Sabe-se que a epilepsia do lobo temporal associada à esclerose hipocampal (ELT-EH) é uma síndrome epiléptica frequente e de difícil controle medicamentoso. Além disso, esta condição acarreta em uma série de prejuízos cognitivos aos seus portadores antes e após a cirurgia para tratamento das crisesrefratárias. Alguns trabalhos mostram que o prognóstico cognitivo pode mudar dependendo da abordagem cirúrgica realizada. Dessa forma, este trabalho teve como objetivo verificar qual o papel do polo temporal no funcionamento cognitivo. Para isso, foi realizada uma análise retrospectiva dos prontuários médicos de 146 pacientes adultos com ELT-EH esquerda, destros, avaliados no Centro de Cirurgia de Epilepsia (CIREP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP) - Universidade de São Paulo (USP). Os resultados mostraram um melhor desempenho na tarefa de nomeação por confronto visual nos pacientes que passaram por lobectomia temporal esquerda sem ressecção do polo (p=0.007). Quando realizada da análise do índicede mudança confiável (RCI) para verificar a relevância clínica dos achados, 39,4% dos pacientes que passaram pela cirurgia com ressecção do polo temporal mostraram uma piora significativa de desempenho no teste de nomeação por confronto visual no Boston Naming Test (BNT), enquanto apenas 16% dos que passaram pela cirurgia sem ressecção do polo mostraram piora significativa no mesmo teste (p=0.015). No entanto, este mesmo grupo mostrou um pior prognóstico de controle de crises quando comparado ao grupo com ressecção do polo (p=0.018). Assim, esses dadosindicam que o polo temporal pode estar envolvido em habilidades de nomeação. Nossos resultados sugerem, portanto, que a cirurgia para o tratamento das crises refratárias nos pacientes com ELT-EH esquerda poderiam considerar as diferenças individuais para decidir a melhor abordagem cirúrgica para cada paciente / It is known that the temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) is a frequent epileptic syndrome with difficult medication control. In addition, this condition leads to a series of cognitive impairments to patients before and after surgery for the treatment of refractory crises. Studies shown that cognitive prognosis may change depending on the surgical approach. Thus, this study aimed to verify the role of temporal pole in cognitive functions. A retrospective analysis of medical records from 146 adult patients with left-sided TLE-HS - evaluated at the Center for Epilepsy Surgery (CIREP) of the Clinical Hospital from Ribeirão Preto Medical School was performed. The results showed a higherperformance on visual confrontation namingtests - according to the Boston Naming Test (BNT) - in patients submitted to left temporal lobectomy without pole resection (p=0.007). Reliable change index (RCI)analysis, for clinical relevance,revealed that 39.4% of the patients submitted to temporal pole resectionshowed significantly worse performance on visual confrontation naming and only 16% of the patients without pole resection were significantly worse in the same test (p=0.015). However, this same group showed a worse prognosis of crisis control when compared to the group with pole resection (p=0.018). Altogether, the present study suggest that the temporal pole may be involved in naming skills. Our results suggest that surgery for left TLE-HS should be performed considering individual differences to decide the best surgical approach for each patient

