Fast Scan Cyclic Voltammetry (FSCV) is an electrochemical technique, based on ramping a voltage through a microelectrode and measuring the resulting redox current to obtain information about an electroactive molecule. FSCV can be used for the detection of dopamine, which is a vital neurotransmitter. Dopamine is central to conditions such as Parkinson’s disease. The purpose of this thesis was to evaluate if a new type of highly biocompatible microelectrode, called tube electrode, can be used to detect dopamine using FSCV and determine how they compare to standard carbon fibre microelectrodes (CFMEs). In order to achieve this, three main tasks were set and fulfilled. First, a station for in-vitro FSCV was set up and CFMEs of varying sizes were used to detect dopamine at different concentrations. Secondly, the same trials were done with tube electrodes. Finally, the results of the tubes were compared to the CFMEs. In total, four CFMEs and four tube electrodes were investigated. The dopamine concentrations ranged from 20 nM to 40 μM. In short, the results indicate that the tubes generally have lower sensitivity than the CFMEs but better linearity between the increasing dopamine concentration and the resulting current. The tubes also had a marginally higher concentration threshold for dopamine detection. The main challenge encountered was a decrease in sensitivity over time. Here, further investigations are necessary to map the causes responsible. In conclusion, the tube electrodes are able to detect dopamine in-vitro, with concentrations relevant for in-vivo sensing, with a performance comparable to CFMEs. However, further studies are necessary before the tube electrodes can be used for dopamine detection in-vivo. / Fast Scan Cyclic Voltammerey (FSCV) är en elektrokemisk teknik, baserad på att ändra en spänning genom en mikroelektrod och sedan mäta den resulterande redox-strömmen för att få information om en elektroaktiv molekyl. FSCV kan användas för detektering av dopamin, som är en livsviktig signalsubstans. Dopamin har en central roll vid tillstånd så som Parkinsons sjukdom. Syftet med detta examensarbete var att utvärdera om en ny typ av mycket biokompatibel mikroelektrod, kallad tubelektrod, kan användas för att detektera dopamin genom FSCV och fastställa hur de jämför sig med vanliga kolfibermikroelektroder (KFME). För att uppnå detta sattes och uppfylldes tre huvuduppgifter. Först upprättades en station för in-vitro FSCV där KFME med varierande storlek användes för att detektera olika koncentrationer dopamin. Sedan gjordes samma försök med tubelektroder. Slutligen jämfördes resultaten med de från KFME. Totalt testades fyra KFME och fyra tubelektroder. Dopaminkoncentrationerna sträckte sig från 20 nM till 40 μM. Kort sagt indikerar resultaten att tuberna generellt hade lägre känslighet än KFME men bättre linjäritet mellan den ökande dopaminkoncentrationen och den resulterande strömmen. Tuberna hade även något högre koncentrationströskel för detektionen av dopamin. Den största utmaningen som påträffades var en minskning i känslighet över tid. Här krävs vidare undersökningar för att helt förstå de bakomliggande anledningarna. Slutsatsen är att tuberna kan detektera dopamin in-vitro, med koncentrationer som är relevanta för mätningar in-vivo, och med en prestation jämförbar med den för KFME. Dock krävs mer studier innan tubelektroderna kan användas för att detektera dopamin in-vivo.

Parkinson’s Disease (PD) is the second most common neurodegenerative disease (NDD) affecting approximately 1 - 2% of the population older than 65 and it is characterized by both motor and non-motor symptoms such as rest tremors, stooping posture, and rigidity. The neuromolecular basis of PD is quite complex and that is why there is a need for in vitro systems that can be utilized for studies of PD and NDDs in general. Human-derived cell lines are a good candidate for in vitro systems since they are easy to manipulate and are a less costly alternative to post-mortem human tissue sections or animal models. In this study, I optimize the Lund human mesencephalic (LUHMES) cell line differentiation protocol by determining that the optimal seeding density of cells is 37 500 cells/ml and that the differentiation media can contain quadruple the recommended concentration of tetracycline hydrochloride. Additionally, I use the differentiated LUHMES cells to conduct an exploratory study by treating the cells with cerebrospinal fluid (CSF) from PD patients and CSF from healthy individuals to investigate the neuromodulatory effects of the CSF on the neuronal cell culture. Cell viability assay showed neurotoxicity 24 hours post-treatment for the control CSF and 48 hours post-treatment for both control and PD CSF. Immunohistochemistry showed differential expression of proteins of interest that reflect hallmarks of neurodegenerative diseases. Further studies are needed to reach conclusive results.

