Orientador: Luiz Eduardo Gomes Garcia Betting / Resumo: A conectividade funcional é anormal na epilepsia do lobo temporal mesial (ELTm). O objetivo deste estudo foi investigar os efeitos de fármacos antiepilépticos (FAES) na conectividade funcional de pacientes com ELTm. Para isso, 31 pacientes com ELTm (16 à direita e 15 à esquerda) e 36 controles foram investigados. Sequências 3D volumétricas T1 e imagens funcionais a partir de sinal BOLD foram adquiridas em um equipamento 3T. Os dados da ressonância magnética funcional (RMf) em repouso foram processados e analisados utilizando o programa CONN. Para cada sujeito, duas formas de análise foram realizadas: uma de correlação entre as várias regiões de interesse e outra de região interesse para todos os voxels. A análise de grupos foi feita utilizando um modelo linear geral com nível de significância de p < 0,05 corrigido para múltiplas comparações. Foram realizadas comparações entre pacientes com ELTm (direita ou esquerda) e controles, seguidas de comparações de acordo com a carga de FAEs. A partir dessas análises, foi constatado uma redução de conectividade com volume total de 9092 mm3 (p<0,0001), em pacientes com ELTm esquerda e 5234 mm3 (p<0,0001), em pacientes com ELTm direita . Quando considerada a carga de medicação, pacientes com ELTm esquerda, recebendo doses altas, apresentaram redução de conectividade nas regiões temporais. Nos pacientes que recebiam doses baixas, essa redução atingiu uma área total mais extensa, no córtex frontal medial, na região posterior do cíngulo e p... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Submitted by Elaine Keiko Fujisao (elaine.keiko@gmail.com) on 2018-04-12T14:22:20Z No. of bitstreams: 1 TESE FINAL.pdf: 2975070 bytes, checksum: 8ffbc7134e5dd728eccf978c05eb3ddf (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-16T12:54:40Z (GMT) No. of bitstreams: 1 fujisao_ek_dr_bot.pdf: 2975070 bytes, checksum: 8ffbc7134e5dd728eccf978c05eb3ddf (MD5) / Made available in DSpace on 2018-04-16T12:54:40Z (GMT). No. of bitstreams: 1 fujisao_ek_dr_bot.pdf: 2975070 bytes, checksum: 8ffbc7134e5dd728eccf978c05eb3ddf (MD5) Previous issue date: 2018-02-23 / FUJISAO, E.K. Análise das descargas epileptiformes interictais (IED) na epilepsia de lobo temporal mesial utilizando análise quantitativa do eletroencefalograma e da neuroimagem. Doutorado – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista ―Júlio de Mesquita Filho‖, Botucatu, 2018. Objetivos: Investigar áreas de correlação entre a substância cinzenta e mapas de fonte interictal nos subtipos de epilepsia de lobo temporal mesial (ELTM). Introdução: Na ELTM, os eletroencefalogramas (EEG) de rotina de escalpo interictais mostram descargas epileptiformes na região temporal anterior revelando a circuitaria epileptiforme. Os geradores anatômicos precisos destas descargas ainda não foram identificados. Métodos: Setenta e um pacientes e trinta e seis controles foram submetidos à ressonância magnética (RM) de3T. Imagens de alta resolução T1 foram utilizadas para análise estrutural. A segmentação do hipocampo foi realizada com o pacote Freesurfer e utilizada para confirmar a atrofia do hipocampo (AH). O software SPM foi utilizado para segmentação da matéria cinzenta, registro e análise estatística. Os pacientes também foram submetidos à EEG de rotina com eletrodos temporais anteriores adicionais. Para cada paciente, as descargas epileptiformes foram selecionadas, promediadas e a fonte foi extraída com o algoritmo CLARA incluído no software BESA. Finalmente, a análise de correlação voxel-wise foi realizada entre a matéria cinzenta suavizada e os mapas de origem EEG em subtipos ELTM distintos. Resultados: 16 pacientes apresentaram ELTM sem AH, foram avaliadas 154 descargas (67 à esquerda e 87 à direita), 10826 mm³ correlacionadas envolvendo regiões extra-temporais (lobos frontal e parietal, r = -0,78, x = 19, y = 61, z = 6). 