Obwohl die Struktur und das Ausmaß dendritischer Verzweigungen eine wichtige Rolle bei der Informationsübertragung neuronaler Zellen spielen, ist bislang wenig über die Bausteine und Molekularmechanismen des Dendritenwachstums bekannt. Unter der Verwendung primär dissoziierter hippocampaler Zellkulturen embryonaler Mäuse untersuchte ich frühe Stadien des Zellfortsatzwachstums. Dabei konnte ich SNAP-25 (synaptosomal associated protein of 25 kDA), ein Schlüsselprotein der regulierten Exozytose, nicht nur in Axonen und terminalen Axonendigungen, sondern auch anhand von Doppelimmunmarkierungen mit den dendritischen Markern Transferrin-Rezeptor und MAP-2 in Dendriten lokalisieren. Die spezifische Inaktivierung von SNAP-25 durch Botulinumneurotoxin A (BoNT/A) führte zur Hemmung des Axonwachstums und des Vesikelrecyclings in terminalen Axonendigungen. Darüberhinaus wurde auch das Wachstum dendritischer Fortsätze von Körner- und Pyramidenzellen durch BoNT/A signifikant gehemmt. Daraus läßt sich schließen, daß SNAP-25, im Gegensatz zu Synaptobrevin, an konstitutiven Prozessen in den Axonen und Dendriten hippocampaler Neurone beteiligt ist. / Structure and dimension of the dendritic arbor are important determinants of information processing by the nerve cell, but mechanisms and molecules involved in dendritic growth are essentially unknown. I investigated early mechanisms of dendritic growth using mouse fetal hippocampal neurons in primary culture, which form processes during the first week in vitro. I detected a key component of regulated exocytosis, SNAP-25 (synaptosomal associated protein of 25 kDa)., in axons and axonal terminals as well as in dendrites identified by the occurrence of the dendritic markers transferrin receptor and MAP2. Selective inactivation of SNAP-25 by botulinum neurotoxin A (BoNTA) resulted in inhibition of axonal growth and of vesicle recycling in axonal terminals. In addition, dendritic growth of hippocampal pyramidal and granule neurons was significantly inhibited by BoNTA. These observations indicate that SNAP-25, but not synaptobrevin, is involved in constitutive axonal growth and dendrite formation by hippocampal neurons.

Due to two different mutations in the gene that encodes the a1A subunit of voltage-activated CaV 2.1 calcium ion channels, the compound heterozygous tottering/leaner (tg/tgla) mouse exhibits numerous neurological deficits. Human disorders that arise from mutations in this voltage dependent calcium channel are familial hemiplegic migraine, episodic ataxia-2, and spinocerebellar ataxia 6. The tg/tgla mouse exhibits ataxia, movement disorders and memory impairment, suggesting that both the cerebellum and hippocampus are affected. To gain greater understanding of the many neurological abnormalities that are exhibited by the 90-120 day old tg/tgla mouse the following aspects were investigated: 1) the morphology of the cerebellum and hippocampus, 2) proliferation and death in cells of the hippocampal dentate gyrus and 3) changes in basic biochemical parameters in granule cells of the cerebellum and hippocampus. This study revealed no volume abnormalities within the hippocampus of the mutant mice, but a decrease in cell density with the pyramidal layer of CA3 and the hilus of the dentate gyrus. Cell size in the CA3 region was unaffected, but cell size in the hilus of the dentate gyrus did not exhibit the gender difference seen in the wild type mouse. The cerebellum showed a decrease in volume without any decrease in cerebellar cellular density. Cell proliferation and differentiation in the subgranular zone of the hippocampal dentate gyrus remained normal. This region also revealed a decrease in cell death in the tg/tgla mice. Basal intracellular calcium levels in granule cells show no difference within the hippocampus, but an increase in the tg/tgla male cerebellum compared to the wild type male cerebellum. There was no significant difference in granule cell mitochondrial membrane potential within the wild type and mutant animals in either the hippocampus or cerebellum. The rate of reactive oxygen species (ROS) production in granule cells revealed no variation within the hippocampus or cerebellum. The amount of ROS was decreased in cerebellar granule cells, but not granule cells of the hippocampus. Inducing ROS showed no alteration in production or amount of ROS produced in the hippocampus, but did show a ceiling in the amount of ROS produced, but not rate of production, in the cerebellum.