Thesis (MScMedSC)--Stellenbosch University, 2012. / Bibliography / ENGLISH ABSTRACT: Parkinson’s disease (PD) is a neurodegenerative movement disorder characterized by the loss of dopaminergic neurons in the substantia nigra of the midbrain. Although the aetiology of PD is still not fully understood, it is thought to involve a combination of environmental (such as exposure to pesticides and neurotoxins) and genetic factors. A number of PD-causing genes have been found including SNCA, LRRK2, EIF4G1 and VPS35 (for autosomal dominant forms of PD) and parkin, PINK1, DJ-1 and ATP13A2 (for autosomal recessive forms of PD – arPD). Mutations in the parkin gene are the predominant cause of arPD. Parkin plays a role in the ubiquitin-proteasomal system which degrades damaged and unwanted proteins in the cell and it is also thought to be involved in maintaining healthy mitochondria. Numerous studies have implicated mitochondrial function in the pathogenesis of PD. Therefore the aim of the present study was to investigate the role of mitochondrial dysfunction in PD patients with parkin-null mutations. Four South African PD patients, each harbouring two parkin-null mutations, were recruited for this study. A muscle biopsy was performed for analysis of mitochondrial morphology using histology and transmission electron microscopy (TEM). Skin biopsies were taken, from which fibroblasts were cultured. These fibroblasts were used in i) mitochondrial morphological assessments using TEM, ii) mitochondrial network analysis, iii) functional studies via ROS measurement and iv) analysis of the proteome using a LTQ Orbitrap Velos mass spectrometer. In addition, RNA was isolated from peripheral blood samples for gene expression studies using the RT² Profiler PCR Array (SABiosciences, USA) and the RT² PCR Primer Assay (SABiosciences, USA). Heterozygous family members (carriers) and wild-type controls were also recruited for this study. Results from the histological and TEM analysis from the muscle biopsy observed subtle mitochondrial changes including the presence of type II fibres, atrophic fibres, the presence of lipids, and wrinkling of the sarcolemmal membrane. Enlarged mitochondria were also observed in one patient. TEM analysis on the patient’s fibroblasts observed an increase in the number of electron dense vacuoles, speculated to be autolysosomes. The mitochondrial network in two of the patients’ fibroblasts showed fragmented and dot-like networks which are indicative of damaged mitochondria. An increase in mitochondrial ROS levels was observed in three of the four patients. Expression studies found down-regulation of 14 genes from four of the five mitochondrial complexes and a total of 688 proteins were found only in the control and not in the patient fibroblasts. Some of these proteins are known to be part of the ‘mitochondrial dysfunction’ pathway. Taken together, these results indicate that the absence of parkin results in a number of mitochondrial alterations. Based on these findings, a model of PD was proposed: It is speculated that when parkin is absent, electron transport chain complex genes are down-regulated. This results in impaired oxidative phosphorylation, causing an increase in the production of mitochondrial ROS and subsequent oxidative stress. Mitochondria are then damaged; resulting in the fragmentation of the mitochondrial network. The impaired mitochondria are thus tagged for degradation, causing the recruitment of autolysosomes which engulf the mitochondria via mitophagy. Ultimately, as the compensatory mechanisms fail, this triggers the consequential cascade of cellular apoptotic events. This study has elucidated the effect of parkin on the mitochondria, and can act as a ‘stepping stone’ towards future development of therapeutic strategies and/or biochemical markers that will benefit not only patients with PD but also other neurodegenerative disorders. / AFRIKAANSE OPSOMMING: Parkinson se siekte (PS) is ‘n neurodegeneratiewe bewegings-afwyking gedefineer deur die verlies van dopaminergiese neurone in die substantia nigra van die midde brein. Alhoewel die spesifieke oorsprong van die afwyking nog nie ten volle begryp is nie, word bydraes van beide omgewings