22 pacientes tinham AH esquerda, 839 descargas foram avaliadas (818 à esquerda e 21 à direita), 2700 mm3 foram correlacionadas envolvendo o lobo temporal esquerdo (r = -0,56, x = -28, y = -5, z = -19). 21 pacientes tinham AH direita, foram avaliadas 910 descargas (139 à esquerda e 771 à direita), 3625 mm3 foram correlacionadas envolvendo o giro frontal inferior direito (r = -0,70, x = 32, y = 33, z = 8). 12 pacientes apresentaram AH bilateral, 343 descargas foram avaliadas (264 à esquerda e 79 à direita), 4932 mm3 foram correlacionadas envolvendo principalmente a ínsula direita (r = -0,87, x = 29, y = 0, z = 8). Conclusão: Correlações negativas foram encontradas entre volumes de matéria cinzenta e imagens de origem EEG. Os geradores neuroanatômicos de IED são heterogêneos e variam de acordo com o subtipo ELTM. / FUJISAO, E.K. Analysis of interictal epileptiform discharges (IED) in mesial temporal lobe epilepsy using quantitative EEG and neuroimaging. PhD - Medical School of Botucatu City, State University of São Paulo "Júlio de Mesquita Filho", Botucatu, 2018. Aims: To investigate areas of correlation between gray matter and interictal EEG source maps in subtypes of mesial temporal lobe epilepsy (MTLE). Background: In MTLE, routine interictal scalp EEG typically shows epileptiform discharges over the anterior temporal region disclosing the epileptogenic circuitry. The precise anatomical generators of these discharges have not yet been identified. Methods: 71 patients and 36 controls underwent to 3T MRI. High resolution T1 images were used for structural analysis. Hippocampal segmentation was performed with Freesurfer package and used to confirm hippocampal atrophy (HA). SPM software was used for segmentation of the gray matter, registration and statistical analysis. Patients were also submitted to routine EEG with additional anterior temporal electrodes. For each patient, epileptiform discharges were selected, averaged and the source was extracted with CLARA algorithm included in the BESA´s software. Finally, voxel-wise correlation analysis was conducted between the smoothed gray matter and EEG source maps in distinct mTLE subtypes. Results: 16 patients had mTLE without HA, 154 discharges were evaluated (67 left and 87 right), 10826mm³ were correlated involving extra-temporal regions (frontal and parietal lobes; r=-0.78, x=19, y=61, z=6). 22 patients had left HA, 839 discharges were evaluated (818 left and 21 right), 2700mm3 were correlated involving the left temporal lobe (r=-0.56, x=-28, y=-5, z=-19). 21 patients had right HA, 910 discharges were evaluated (139 left and 771 right), 3625mm3 were correlated involving the right inferior frontal gyrus (r=-0.70, x=32, y=33, z=8). 12 patients had bilateral HA, 343 discharges were evaluated (264 left and 79 right), 4932mm3 were correlated mainly involving the right insula (r=-0.87, x=29, y=0, z=8). Conclusion: Negative correlations were disclosed between gray matter volumes and EEG source imaging. Neuroanatomical generators of interictal discharges are heterogeneous and vary according to mTLE subtype.