The fundamental attribute of neurons is their cellular electrical excitability, which is based on the expression of a plethora of ligand- and voltage-gated membrane channels that give rise to prominent membrane currents and membrane potential variations that represent the biophysical substrate underlying the transfer and integration of information at the cellular level. Dendrites have both an electrical and a biochemical character, which are closely linked. In contrast, glial cells are non-electrically excitable but nevertheless display a form of excitability that is based on variations of the Ca2+ concentration in the cytosol rather than electrical changes in the membrane. Cytoplasmic Ca2+ serves as an intracellular signal that is responsible for controlling a multitude of cellular processes. The key to this pleiotropic role is the complex spatiotemporal organization of the [Ca2+]i rise evoked by extracellular agonists, which allows selected effectors to be recruited and specific actions to be initiated. Ca2+ handling in the cell is maintained by operation of multiple mechanisms of Ca2+ influx, internal release, diffusion, buffering and extrusion. Ca2+ tends to be a rather parochial operator with a small radius of action from its point of entry at the cytoplasm resulting in the concept of microdomains. Dendritic Ca2+ signaling have been shown to be highly compartmentalized and astrocytic processes have been reported to be constituted by hundreds of microdomains that represent the elementary units of the astrocyte Ca2+ signal, from where it can eventually propagate to other regions of the cell. The astrocyte Ca2+ elevation may thus act as intra and intercellular signal that can propagate within and between astrocytes, signaling to different regions of the cell and to different cells. The spatio-temporal features of neuron-to-astrocyte communication, results from diverse neurotransmitters and signaling pathways that converge and cooperate to shape the Ca2+ signal in astrocytes. Alterations in Ca2+ homeostasis have been shown to be associated with major pathological conditions of the brain such as epilepsy, ischemia and neurodegenerative diseases. Although there are evidences of Ca2+ rise in hippocampal neurons in in vitro models of epilepsy (Pal et al., 1999; Limbrick et al., 2001), there is no information on the Ca2+ regulatory mechanisms operating in discrete compartments of the epileptic neuron following Ca2+ influx through voltage gated calcium channels (VGCCs). In the first part of the work, the spatial and temporal profiles of depolarization induced changes in the intracellular Ca2+ concentration in the dendrites of cultured autaptic hippocampal pyramidal neurons rendered epileptic experimentally have been addressed. Our in vitro epilepsy model consisted of hippocampal neurons in autaptic culture that were grown in the presence of kynurenate and high Mg2+, and subsequently washing the preparation free of the blockers. To understand the differences in Ca2+ handling mechanisms in different compartments of a control neuron and the kynurenate treated neuron, a combination of whole-cell patch-clamp recording and fast Ca2+ imaging methods using the Ca2+ indicator Oregon Green 488 BAPTA-1 was applied. All our analysis was focused on localized regions in the dendrite that showed pronounced Ca2+ transients upon activation of high voltage activated (HVA) Ca2+ channels. The spatial extent of Ca2+ signals suggested the presence of distinct dendritic compartments that respond to the depolarizing stimulus. Further, the local Ca2+ transients were observed even in the presence of NMDA and AMPA receptor antagonists, suggesting that the opening of VGCCs primarily triggered the local Ca2+ changes. The prominent changes in intracellular Ca2+ observed in these dendritic regions appear to be sites where Ca2+ evoked dendritic exocytosis (CEDE) takes place. Since cellular Ca2+ buffers determine the amplitude and diffusional spread of neuronal Ca2+ signals, quantitative estimates of the time-dependent spread of intracellular Ca2+ in the dendritic compartments in the control and treated neurons were done using image processing techniques. Physiological changes in Ca2+ channel functioning were also induced by kynurenate treatment and one such noticeable difference was the observation of Ca2+ dependent inactivation in the treated neurons. We provide evidences of localized Ca2+ changes in the dendrites of hippocampal neurons that are rendered epileptic by kynurenate treatment, suggesting that these sites are more vulnerable (Padmashri et al., 2006). This might contribute to the epileptiform activity by local changes in cellular and membrane properties in complex ways that remains to be clearly understood. Status Epilepticus (SE), stroke and traumatic brain injury are all associated with large increases in extracellular glutamate concentrations. The concentration of glutamate in the extracellular fluid is around 3-4 µM and astrocytes are primarily responsible for the uptake of glutamate at the synapses. The extracellular levels of glutamate has been shown to increase dramatically (16 fold) in human SE