faktore (bv. blootstelling aan plaagdoders en neurotoksienes) asook genetiese faktore gespekuleer. Vanuit ‘n genetiese aspek is ‘n aantal gene al geassosieer met PS. Hierdie gene sluit in SNCA, LRRK2, EIF4G1 en VPS35 (vir outosomale dominante vorms van PS) en parkin, PINK1, DJ-1, en ATP13A2 (vir outosomale resessiewe vorms van PS - orPS). Mutasies in die parkin geen is aangedui as die hoof oorsaak van orPS. Parkin speel ‘n rol in die ubiquitine-proteasomale sisteem wat beskadige en ongewensde proteïne binne in die sel verwyder en is verdink om by te dra tot die instandhouding van gesonde mitokondria. Mitokondriese wanfunksionering is ook deur talle studies gewys as ‘n bydraende faktor in die patologie van PS. Die doel van die studie is om ondersoek in te stel tot die spesifieke rol wat mitokondriese wanfunsionering speel in PS pasiënte met parkin-nul mutasies. Vier Suid-Afrikaanse PS-pasiënte, elk met twee parkin-nul mutasies, is gebruik vir die studie. Deur middel van spierbiopsies is monsters verkry vir mitokondriese morfologiese analises met behulp van histologiese en elektron-oordrag mikroskopie tegnieke (TEM). Vel biopsies is ook geneem en fibroblaste is gekweek vir die gebruik in: i) mitokondriese morfologiese assesering; ii) mitokondriese netwerk analiese; iii) funksionele studies waar vlakke van reaktiewe suurstof spesies (ROS) gemeet is; iv) proteoom analiese met behup van ‘n LTQ Orbitrap Velos massa spektrometer. RNA is ook geisoleer vanaf perifere bloedmonsters vir die gebruik in geen-uitdrukkings studies met behulp van ‘n RT² Profiler PCR Array en ‘n RT² Primer Assay. Selle vanaf famielie lede wat heterosigotiese draers is van die mutasie, asook normale (geen parkin mutasie) selle is gebruik as kontroles in die studie. TEM resultate vanaf die spier monsters het subtiele mitokondriese veranderinge getoon. Hierdie sluit in die teenwoordigheid van tipe II vesels, atrofiese vesels, teenwoordigheid van lipiedes, assook waarnemings van rimpeling van die sarcolemmal membraan. Vergrote mitokondrias is ook in een van die pasiënte opgelet. TEM resultate vanaf die fibroblaste het toename in die aantal elektron-digte vakuole vertoon, moontlik geidentifiseer as autolisosome. Gefragmenteerde en onderbreekte mitokondria netwerke is gelet tydens netwerk analiese van die fibroblaste, ‘n indikasie van beskadigde mitokondria. ‘n Toename in mitokondriese ROS vlakke is gevind in drie van die vier pasiënte. Af-regulering van 14 gene, geassosieerd met vier uit die vyf mitokondria komplekse, is verneem tydens die geen-uitdrukkings studie. Saam met dit is ‘n totaal van 688 proteïene geidentifiseer wat slegs teenwoordig is in die kontrole monsters en nie in die pasiënt monsters nie. Hierdie proteïene is almal uitgedruk en betrokke in die mitokondriese wanfunsionerings-weë. Hierdie resultate dui dat die afwesigheid van parkin mitokondriese afwykings tot gevolg het wat kan lei tot die afsterwing van selle. Dit dra ook by tot die vorming van ‘n beter-verstaande siekte-model vir PS: Mutasies in parkin (wat lei tot die afwesigheid van parkin) kan dus moontlik lei tot die af-regulasie van gene geassosieerd met die elektron-vervoer ketting komplekse in die mitokondria. Dit lei tot gebrekkige oksidatiewe fosforilering en veroorsaak ‘n toename in die vorming van ROS, wat dan ‘n toename in oksidatiewe stres binne in die sel tot gevolg het. Uiteindelik lei dit dus tot die beskadiging van die mitokondria wat gepaard gaan met fragmentering van die mitokondriese netwerk. Beskadigde mitokondrias word geetiketeer vir afbraking. Hierdie etiketering aktiveer omringende autophagosome wat die beskadigde mitokondrias dan verwyder deur middel van ‘n verswelgende proses genaamd mitophagy. Dit veroorsaak die aktivering van ‘n aantal gekorreleerde sellulêre prosesse wat lei tot apoptose (afsterwing van die sel). Hierdie studie dra by tot die verklaring van die spesifieke effek wat parkin mutasies het op die funksionering van die mitokondria. Resultate hier lê ook die grondslag vir toekomstige studies met die doel tot die ontwikkeling van terapeutiese strategeë en biochemiese merkers wat kan bydrae tot die genesing van beide pasiënte met PS, asook pasiënte met ander neurodegeneratiewe afwykings.