Individuals in modern Western societies are experiencing increasing sedentary lifestyles, overindulgence of high fat, high-sugar diets, and extremely sterilized conditions, putting immense pressure on researchers and clinicians alike to come up with viable treatments for conditions implicated with an aging society. Emerging research have published the benefits of IMS and metabolic switching in a variety of neuroprotective, cellular stress resistance, and neuroplasticity pathways in animal models and clinical results from randomized trials of IMS regimens with susceptible human populations are soon to be published. The application of genome editing and next-generation sequencing (NGS) strategies to clinical and neurodegenerative research continues to elucidate the relationship between a patient’s specific genetic background and modern environmental stressors towards disease pathology. This study attempts to utilize novel CRISPR/Cas9 strategies to introduce targeted gene edits and explores the role of reduced ketone-body synthesis/metabolism with 3-hydroxymethyl-3-methylglutaryl-CoA lyase HMGCL KO, in the therapeutic and neuroprotective potential of intermittent metabolic switching in 3xTg mice, genetically predisposed for Alzheimer pathology. IMS-mediated attenuation of hippocampal spatial memory deficits was confirmed in 5-month-old 3xTg mice using Morris Water Maze and Aβ1-40, Aβ1-42, total tau and p-tau levels were calculated accordingly. Mice receiving time-restricted feeding (TRF) and caloric restriction (CR) regardless of KO performed better in the hippocampal-dependent spatial memory test and ELISA analysis of CSF revealed reduced p-tau levels of 3xTg WT TRF + CR mice relative to WT control or the two experimental groups. Overall, genetic modifications of key metabolic enzymes highlight the variable therapeutic results of the glucose to ketone metabolic switch on cognitive deficits depending on an organism’s genetic background.

Orientador: Luiz Betting / Resumo: FUJISAO, E.K. Análise das descargas epileptiformes interictais (IED) na epilepsia de lobo temporal mesial utilizando análise quantitativa do eletroencefalograma e da neuroimagem. Doutorado – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista ―Júlio de Mesquita Filho‖, Botucatu, 2018. Objetivos: Investigar áreas de correlação entre a substância cinzenta e mapas de fonte interictal nos subtipos de epilepsia de lobo temporal mesial (ELTM). Introdução: Na ELTM, os eletroencefalogramas (EEG) de rotina de escalpo interictais mostram descargas epileptiformes na região temporal anterior revelando a circuitaria epileptiforme. Os geradores anatômicos precisos destas descargas ainda não foram identificados. Métodos: Setenta e um pacientes e trinta e seis controles foram submetidos à ressonância magnética (RM) de3T. Imagens de alta resolução T1 foram utilizadas para análise estrutural. A segmentação do hipocampo foi realizada com o pacote Freesurfer e utilizada para confirmar a atrofia do hipocampo (AH). O software SPM foi utilizado para segmentação da matéria cinzenta, registro e análise estatística. Os pacientes também foram submetidos à EEG de rotina com eletrodos temporais anteriores adicionais. Para cada paciente, as descargas epileptiformes foram selecionadas, promediadas e a fonte foi extraída com o algoritmo CLARA incluído no software BESA. Finalmente, a análise de correlação voxel-wise foi realizada entre a matéria cinzenta suavizada e os mapas de origem EEG em su... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: FUJISAO, E.K. Analysis of interictal epileptiform discharges (IED) in mesial temporal lobe epilepsy using quantitative EEG and neuroimaging. PhD - Medical School of Botucatu City, State University of São Paulo "Júlio de Mesquita Filho", Botucatu, 2018. Aims: To investigate areas of correlation between gray matter and interictal EEG source maps in subtypes of mesial temporal lobe epilepsy (MTLE). Background: In MTLE, routine interictal scalp EEG typically shows epileptiform discharges over the anterior temporal region disclosing the epileptogenic circuitry. The precise anatomical generators of these discharges have not yet been identified. Methods: 