suggesting an important role of glutamate in the mechanism of seizure activity and seizure related brain damage (Carlson et al., 1992). Several other studies have also shown a persistent increase in extracellular glutamate concentration to potentially neurotoxic concentrations in the epileptogenic hippocampus (During and Spencer, 1993; Sherwin, 1999; Cavus et al., 2005). We addressed the problem related to the effects of prolonged glutamate pretreatment on Ca2+ signaling in an individual astrocyte and its adjoining astrocyte (astrocyte pair), rather than on a syncytium of astrocytes in culture. Individual astrocytes may have functional domains that respond to an agonist through distinct receptor signaling systems. These are difficult to observe in studies that are done on glial syncytium because of spatial limits of image capture. This was examined with simultaneous somatic patch-pipette recording of a single astrocyte to evoke voltage-gated calcium currents, and Ca2+ imaging using the Ca2+ indicator Oregon Green 488 BAPTA-1 to identify the Ca2+ microdomains. Transient Ca2+ changes locked to the depolarization were observed in certain compartments in the astrocyte processes of the depolarized astrocyte and the responses were more pronounced in the adjoining astrocyte of the astrocyte pair. The Ca2+ transient amplitudes were enhanced on pretreatment of cells with glutamate (500 µM for 20 minutes). Estimation of local Ca2+ diffusion coefficients in the astrocytic processes indicated higher values in the adjoining astrocyte of the glutamate pretreated group. In order to understand the underlying mechanisms, we performed the experiments in the presence of different blockers for the metabotropic glutamate receptor, inositol 1,4,5 triphosphate (IP3) receptors and gap junctions. Ca2+ transients recorded on pretreatment of cells with glutamate showed attenuated responses in the presence of the metabotropic glutamate receptor (mGluR) antagonist α-Methyl(4-Carboxy-Phenyl) Glycine (MCPG). Intracellular heparin (an antagonist of IP3 receptor) introduced in the depolarized astrocyte did not affect the Ca2+ transients in the heparin loaded astrocyte, but attenuated the [Ca2+]i responses in the adjoining astrocyte suggesting that IP3 may be the transfer signal. The uncoupling agent 1-Octanol attenuated the [Ca2+]i responses in the adjoining cell of the astrocyte pair in both the control and glutamate pretreated astrocytes indicating the role of gap junctional communication. The findings of [Ca2+]i responses within discrete regions of astrocytic processes suggest that astrocytes may be comprised of microdomains whose properties are altered by glutamate pretreatment. The data also indicates that glutamate induced alterations in Ca2+ signaling in the astrocyte pair may be mediated through phospholipase C (PLC), IP3, internal Ca2+ stores, VGCCs and gap junction channels (Padmashri and Sikdar, 2006). Neuronal (EAAC-1) and glial (GLT-1 and GLAST) glutamate transporters facilitate glutamate reuptake after synaptic release. Transgenic mice with GLT-1 knockout display spontaneous epileptic activity (Tanaka et al., 1997) and loss of glial glutamate transporters using chronic antisense nucleotide administration was reported to result in elevated extracellular glutamate levels and neurodegeneration characteristic of excitotoxity (Rothstein et al., 1996). Dysfunction of glutamate transporters and the resulting increase of glutamate have been speculated to play an important role in infantile epilepsies (Demarque et al., 2004). We examined the effects of pretreatment with glutamate in the presence of the glutamate transport inhibitor threo-β-hydroxy-aspartate (TBHA) and in Na+-free extracellular medium to understand whether this resulted in any alteration in the astrocytic intracellular Ca2+ dynamics following activation of voltage gated calcium channels. The Ca2+ responses were found to be attenuated in both the cases indicating that the elevated levels of extracellular glutamate due to blockade of glutamate transporters may influence the responses mediated by the astrocytic glutamate receptors. Our studies indicate that the heightened extracellular glutamate concentration is not gliotoxic in our experimental system, although it may have a profound effect on altering the activity of surrounding neurons which was not addressed in the present work. Several studies have indicated that neurons control the level of gap junction mediated communication between astrocytes (Giaume and McCarthy, 1996; Rouach et al, 2000). All our earlier studies were done on process bearing astrocytes that were co-cultured with neurons. We have addressed the question as to whether the spatio-temporal changes in [Ca2+]i in astrocyte pairs differ if the astrocytes are cultured in the absence of neurons. The results indicate that there is indeed a significant reduction in the responses that are evoked in response to the depolarization pulse in the adjoining cell of the astrocyte pair. These experiments demonstrate that neurons in the cocultures may selectively enhance the Ca2+ responses possibly by increasing the coupling between the two cells.