帕金森氏症是現今常見的神經退化性疾病，其特徵主要表現在運動功能上的缺失包含靜止時振顫、步態不穩及肢體僵硬等特徵。而基因研究指出當PTEN-induced putative kinase 1 (PINK1)及Parkin基因發生突變可能會導致粒腺體功能失常，進而導致帕金森氏症之神經退化性疾病，另外PINK1基因突變的果蠅亦會產生嗅覺辦識功能障礙。在環境因素方面，一種廣效使用的除草劑百草枯(paraquat)被認為與誘發帕金森氏症有關。根據中醫生理學概念，消化系統功能紊亂，不但影響腸道功能亦會影響其他系統的運作,包含中樞神經系統。因此本實驗採用中草藥紫蘇初萃取物作為實驗藥物，紫蘇(Perilla frutescens)在中醫臨床的主要功能用於治療因飲食不節而導致的腸胃氣滯，進而減緩其他表症的不適感，另外紫蘇另一項功能在於能解食魚蟹之毒。因此我們評估紫蘇可能對於野生型及突變型果蠅因百草枯引發之毒性具有保護作用。實驗結果顯示，紫蘇可以有效的降低因曝露在百草枯(24-72小時)下的致死率，不論在野生型Oregon-R品系及PINK1B9或Parkin25的突變型(年齡：3-7天, 10-14天)。然而紫蘇對於果蠅的運動爬行功能只有在施予百草枯後的野生型Oregon-R 品系(年齡：3-7天)有些微改善，但是在嗅覺辨識功能被百草枯破壞的PINK1B9 突變果蠅，則能經由紫蘇而減少嗅覺辨識的損害。綜合以上實驗結果得知紫蘇對於百草枯所造成的毒性具有保護效果，期望未來可作為治療帕金森氏症的潛在藥物。 / Parkinson’s disease (PD) is the most common neurodegenerative disease characterized by motor deficits including resting tremor, akinesia, and rigidity. The olfactory disturbance appears to be an earlier symptom prior to the onset of motor dysfunction in PD. Genetic research has shown that mutations of the PTEN-induced putative kinase 1 (PINK1) and Parkin genes could lead to mitochondrial dysfunction and neuronal degeneration in PD. Moreover, the environmental neurotoxin paraquat (PQ), a widely used pesticide, is known to induce PD-like symptoms. According to Traditional Chinese medicine physiology theory, that the central nervous system and gut interact bidirectionally in functional gastrointestinal disorders. Perilla frutescens, a traditional herbal medicine, is mainly prescribed for the treatment of gastrointestinal discomfort after eating and symptom of qi stagnation. In addition, perilla has an important role in detoxification of seafood intake. Therefore, this study evaluated the protective effects of perilla on paraquat-induced toxicity in Drosophila PINK1 and parkin mutants and wild type flies. Result showed that perilla can effectively alleviate lethality of drosophila, including PINK1 and parkin mutant flies, exposed to paraquat for 24-72 hours. However, their motor dysfunctions induced by paraquat were little ameliorated by perilla. Importantly, the olfactory dysfunction, particularly olfactory discrimination, elicited by paraquat in PINK1 mutant fly was improved by perilla. Taken together, our findings provide the protective potential of perilla for treatment of PD syndromes.

