipital for negative images; in the left angular parietal for positive images; and in the right superior temporal region for neutral images. While examining the two sexes separately, we observed inverse correlations between WMD and both negative and positive pictures in male patients. In addition, only in male controls, GMD positively correlated with negative pictures and this correlation was absent in female SZ subjects and NC females. These findings support the hypothesis of fronto-temporal regional atrophy in schizophrenia. Schizophrenia patients have relatively increased occipito-parietal WMD, advancing the hypothesis that the core pathophysiological problem underlying recall memory in SZ may be related to disruptive alterations in the coordination of large-scale brain networks, and this may be affected by structural deficits that are more evident in male patients. It is recommended that future studies should use the connectomes or the brain networks approach to investigate the effect of sex on memory deficits in schizophrenia. Our overall findings point out to the importance of sex in modulating the clinical and functional manifestations of schizophrenia. We believe that controlling for covariates as age, duration of illness, social status, etc. is insufficient and that future studies in schizophrenia should systematically separate male and female findings, if we wish to understand this complex and devastating mental illness.

Pathologisches Glücksspiel (PG) ist eine psychiatrische Erkrankung, die gerade erst im DSM-5 der gleichen Kategorie wie substanzgebundene Suchterkrankungen zugeordnet wurde. Bildgebungsstudien zu Substanzabhängigkeit beobachteten funktionelle und strukturelle Veränderungen im präfrontalen Kortex (PFC) und mesolimbischen Belohnungssystem (d.h. Striatum). Für PG wurden ähnliche Veränderungen berichtet; jedoch gibt es kaum Studien, die sich mit verschiedenen Aspekten funktioneller und struktureller Korrelate in diesen Regionen beschäftigen. Diese Arbeit untersuchte PG Patienten, alkoholabhängige (AD) Patienten und Kontrollpersonen (HC) mit Magnetresonanztomografie. In Analyse I wurden funktionelle Gehirndaten während der Belohnungsaufgabe zwischen den drei Gruppen verglichen. In Analyse II wurde das Volumen grauer Substanz mit voxelbasierter Morphometrie und in Analyse III die intrinsische Gehirnaktivität mit einer seedbasierten funktionellen Konnektivitätsanalyse von PG Patienten und HC ausgewertet. Die Analysen ergaben veränderte Aktivierungen in frontostriatalen Arealen während der Verarbeitung von Verlustvermeidung für PG Patienten im Vergleich zu HC. PG Patienten unterschieden sich dabei in ihrer Aktivierung von AD Patienten während der Antizipation von Geldverlust. Weiterhin zeigten PG Patienten erhöhte Volumina grauer Substanz und eine erhöhte funktionelle Konnektivität in frontostriatalen Arealen im Vergleich zu HC. Die Ergebnisse liefern weitere Hinweise für eine veränderte Belohnungsverarbeitung in PG und betonen die Bedeutung der Verlustvermeidungsverarbeitung. Die Volumenveränderungen im und die erhöhte Konnektivität zwischen dem PFC and Belohnungssystem deuten auf eine veränderte Interaktion zwischen diesen Regionen hin. Da solche Veränderungen in kortikostriatalen Systemen Ähnlichkeiten zu denen in Substanzabhängigkeiten aufweisen, unterstützen die Ergebnisse die neue Klassifikation des PG im DSM-5. / Pathological gambling (PG) is a psychiatric disorder newly classified under the same category as substance use disorders in the DSM-5. Neuroimaging studies on substance-related addictions reported functional and structural changes in the prefrontal cortex (PFC) and the mesolimbic reward system (i.e., striatum). For PG, findings are not that extensive, but also demonstrate altered reward processing and prefrontal function. However, there is a lack of studies focusing on different aspects of functional and structural correlates within these areas in PG. This thesis investigated PG patients, alcohol dependent (AD) patients and healthy controls with magnetic resonance imaging (MRI). In analysis I, functional brain data of a reward paradigm was compared between the three groups. In analysis II, local gray matter volume of PG patients and controls was processed via voxel-based morphometry. Resting-state data of PG patients and controls was analyzed via seed-based functional connectivity in analysis III. Results revealed altered brain responses in fronto-striatal areas during loss avoidance processing in PG patients as compared to controls. Importantly, PG patients differed in their brain responses from AD patients during the prospect of monetary loss. Moreover, PG patients showed an increase in local gray matter volume and functional connectivity in frontal-striatal areas as compared to controls. Our results add further evidence for an altered reward processing in PG and underline the importance of loss avoidance processing. Moreover, our findings of volumetric alterations within and increased connectivity between PFC and reward system, suggest an altered interaction between these brain regions. Since such alterations in cortico-striatal circuits resemble those reported for substance-related addictions, our findings support the new classification of PG in the DSM-5.

Indiana University-Purdue University Indianapolis (IUPUI) / Magnetic resonance (MR) spectroscopy is a neuroimaging technique. It is widely used to quantify the concentration of important metabolites in a brain tissue. Imbalance in concentration of brain metabolites has been found to be associated with development of neurological impairment. There has been increasing trend of using MR spectroscopy as a diagnosis tool for neurological disorders. We established statistical methodology to analyze data obtained from the MR spectroscopy in the context of the HIV associated neurological disorder. First, we have developed novel methodology to study the association of marker of neurological disorder with MR spectrum from brain and how this association evolves with time. The entire problem fits into the framework of scalar-on-function regression model with individual spectrum being the functional predictor. We have extended one of the existing cross-sectional scalar-on-function regression techniques to longitudinal set-up. Advantage of proposed method includes: 1) ability to model flexible time-varying association between response and functional predictor and (2) ability to incorporate prior information. Second part of research attempts to study the influence of the clinical and demographic factors on the progression of brain metabolites over time. In order to understand the influence of these factors in fully non-parametric way, we proposed LongCART algorithm to construct regression tree with longitudinal data. Such a regression tree helps to identify smaller subpopulations (characterized by baseline factors) with differential longitudinal profile and hence helps us to identify influence of baseline factors. Advantage of LongCART algorithm includes: (1) it maintains of type-I error in determining best split, (2) substantially reduces computation time and (2) applicable even observations are taken at subject-specific time-points. Finally, we carried out an in-depth analysis of longitudinal changes in the brain metabolite concentrations in three brain regions, namely, white matter, gray matter and basal ganglia in chronically infected HIV patients enrolled in HIV Neuroimaging Consortium study. We studied the influence of important baseline factors (clinical and demographic) on these longitudinal profiles of brain metabolites using LongCART algorithm in order to identify subgroup of patients at higher risk of neurological impairment. / Partial research support was provided by the National Institutes of Health grants U01-MH083545, R01-CA126205 and U01-CA086368