This dissertation explores the role of brainstem structures in the development and expression of generalized tonic-clonic seizures. The functional consequences of brainstem seizures are investigated using the kindling paradigm in order to understand the behavioral and cognitive effects of generalized seizures. <BR><BR> I begin by investigating the general characteristics of brainstem kindling. The first experiment demonstrates that certain brainstem sites are indeed susceptible to kindling and begins to delineate the features that distinguish brainstem seizures from those evoked at other brain regions. Further investigation of the EEG signal features using wavelet analysis reveals that changes in the spectral properties of the electrographic activity during kindling include significant changes to high-frequency activity and organized low-frequency activity. I also identify transitions that include frequency sweeps and abrupt seizure terminations. The changing spectral features are shown to be critically associated with the evolution of the kindled seizures and may have important functional consequences. The surprising responsiveness of some brainstem structures to kindling forces us to reconsider the overall role of these structures in epileptogenesis as well as in the healthy dynamical functioning of the brain. <BR><BR> In order to study the functional consequences, a series of experiments examines the changes in behavior, cognition and affect that follow these brainstem seizures. Although the results show no effects on spatial learning or memory, there are significant and complex effects on anxiety- and depression-like behavior that appear to be related to motivation. In order to further study the cognitive effects, a second set of behavioral experiments considers how context (i.e., the environment) interacts with the behavioral changes. The results indicate that changes in affect may only be apparent when choice between seizure-related and seizure-free contexts is given, suggesting that the environment and choice can play key roles in the behavioral consequences of seizures. This thesis also includes an appendix that applies synchrotron imaging to investigate the anatomical consequences of electrode implantation in kindling and shows that significantly increased iron depositions occur even with purportedly biocompatible electrodes widely used in research and clinical settings. <BR><BR> Examination of the role of brainstem structures in generalized seizures in this dissertation offers new perspectives and insights to epileptogenesis and the behavioral effects of epilepsy. The changes in EEG features, behavior, affect and motivation observed after brainstem seizures and kindling may have important clinical implications. For example, the results suggest a need to reexamine the concept of psychogenic seizures, a potential connection to Sudden Unexplained Death in Epilepsy (SUDEP), and the contribution of environmental factors. It is hoped that these findings will help elucidate the complex issues involved in understanding and improving the quality of life for people with epilepsy.

This dissertation explores the role of brainstem structures in the development and expression of generalized tonic-clonic seizures. The functional consequences of brainstem seizures are investigated using the kindling paradigm in order to understand the behavioral and cognitive effects of generalized seizures. <BR><BR> I begin by investigating the general characteristics of brainstem kindling. The first experiment demonstrates that certain brainstem sites are indeed susceptible to kindling and begins to delineate the features that distinguish brainstem seizures from those evoked at other brain regions. Further investigation of the EEG signal features using wavelet analysis reveals that changes in the spectral properties of the electrographic activity during kindling include significant changes to high-frequency activity and organized low-frequency activity. I also identify transitions that include frequency sweeps and abrupt seizure terminations. The changing spectral features are shown to be critically associated with the evolution of the kindled seizures and may have important functional consequences. The surprising responsiveness of some brainstem structures to kindling forces us to reconsider the overall role of these structures in epileptogenesis as well as in the healthy dynamical functioning of the brain. <BR><BR> In order to study the functional consequences, a series of experiments examines the changes in behavior, cognition and affect that follow these brainstem seizures. Although the results show no effects on spatial learning or memory, there are significant and complex effects on anxiety- and depression-like behavior that appear to be related to motivation. In order to further study the cognitive effects, a second set of behavioral experiments considers how context (i.e., the environment) interacts with the behavioral changes. The results indicate that changes in affect may only be apparent when choice between seizure-related and seizure-free contexts is given, suggesting that the environment and choice can play key roles in the behavioral consequences of seizures. This thesis also includes an appendix that applies synchrotron imaging to investigate the anatomical consequences of electrode implantation in kindling and shows that significantly increased iron depositions occur even with purportedly biocompatible electrodes widely used in research and clinical settings. <BR><BR> Examination of the role of brainstem structures in generalized seizures in this dissertation offers new perspectives and insights to epileptogenesis and the behavioral effects of epilepsy. The changes in EEG features, behavior, affect and motivation observed after brainstem seizures and kindling may have important clinical implications. For example, the results suggest a need to reexamine the concept of psychogenic seizures, a potential connection to Sudden Unexplained Death in Epilepsy (SUDEP), and the contribution of environmental factors. It is hoped that these findings will help elucidate the complex issues involved in understanding and improving the quality of life for people with epilepsy.