71 patients and 36 controls underwent to 3T MRI. High resolution T1 images were used for structural analysis. Hippocampal segmentation was performed with Freesurfer package and used to confirm hippocampal atrophy (HA). SPM software was used for segmentation of the gray matter, registration and statistical analysis. Patients were also submitted to routine EEG with additional anterior temporal electrodes. For each patient, epileptiform discharges were selected, averaged and the source was extracted with CLARA algorithm included in the BESA´s software. Finally, voxel-wise correlation analysis was conducted between the smoothed gray matter and EEG source maps in distinct mTLE subtypes. Results: 16 patients had mTLE without HA, 154 discharges were evaluated (67 left and 87 right), 10826mm³ were correlated involving extra-temporal regions... (Complete abstract click electronic access below) / Doutor

A área de transição amígdalo-piriforme (APir) está situada na confluência dos córtices piriforme, periamigdalóide e entorrinal lateral (ENTl). Com técnicas de rastreamento retrógrado foi observado que as principais aferências da APir se originam do bulbo olfativo, dos córtices piriforme, insular disgranular e agranular posterior, perirrinal, da formação hipocampal e da amígdala. Outras estruturas como o núcleo da banda diagonal de Broca, o pálido ventral, a substância inominada sublenticular, o tálamo da linha média, o núcleo dorsal da rafe, o locus coeruleus e a área parabraquial são fontes de aferências mais modestas a esta área de transição. A APir e o ENTl diferem no que diz respeito à origem de suas aferências mesocorticais, amigdalianas e talâmicas. Assim, a APir está em condições de integrar informações olfativas, gustativas, interoceptivas gerais e polissensoriais complexas e, através de suas projeções para a amígdala expandida, striatum ventral e formação hipocampal, influenciar a expressão de comportamentos motivados. / The amygdalo-piriform transition area (APir) lies at the junction of the piriform, periamygdaloid and entorhinal cortices. The afferent connections of this olfactory district were studied with retrograde tracing methods using the cholera toxin B subunit and Fluoro-Gold as tracers. Our retrograde experiments showed that the main input sources to APir derive from the olfactory bulb, mesocortical and allocortical areas including the dysgranular insular, posterior part of the agranular insular, piriform, lateral entorhinal and perirhinal cortices, temporal field CA1 of Ammon horn, ventral subiculum, as well as the endopiriform nucleus and the amygdaloid complex (anterior basomedial, posterior basolateral and anterior, posterolateral, posteromedial cortical nuclei). Several other structures among which the diagonal band, ventral pallidum, sublenticular substantia inominatta, midline thalamic nuclei, dorsal raphe nucleus, locus coeruleus and parabrachial area provide more modest inputs to APir. Our results suggest in addition that projections from mesocortical areas, hippocampal formation and the posterior basolateral amygdaloid nucleus to APir are topographically organized. Fluoro-Gold injections in the ventrolateral entorhinal cortex indicate that the afferent connections of this district differ in many regards from the afferent connections of APir. Cortical and amygdaloid inputs suggest tha APir is chiefly involved in the processing of olfactory, gustatory, visceral and somesthesic information, whereas the ventrolateral entorhinal cortex seems to be more crucially related with visual and auditory processes. APir is also less densely projected upon by midline thalamic nuclei than the lateral entorhinal cortex. Taken as a whole our results suggest that APir is in position to relay highly integrated olfactory, gustatory, interoceptive and somesthesic information to the extended amygdala, ventral striatum and ventral subiculum, and as such modulate the expression of motivated and emotional behavior.