Due to the blood-brain barrier, delivery of many drugs to the brain has required intracranial surgery which is prone to complication. Here we show that Dopamine Neuron Stimulating Peptide 11 (DNSP-11), following non-invasive intranasal administration, protects dopaminergic neurons from a lesion model of Parkinson’s disease in the rat. A significant and dose-dependent increase in an index of dopamine turnover (the ratio of DOPAC to dopamine) was observed in the striatum of normal young adult Fischer 344 rats by whole-tissue neurochemistry compared to vehicle administered controls. Among animals challenged with a moderate, unilateral 6-hydroxy-dopamine (6-OHDA) lesion of the substantia nigra, those treated repeatedly with intranasally administered DNSP-11 exhibited greater numbers of tyrosine hydroxylase (TH) positive dopaminergic neuronal cell bodies in the substantia nigra and greater TH+ fiber density in the striatum when compared to animals treated intranasally with vehicle only or a scrambled version of the DNSP-11 sequence. Lesioned animals that received intranasal DNSP-11 treatment did not exhibit abnormal, apomorphine-induced rotation behavior, contrasted with animals that received only vehicle or scrambled peptide that did exhibit significantly greater rotation behavior. In addition, the endogenous expression of DNSP-11 from the pro-region of GDNF was investigated by immunohistochemistry with a custom, polyclonal antibody. Signal from the DNSP-11 antibody was found to be differentially localized from the mature GDNF protein both spatially and temporally. While DNSP-11-like immunoreactivity extensively colocalizes with GDNF immunoreactivity at post-natal day 10, the day of maximal GDNF expression, DNSP-11-like signal was found to be present in the 3 month old rat brain with signal in the substantia nigra, ventral thalamic nucleus, dentate gyrus of the hippocampus, with the strongest signal observed in the locus ceruleus where GDNF is not expressed. Results from immunoprecipitation of brain homogenate were not consistent with the synthetic, amidated 11 amino-acid rat DNSP-11 sequence. However, binding patterns in the literature of NPY, the only homologous sequence present in the CNS, do not recapitulate the immunoreactive patterns observed for the DNSP-11 signal. This study provides evidence for a potential easy-to-administer intranasal therapeutic using the DNSP-11 peptide for protection from a 6-OHDA lesion rat model of Parkinson’s disease.

Aims of this project - The aim of this study was to design and synthesise novel 2-aminopyrimidine derivatives as potential adenosine A1 and A2A receptor antagonists. Background and rationale - Parkinson’s disease is the second most common neurodegenerative disorder (after Alzheimer’s disease) and is characterised by the selective death of the dopaminergic neurons of the nigro-striatal pathway. Distinctive motor symptoms include bradykinesia, muscle rigidity and tremor, while non-motor symptoms, of which cognitive dysfunction is an example, also frequently occur. Current therapy provides symptomatic relief mainly by augmentation of dopaminergic signalling (levodopa, dopamine agonists, MAO and COMT enzyme inhibitors), but disease progression is not adequately addressed. New therapies that can prevent further neurodegeneration in addition to providing symptomatic relief are therefore urgently required. Adenosine has an important function as neuromodulator in the central nervous system. The adenosine A2A receptor in particular plays an essential role in the regulation of movement. This, coupled to the fact that it is uniquely distributed in the basal ganglia, contributes to its attractiveness as non-dopaminergic target in the treatment of movement disorders, such as Parkinson’s disease. The efficacy of adenosine receptor antagonists has been illustrated in animal models of Parkinson’s disease and several adenosine receptor antagonists have also reached clinical trials. The neuroprotective properties of adenosine A2A receptor antagonists are further attributed to their ability to modulate neuro-inflammation and decrease the release of the excitatory neurotransmitter glutamate, which is implicated in neurotoxicity. While adenosine A1 receptor antagonism has a synergistic effect on the motor effects of adenosine A2A receptor antagonism, it has the additional benefit of improving cognitive dysfunction, a cardinal non-motor symptom of Parkinson’s disease. Dual antagonism of adenosine A1 and A2A receptors therefore offers the potential of providing symptomatic relief as well as the neuroprotection so desperately needed in the clinical environment. Amino substituted heterocyclic