La compréhension des mécanismes physiologiques et physiopathologiques du contrôle la locomotion et de ses troubles, constitue un enjeu majeur de la recherche biomédicale, pour améliorer la qualité et l'espérance de vie des patients atteints de la maladie de Parkinson. A partir de données expérimentales, la stimulation cérébrale profonde de la formation réticulée mésencéphalique (FRM), incluant les noyaux pédonculopontins et cunéiformes, a été proposée en 2005 comme nouvelle stratégie thérapeutique pour traiter le freezing de la marche. Cependant, au regard de résultats cliniques très hétérogènes, de nombreuses interrogations se posent concernant les connaissances anatomiques et fonctionnelles de la FRM, marquées notamment par un nombre limité de données expérimentales chez le primate non-humain. Cette étude s'inscrit dans une approche translationnelle associant des données cliniques et pré-cliniques. Dans un premier temps, un modèle de locomotion bipède chez le primate non-humain a été développé puis validé à partir de données cinématiques. Une approche IRM multi-séquences a été développée pour permettre un suivi longitudinal du protocole et la construction d'un atlas du tronc cérébral de Macaca fascicularis. Un mapping électrophysiologique de la FRM a ensuite été réalisé chez deux primates éveillés, qui a permis de mettre en évidence pour la première fois, des activités neuronales qui répondaient à la locomotion, confirmant ainsi l'existence d'une région locomotrice mésencéphalique chez le primate. Après intoxication au MPTP, seule une modification du pattern de décharge des neurones de la FRM a été observée, ainsi que des arguments en faveur d'un dysfonctionnement de l'activité de certains neurones de la FRM durant le blocage du pas. Enfin, des enregistrements électrophysiologiques durant des phases de locomotion puis d'endormissement naturel, suggèrent une double implication de populations neuronales dans le contrôle de la locomotion et du niveau de vigilance. La réalisation d'un nouveau système de coordonnées adapté au tronc cérébral humain a permis de réaliser une étude de corrélations anatomo-cliniques des effets de la stimulation cérébrale profonde du noyau pédonculopontin et de proposer une cible probabiliste pour l'implantation d'électrodes dans la FRM pour traiter le freezing de la marche dans le contexte parkinsonien. / The comprehension of the physiological and pathophysiological mechanisms involved in the control of locomotion and gait troubles remains a major challenge for biomedical research in order to improve quality and expectancy of life in parkinsonian patient. On the basis of experimental data, deep brain stimulation of the mesencephalic reticular formation (MRF), including the pedunculopontine and cuneiform nuclei, was proposed in 2005 as a new target to treat freezing of gait. However, regarding the heterogeneity of the clinical results, different questions now raise concerning the lack of anatomical and functional data of the MRF especially in non-human primate. The present study falls within a translational approach using clinical and pre-clinical data. First, a non-human primate model of bipedal locomotion was developed and validated on the basis of kinematic data. Multi-sequences MRI methodology was developed, allowing a longitudinal monitoring of the primate protocol and to construct a brainstem atlas of Macaca fascicularis. Then, an electrophysiological mapping of the MRF was performed in two behaving primates during rest and locomotion periods. For the first time, neurons within the MRF were found to respond to locomotion confirming the existence of a mesencephalic locomotor region in primate. After MPTP intoxication, only changes in neuronal discharge pattern were observed and arguments in favor of a misfunctioning of some MRF neurons during gait blockage. Finally, electrophysiological recordings during locomotion and natural transition from wakefulness to sleep suggest a dual function of some MRF neurons in the control of locomotion and arousal. The development of a new coordinate system adapted to human brainstem anatomy allowed to perform an anatomo-clinical evaluation of deep brain stimulation of the pedunculopontine nucleus and to provide a probabilist target for electrode implantation in the MRF to treat freezing of gait in the parkinsonian context.