La maladie d’Alzheimer (MA) se caractérise par une perte des fonctions cognitives liée à une dégénérescence neuronale induite par l’accumulation de peptides amyloïdes-β (Aβs) dans des régions vulnérables du cerveau comme l’hippocampe. Au niveau moléculaire, les peptides Aβs se lient préférentiellement à la densité post-synaptique des synapses excitatrices, espace au niveau duquel la protéine d’échafaudage PSD-95 organise l’ancrage des récepteurs NMDA (RNMDAs) et régule leur mobilité membranaire. A l’aide d’une stratégie intégrative qui favorise des niveaux d’analyse verticaux (du phénotype aux événements moléculaires) et qui combine un ensemble d’approches corrélatives et invasives chez des souris double transgéniques APPswe/PS1dE9 modèles de la MA, nous avons mis en évidence que les peptides Aβs déstabilisent l’organisation synaptique (altération de l’expression de la PSD-95) et augmentent le pool extrasynaptique de sous-unités GluN2B des RNMDAs dans l’hippocampe. Cette réorganisation se traduit par une perturbation des fonctions mnésiques. Par ailleurs, il a été montré que certaines oscillations de l’activité hippocampique, comme les « sharp-wave ripples » (SWRs) générées pendant les périodes de sommeil, jouent un rôle crucial dans la formation de la mémoire. De façon surprenante, l’accumulation des peptides Aβs semble épargner la dynamique d’expression des SWRs durant les comportements de routine. Afin d’examiner l’effet potentiel des Aβs sur les SWRs chez des animaux confrontés à des challenges cognitifs, nous avons soumis des souris adultes injectées intracérébralement avec une solution d’Aβs à un test de reconnaissance spatiale. Alors qu’elles sont capables de former une mémoire à court terme, les souris Aβs montrent un oubli plus rapide, suggérant qu’elles encodent avec succès, mais qu’elles sont incapables de stabiliser et de rappeler une information acquise antérieurement. En l’absence d’une demande cognitive préalable, les propriétés des SWRs ne sont pas altérées par les Aβs. En revanche, lorsqu’elles doivent résoudre un test cognitif, les pics de SWRs normalement observés après encodage ou reconnaissance chez les souris témoins sont abolis chez les souris Aβs, indiquant une perturbation du traitement hippocampique de l’information spatiale. Pris dans leur ensemble, ces résultats identifient deux nouveaux mécanismes délétères sous-tendant les déficits de mémoire spatiale associés à la MA. / Cognitive impairments in Alzheimer’s disease (AD) are thought to be related to degenerative synaptic changes caused by the accumulation of amyloid-β peptides (Aβs) in vulnerable brain regions such as the hippocampus. At the molecular level, Aβs bind preferentially to the postsynaptic density of neuronal excitatory synapses, where the scaffolding post-synaptic protein-95 (PSD-95) organizes NMDA receptor (NMDAR) location as well as its downstream signaling. By using an integrative strategy which favoured vertical levels of analyses (from phenotype to molecular events) and combined a set of interrelated correlative and invasive approaches in a double transgenic mouse model of AD (APPswe/PS1dE9 mice), we were successful in establishing that Aβs destabilize the synaptic organization (reduction of expression of PSD-95) and increase the extrasynaptic pool of GluN2B-containing NMDAR in the hippocampus, a reorganization which translates into impaired memory functions. It is also well-known that hippocampal sharp wave-ripples (SWRs) generated during sleep periods are crucial for memory formation but accumulation of soluble Aβs, surprisingly seems to spare SWR dynamics during routine behavior. To unravel a potential effect of Aβs on SWRs in cognitively-challenged animals, we submitted vehicle- and Aβ-injected mice to spatial recognition memory testing. While capable of forming short-term memory, Aβ mice exhibited faster forgetting, suggesting successful encoding but an inability to adequately stabilize and/or retrieve previously acquired information. Without prior cognitive requirements, similar properties of SWRs were observed in both groups. In contrast, when cognitively challenged, the post-encoding and -recognition peaks in SWR occurrence observed in controls were abolished in Aβ mice, indicating impaired hippocampal processing of spatial information. Altogether these results identify two new disruptive mechanisms for the spatial memory deficits associated with AD.