scaffolds, such as those containing the 2-aminopyrimidine motif, have been shown to exhibit good efficacy as dual adenosine receptor antagonists. Since the structure activity relationships of 2-aminopyrimidines have not been comprehensively explored, it is in this regard that this study aimed to make a contribution. Results - Fourteen 2-aminopyrimidines were synthesised successfully over three steps, (although in low yields) and characterised by nuclear magnetic resonance and infrared spectroscopy, mass spectrometry, by determination of melting points and high performance liquid chromatography. Structure modifications explored included variation of the aromatic substituent on position 4, as well as variations in the substituents of the phenyl ring, present on position 6 of the pyrimidine ring. Radioligand binding assays were performed to determine the affinities of the synthesised compounds for the adenosine A1 and A2A receptor subtypes. Several high dual affinity derivatives were identified during this study; the compound with the highest affinity was 4-(5- methylthiophen-2-yl)-6-[3-(piperidine-1-carbonyl)phenyl]pyrimidin-2-amine (39f) with Ki values of 0.5 nM and 2.3 nM for the adenosine A2A and adenosine A1 receptors, respectively. A few general structure activity relationships were derived, which included: The effect of the aromatic substituent (position 4) on A2A affinity could be summarised (in order of declining affinity) as follows: 5-methylthiophene > phenyl > furan > pyridine > p-fluorophenyl > benzofuran. On the other hand, the effect of this substituent on A1 receptor affinity could be summarised (in order of declining affinity) as follows: phenyl > 5-methylthiophene > pfluorophenyl > benzofuran > pyridine. The affinities as exhibited by the methylthiophene derivatives 39f, 39h – 39j, further showed that while piperidine substitution (39f) resulted in optimal A2A and A1 affinity, pyrrolidine substitution (39j) was less favourable. Substitution at the 4ʹ position of the phenyl ring, as well as thiazole substitution, generally resulted in poor adenosine A1 and A2A receptor affinity. However, 4-[2-amino-6-(5-methylfuran-2-yl)pyrimidin- 4-yl]-N-(1,3-benzothiazol-2-yl)benzamide (39l) surprisingly demonstrated good affinity and selectivity for the adenosine A1 receptor. The results obtained during radioligand binding assays were rationalised by QSAR and molecular modelling (Discovery Studio 3.1, Accelrys) studies. The inverse relationship seen between log Ki (as indicator of affinity) and polar surface area, illustrated the importance of this physico-chemical property in the design of 2-aminopyrimidine A2A antagonists. The results from the docking study further showed that the orientation adopted by derivatives in the binding cavity (and particular hydrogen bonding to Asn 253 and Glu 169) is of importance. Results from the MTT cell viability assay indicated that none of the high affinity derivatives had a significant effect on cell viability at 1 μM, a concentration much higher than their Ki values. However, incorporation of the furan, benzofuran and p-fluorophenyl groups as aromatic substituent and a pyrrolidine as amine substituent, presented liabilities. Lastly, the haloperidol induced catalepsy assay (in rats) was used to give a preliminary indication of adenosine receptor antagonism or agonism. Compound 39f failed to reverse catalepsy under standard conditions, but showed some reversal after an increased time period. Indications therefore exist that 39f is an adenosine receptor antagonist that suffers from bioavailability issues. Compound (39c), 4-phenyl-6-[3-(piperidine-1- carbonyl)phenyl]pyrimidin-2-amine which also demonstrated promising affinity in the radioligand binding assays however showed a statistically significant reduction in catalepsy, indicating adenosine A2A receptor antagonism, and in vivo efficacy. Highly potent, dual affinity aminopyrimidine derivatives with acceptable toxicity profiles were identified in this study, with compound 39c demonstrating in vivo activity. The aim of designing and synthesising a promising dual adenosine A1/A2A receptor antagonist is therefore realised, with compound 39c as the most favourable example. / MSc (Pharmaceutical Chemistry), North-West University, Potchefstroom Campus, 2014