Κύριος στόχος της εργασίας ήταν η συγκριτική μελέτη της παλίνδρομης αναστολής μεταξύ του ραχιαίου και του κοιλιακού πόλου του ιππόκαμπου αρουραίου. Χρησιμοποιήθηκε η μεθοδολογία της in vitro διατήρησης τομών ιππόκαμπου και εξωκυττάριων καταγραφών προκλητών δυναμικών πεδίου. Τα αποτελέσματά μας έδειξαν ότι η GABAA εξαρτώμενη παλίνδρομη αναστολή είναι ασθενέστερη, έχει μικρότερη διάρκεια και φθίνει πιο γρήγορα στον κοιλιακό σε σχέση με το ραχιαίο ιππόκαμπο. Χρησιμοποιώντας διάφορα φάρμακα που δρουν ενισχυτικά στον GABAA υποδοχέα δείξαμε ότι υπάρχει λειτουργική διαφοροποίηση του GABAA εξαρτώμενου ανασταλτικού μηχανισμού μεταξύ των δύο πόλων του ιππόκαμπου, ενισχύοντας την υπόθεση της λειτουργικής διαφοροποίησης στο επίπεδο του υποδοχέα μεταξύ των δύο πόλων. Στην in vivo μελέτη, χρησιμοποιώντας το μοντέλο επαγωγής επιληπτικών κρίσεων με χορήγηση πεντυλενοτετραζόλης, δείξαμε ότι η ενίσχυση της GABAA εξαρτώμενης αναστολής απο τα κατασταλτικά φάρμακα συσχετίζεται με το μέγεθος της αντιεπιληπτικής τους δράσης. Επιπλέον, η βιταμίνη D δεν παρουσίασε αντιεπιληπτική δράση στους C57BL/6J μύες, ούτε ενίσχυσε την αναστολή, κάτι που δείχνει ότι δεν έχει επίδραση στον GABAA υποδοχέα ή, τουλάχιστον, στους υπότυπούς του στον ιππόκαμπο. / The major aim of this work was the comparative study of recurrent inhibition between the dorsal and ventral pole of the rat hippocampus. We used the methodology of in vitro maintenance of hippocampal slices and recording of evoked field potentials. We showed that the GABAA mediated recurrent inhibition is weaker, lasts less and decays faster in ventral than in dorsal hippocampus. Using various drugs that act as positive allosteric modulators of the GABAA receptor, we showed that there is a functional differentiation of the GABAA inhibitory mechanism between the two hippocampal poles, strengthening the hypothesis of the functional differentiation at the level of the receptor between the two poles. In the in vivo study, using the pentylenetetrazole model for inducing epileptic seizures, we showed that the enhancement of the GABAA mediated recurrent inhibition correlates with the strength of antiepileptic action of the sedative drugs used. In addition vitamin D did not show antiepileptic action in C57BL/6J mice. Moreover it didn’t enhance recurrent inhibition, showing that it doesn’t have any action on the GABAA receptor or, at least, on its subtypes in hippocampus.