La maladie d'Alexander est une maladie neurodégénérative due à des mutations hétérozygotes du gène GFAP codant le principal filament intermédiaire des astrocytes matures. Nous avons étudié l'effet des mutations GFAP dans l'hippocampe d'un patient avec AxD infantile et de deux souris knockin, l'une portant une mutation dans le rod domain (p.R85C) et l'autre dans le tail domain (p.T409I). Chez le patient, nous décrivons pour la première fois: (i) des changements morphologiques sévères des cellules GFAP+ dans la zone subgranulaire du gyrus denté, qui ont perdu la plupart de leurs processus radiaux; (ii) une réactivité microgliale; (iii) et un déficit de la neurogénèse hippocampique postnatale. Nous avons trouvé des anomalies similaires dans les deux souris knockin, plus sévères chez les homozygotes. La comparaison de ces modèles a montré que ces anomalies prédominent chez les souris GFAPT409I, tandis que l’accumulation de GFAP est supérieure chez les souris GFAPR85C. La comparaison des deux modèles de souris a montré que les conséquences pathologiques dépendent la localisation de la mutation dans la GFAP. Ces résultats suggèrent qu'en plus du gain évident de fonction, d'autres dysfonctions astrocytaires dans peuvent être dues à une perte de fonction. De plus, nous avons traité les souris mutantes avec de la ceftriaxone, connu pour son effet neuroprotecteur, mais nous n'avons observé aucun effet significatif. Enfin, la mégalencéphalie étant fréquente chez les patients AxD, nous avons mesuré la quantité d'eau cérébrale chez les souris mutantes GFAP. Nous avons trouvé une augmentation significative de la teneur en eau chez les souris GFAPR85C/R85C âgées d'un an. Nous avons observé une localisation anormale de l'AQP4 dans les astrocytes des asouris mutées, pouvant participer au déséquilibre hydrique cérébral. / Alexander disease is a neurodegenerative disorder caused by heterozygous mutations of GFAP gene coding the major intermediate filament of mature astrocytes. We studied the effect of GFAP mutation in the hippocampus of infantile onset AxD patient and two novel knockin mouse models, one bearing a mutation located in the rod domain (p.R85C), and the other bearing a mutation located in the tail domain (p.T409I) of mouse Gfap. In the AxD patient, we describe for the first time: (i) obvious morphological changes of GFAP+ cells in the subgranular zone of the dentate gyrus, which have lost most of their radial processes; (ii) microglial reactivity; (iii) and deficit in postnatal hippocampal neurogenesis. We found similar abnormalities in the two knockin mouse lines, more obvious in homozygous mice. A comparison of these mouse models showed that pathological findings predominated in the GFAPT409I mice, whereas GFAP accumulated in larger amounts in the GFAPR85C mice. The comparison of the two mouse models showed that their pathological consequences depend on the location of the mutated residues in GFAP. These findings suggest that in addition to the evident gain of GFAP function, other astrocyte dysfunctions in this disease may be due to a loss of function of GFAP. In addition, we treated the mice mutants with ceftriaxone, which has been reported to have a neuroprotective effect, but we observe no significant effect. Finally, AxD patients have often megalencephaly, therefore we measured the brain water content in AxD mouse models. We found a significant increase in brain water content in the one year old GFAPR85C/R85C mice vs controls. We observed mislocalization of AQP4 in mutant mice astrocytes that can participated to water imbalance in brain.

Le déclin cognitif associé au vieillissement chez l’Homme, impacte fortement la vie quotidienne des personnes âgées. Si la pratique musicale apparait comme une activité de loisir prometteuse pour le maintien d’un bon fonctionnement cognitif au cours du vieillissement, les mécanismes neurobiologiques sous-jacents sont à l’heure actuelle, mal connus. L’objectif de ce travail a donc été d’étudier les effets d’une exposition tardive et chronique à la musique sur les performances comportementales et certains processus neurobiologiques au cours du vieillissement chez le rat Wistar. Si quelques études rapportent qu’une exposition à la musique améliore les performances d’apprentissage et de mémoire, associé à une augmentation de la neurogenèse hippocampique et du BDNF chez le Rongeur jeune adulte, il n’en existe aucune qui se soit intéressée à ces effets chez le Rongeur âgé. Des rats d’âge médian ont été répartis dans 2 groupes, l’un exposé à de la musique et l’autre à du bruit blanc, puis inclus dans une étude longitudinale, au cours de laquelle les performances comportementales ont été évaluées jusqu’à l’âge de 24 mois, suivi d’analyses biologiques. Ainsi, nous avons pu montrer qu’une exposition chronique à la musique démarrant à un âge médian, réduit le déclin cognitif associé au vieillissement. En revanche, la neurogenèse hippocampique et le BDNF n’apparaissent pas comme des mécanismes neurobiologiques potentiels impactés par la musique chez le rat âgé. / Cognitive decline associated to aging impacts daily life of elderly. While the music practice appears as promising leisure activity to prevent cognitive decline in elder, little is known about the neurobiological mechanisms involved. The aim of this work was to study the effects of music exposure on behavioral performances and some neurobiological processes across aging in rats. Indeed, improved behavioral performances together with an increased hippocampal neurogenesis and a higher BDNF expression were reported after music exposure in both young and adult animals. Yet, no study has so far investigated these effects in aged rats. After a fine appraisal of the cognitive state in middle-aged Wistar rats (15 months), they were divided in two groups, exposed either to classic music or to white noise. Thereafter, a longitudinal follow up of 9 months was performed. We observed for the first time that chronic music exposure alleviated age-related cognitive decline. However, contrary to what was observed in adult animals, we did not reported any differences in age-related changes of hippocampal neurogenesis and BDNF expression. These promising results of a beneficial effect of music exposure in the field of aging still lay open the question about the underlying mechanisms in the context of aging of the beneficial effect of music exposure.

Diese Arbeit beschäftigt sich mit den Auswirkungen der Herz-Lungen-Maschine auf das Gewebe des Hippocampus in einem Ferkelmodell. Die Tiere untereilte man in 5 Gruppen: „Kontrolle“, „Kontrolle mit Minozyklin“, „HLM pulsatil“, „HLM nicht-pulsatil“, sowie „HLM nicht-pulsatil mit Minozyklin“. Es wurde untersucht, ob eine pulsatile Perfusion Schäden in den Zellen des Hippocampus gegenüber eines nicht-pulsatilen Blutflusses während der extrakorporalen Zirkulation abmildern kann. Des Weiteren überprüfte man neuroprotektive Effekte des Tetrazyklin-Derivates Minozyklin während eines kardiochirurgischen Eingriffes mit Herz-Lungen-Maschine. Während der Operation wurde bei allen Ferkeln eine Hypothermie von 28 °C durchgeführt und die HLM-Zeit betrug 90 Minuten. Die Rekonvaleszenzzeit umfasste 120 Minuten. Minozyklin verabreichte man in den entsprechenden Gruppen sowohl zu Beginn des Versuches (4 mg/kg KM) und nach Abkopplung von der Herz-Lungen-Maschine (2 mg/kg KM) intravenös. Hauptbestandteil der Arbeit waren histologische und immunhistochemische Färbemethoden zur Untersuchung des Hippocampus. Mithilfe eines Mikroskops wurden Veränderungen auf zellulärer Ebene im CA1- und CA3-Areal des Cornu ammonis im Hippocampus ausgewertet. Für die Ergebnisse betrachtet man die Pyramidenzellen des Stratum pyramidale. In der Hämatoxylin-Eosin-Färbung wurden Zellen mit den Eigenschaften „Ödem“, „Eosinophilie“ und „Pyknose“ für jedes Versuchstier gezählt. Mit den immunhistochemischen Färbungen sollten Faktoren für den programmierten Zelltod, für Hypoxie (HIF 1-alpha) und für oxidativen Stress (3-Nitrotyrosin) detektiert werden. Als Marker für Apoptose wählte man den Apoptose-induzierenden Faktor (AIF), cleaved Caspase 3 und Poly(ADP)Ribose (PAR).:Inhaltsverzeichnis 1 Einführung 1.1 Kinderherzchirurgie 1.2 Herz-Lungen-Maschine 1.3 Pathophysiologie der HLM 1.3.1 Inflammationsreaktion 1.3.2 Ischämie 1.3.3 Reperfusion 1.4 HLM und Folgen für das Gehirn 1.5 Neuroprotektive Strategien 1.5.1 Pulsatile Perfusion 1.5.2 Minozyklin 1.6 Hippocampus 2 Aufgabenstellung 3 Tiere, Material und Methoden 3.1 Versuchstiere 3.2 Versuch Teil 1: Operation 3.2.1 Gruppeneinteilung und Versuchsaufbau 3.2.2 Anästhesie 3.2.3 Operation 3.2.3.1 Vorbereitungszeit 3.2.3.2 Kardioplegie 3.2.3.3 Herz-Lungen-Maschine mit nicht-pulsatilen Blutfluss/ pulsatilen Blutfluss 3.2.3.4 Medikation mit Minozyklin 3.2.4 Intraoperatives Monitoring 3.2.4.1 Vitalparameter 3.2.4.2 Arterielle Blut-Gas-Analyse 3.2.4.3 Elektrolyt-Haushalt 3.2.4.4 Laktat- und Glukose-Haushalt 3.3. Versuch Teil 2: Laboruntersuchungen 3.3.1 Einbetten der Proben und Herstellung der Schnittpräparate 3.3.2 Histologie 3.3.2.1 Hämatoxylin-Eosin-Färbung 3.3.3 Immunhistochemie 3.3.3.1 Allgemeines Prinzip 