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Les nouveaux neurones de l’hippocampe semblent contribuer à l’action thérapeutique des antidépresseurs. La nature fonctionnelle de cette contribution est cependant inconnue. En stimulant la neurogenèse les antidépresseurs pourraient renforcer certaines fonctions de l’hippocampe et ainsi permettre la rémission. Nous montrons dans ce travail que les nouveaux neurones peuvent contribuer à l’action thérapeutique des antidépresseurs en participant au renforcement de rétrocontrôle hippocampique sur la régulation de l’axe HPA, potentiellement via leur rôle dans la capacité de l’hippocampe à moduler l’activité des autres structures impliquées dans la régulation du stress, comme le noyau du lit de la strie terminale. Les différentes composantes fonctionnelles de l’hippocampe sont cependant topographiquement distribuées le long de son axe septo-temporal. A travers une approche corrélative nous avons montré que différents antidépresseurs régulent la neurogenèse différentiellement le long de l’axe septo-temporal. Cela suggère des mécanismes de régulation régiondépendants et que la contribution des nouveaux neurones dans les effets des antidépresseurs pourrait être multiple et sous tendue par des composantes fonctionnelles différentes, et non limitée à la régulation de l’axe du stress. / Hippocampal newborn neurons contribute to some extent to the therapeutic effects of antidepressants. Mechanisms involved in this contribution remain however elusive. By increasing the recruitment of newborn neurons antidepressants could improve several hippocampal functions and thus allow remission. Here we demonstrate that newborn neurons may contribute to the therapeutic effects of antidepressants by allowing the recovery of a proper hippocampal inhibitory feedback over the HPA axis, possibly by normalizing the communication between the hippocampus and stress integrative structures mediating its inhibitory influence, such as the bed nucleus of the stria terminalis. Hippocampal functions are however topographically segregated along its septo-temporal axis. Here we show that different mood-improving manipulations differentially regulate neurogenesis along this septo-temporal axis. This suggest different region-specific mechanisms involved in the regulation of neurogenesis and that newborn neurons may contribute to the therapeutic effects of antidepressants by modulating different aspects of hippocampal functions.

Le traumatisme cérébral (TC) touche des millions de personnes chaque année dans le monde. Les premières conséquences peuvent être une perte de conscience, des hémorragies et l’apparition d’un œdème cérébral. Cependant les personnes qui subissent un TC peuvent présenter des séquelles importantes à plus long terme. Ainsi le traitement préventif des pathologies post-traumatiques est devenu un réel problème de santé publique. La dépression représente la pathologie post-traumatique dont l’occurrence est la plus fréquente. Les origines connues de son apparition s’orientent vers une altération de la neurogenèse adulte hippocampique ainsi que des changements dans la neurotransmission GABAergique, qui est dépendante de l’homéostasie des ions chlorures. Mon travail de thèse suggère que la phase critique, responsable de l’apparition des pathologies post-traumatiques, survient au cours de la première semaine suivant le TC. Pendant cette période, mes résultats montrent que l’hyperexcitabilité des réseaux neuronaux hippocampiques est due à une perturbation des transporteurs des ions chlorure entraînant notamment, une diminution de l’inhibition neuronale. J’ai aussi pu mettre en évidence une altération de la neurogenèse adulte hippocampique liée à la perte d’interneurones dans le gyrus denté. Consécutivement à ces changements, vont s’installer des troubles dépressifs majeurs. Mes travaux indiquent également que la restauration précoce, de l’homéostasie des ions chlorure par un agent pharmacologique, prévient la mort des interneurones ainsi que les changements dans la neurogenèse et permet sur le long terme de réduire très fortement les troubles dépressifs majeurs. / Traumatic brain injury (TBI) affects annually millions of people over the world. The first major consequences include loss of consciousness, haemorrhage and the appearance of cerebral edema. However, people who experience TBI may have significant long-term sequelae and in the majority of cases develop major depressive disorders. In addition, debilitating effects of TBI substantially impair health-related quality of life and are associated with high health care costs. Hence, preventive treatment against posttraumatic pathologies has become a real public health concern. Increasing evidence points to an association between depressive disorders and changes in GABAergic neurotransmission as well as alteration of adult hippocampal neurogenesis.My thesis suggests that the critical phase of posttraumatic pathology occurs over the first week following the trauma. During this period, my results show that hippocampal network hyperexcitability is induced by a disruption of the chloride ion transporters, leading notably to a decrease in neuronal inhibition. Then my work highlighted an alteration of hippocampal neurogenesis related to the loss of interneurons in the dentate gyrus. After some latency, these changes will trigger major depressive disorders. My work also indicates that the early restoration, during this first post-traumatic week, of chloride ion homeostasis by a pharmacological agent, prevents cell death of interneurons as well as changes in neurogenesis and allows significant long-term reduction of major depressive disorders. This therefore suggests the possibility of developing new therapeutic strategies to prevent the emergence of posttraumatic pathologies.