3.3.3.2 Nachweis: Apoptose-induzierender Faktor 3.3.3.3 Nachweis: Hypoxie-induzierter Faktor 1- alpha 3.3.3.4 Nachweis: cleaved Caspase 3 3.3.3.5 Nachweis: 3-Nitrotyrosin 3.3.3.6 Nachweis: Poly(ADP)Ribose 3.3.4 RP-HPLC – Reversed Phase High Performance Liquid Chromatography 3.4 Blutgasanalyse 3.5 Auswertung am Mikroskop 3.6 Statistik 4 Ergebnisse 4.1 Intraoperatives Monitoring 4.2 Arterielle Blutproben 4.3 Arterielles Blut: Laktat-Haushalt 4.4 Ergebnisse der RP-HPLC 4.5 Ergebnisse der Hämatoxylin-Eosin-Färbung 4.6 Ergebnisse der immunhistochemischen Färbungen 4.6.1 Apoptose-induzierender Faktor 4.6.2 Hypoxie-induzierter Faktor 1-alpha 4.6.3 3-Nitrotyrosin 4.6.4 Cleaved Caspase 3 4.6.5 Poly-(ADP)-Ribose 5 Diskussion 5.1 Tiermodell und Versuchsaufbau 5.2 Blutproben 5.3 Herz-Lungen-Maschine und nicht-pulsatiler Blutfluss versus pulsatiler Blutfluss 5.4 Extrakorporale Zirkulation und die Gabe von Minozyklin 5.5 Beantwortung der Fragestellungen 6 Zusammenfassung 7 Literaturverzeichnis 8 Anhang 8.1 Einführung 8.1.1 Kinderherzchirurgie 8.1.2 Pathophysiologie der HLM 8.2 Tiere, Material und Methoden 8.2.1 Operation 8.2.2 Intraoperatives Monitoring 8.2.3 Laboruntersuchungen 8.3 Ergebnisse 8.3.1 Intraoperatives Monitoring 8.3.2 Arterielles Blut 8.3.3 Arterielles Blut – Laktat-Haushalt 8.3.4 RP-HPLC 8.3.5 Hämatoxylin-Eosin-Färbung 8.3.6 Immunhistochemie 9 Selbständigkeitserklärung 10 Lebenslauf 11 Koautorenschaft 12 Danksagung

Temporal lobe epilepsy is the most common form of epilepsy and hippocampal sclerosis represents the main underlying structural abnormity. Approximately 20% of TLE cases are non- lesional due to absence of any obvious epileptogenic lesion and tetanus toxin model is traditionally considered as a model of non-lesional temporal lobe epilepsy. The main aim of this study was to evaluate the presence of the cell damage and to determine its spatiotemporal profile. Tetanus toxin was stereotaxically injected into CA3 subregion of dorsal hippocampus in adult male Wistar rats. Brain tissue was extracted 4, 8 and 16 days following the surgery. Postfixed brains were sectioned to 50 µm slices and labeled using Nissl's and FluoroJade B staining (FJB). Hippocampal sclerosis was present only in animals from D16 group, however, it was localized mainly in contralateral CA1 area. Additional finding was decreased Nissl's staining in contralateral hippocampus which corresponded with the presence of FJB positive neurons. In animals from group D8, we have identified presence of FJB positive neurons predominantly in ipsilateral hippocampus. In D4 animals, cellular degeneration was absent. To examine the non- lesional nature of tetanus toxin model, we have performed blind study, when Nissl's staining were reviewed...