The diagnosis of Parkinson’s disease (PD) follows the UK Brain Bank Criteria, which demands bradykinesia and one additional symptom, i.e. rigidity, resting tremor or postural instability. The latter is not a useful sign for the early diagnosis of PD, because it does not appear before Hoehn and Yahr stage 3. Early symptoms of PD which precede the onset of motor symptoms are hyposmia, REM sleep behavioral disorder, constipation, and depression. In addition, an increasing number of patients whose PD is related to a genetic defect are being described. Thus, genetic testing may eventually develop into a tool to identify at-risk patients. The clinical diagnosis of PD can be supported by levodopa or apomorphine tests. Imaging studies such as cranial CT or MRI are helpful to distinguish idiopathic PD from atypical or secondary PD. SPECT and PET methods are valuable to distinguish PD tremor from essential tremor if this is clinically not possible. Using all of these methods, we may soon be able to make a premotor diagnosis of PD, which will raise the question whether early treatment is possible and ethically and clinically advisable. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

La maladie de Parkinson (MP) est la deuxième maladie dégénérative la plus répandue au Canada. Elle se caractérise par des symptômes moteurs importants tels le tremblement de repos, la rigidité musculaire, l’instabilité posturale, la lenteur dans les mouvements ainsi que par des symptômes non moteurs, notamment une diminution du fonctionnement cognitif. Conséquemment, la nature hétérogène des symptômes de la MP dirige bien souvent l’individu atteint vers une sédentarité physique et mentale involontaire. Les traitements pharmacologiques et neurochirurgicaux demeurent les approches thérapeutiques majoritairement choisies. Toutefois, de plus en plus d’études visant à examiner les impacts de l’exercice physique aérobique (EPA) ont démontré des bénéfices de ce traitement non pharmaceutique, entre autres, en améliorant les symptômes moteurs de la maladie. Néanmoins, l’effet de l’exercice sur la cognition et l’apprentissage moteur à travers la MP est encore méconnu. Ainsi, ce projet de thèse vise à étudier les changements cognitifs et moteurs suite à un entrainement cardiovasculaire. Une première étude visait à mesurer les changements comportementaux au niveau de la capacité aérobique, des fonctions cognitives dites exécutives et de l’apprentissage procédural moteur suite à l’EPA. Une deuxième étude utilisant l’imagerie par résonance magnétique fonctionnelle (IRMf) permettait ensuite d’identifier les corrélats neuronaux associés à l’effet de l’EPA sur l’apprentissage moteur. 20 participants en santé et 19 atteintes de la MP, âgées entre 40-80 ans, ont participé à un programme d’entrainement de 3 mois (3 fois/semaine) à une intensité élevée, débutant à 20 minutes (+5 minutes/semaine) pour atteindre 40 minutes d’EPA. Le niveau d’intensité de base a été prescrit selon la capacité aérobique initiale du participant en réponse au test à l’effort effectué (pré et post entraînement). Plusieurs mesures d’évaluation physiques (VO2peak, pression artérielle, fréquence cardiaque) et neuropsychologiques (« Stroop, trail making test » (TMT)) ont été prises en début et à la fin de l’entraînement. De plus, des sessions d’acquisition de données cérébrales fonctionnelles grâce à l’IRMf ont été administrées durant la passation d’une tâche d’apprentissage moteur implicite (tache : « Serial Reaction Time Task »(SRT)). Les résultats ont montré que l’entraînement en EPA fut efficace car une amélioration significative de la capacité aérobique fut observée chez tous les participants. Au niveau comportemental, l’EPA a eu pour effet d’améliorer les capacités d’inhibition (Stroop) et d’apprentissage moteur (SRT), mais pas celle associée à la flexibilité mentale (TMT). Pour leur part, les données de neuroimagerie ont révélé une augmentation de l’activité fonctionnelle liée à l’amélioration de l’apprentissage moteur au niveau de l’hippocampe, du striatum et du cervelet, et ce en comparaison avec les sujets contrôles. De plus, les changements fonctionnels chez les individus atteints de la MP étaient corrélés au changement de la capacité aérobique : une relation positive fut liée à l’augmentation de l’activité de l’hippocampe et du striatum, tandis qu’une relation négative fut observée au niveau du cervelet. Ce projet est l’un des premiers à mettre en lumière l’impact clinique d’un traitement non pharmaceutique visant à améliorer la nature motrice et cognitive des symptômes de la MP, ainsi que de proposer les mécanismes neurofonctionnels pouvant expliquer l’amélioration observés au niveau de l’apprentissage suivant l’entrainement en EPA. Ainsi, nous croyons que les résultats de cette étude serviront les milieux cliniques et la population de patients atteints de la maladie de Parkinson en proposant une solution thérapeutique efficace et économique afin d’améliorer la qualité de vie de ces derniers. / Parkinson’s disease (PD) is the second most common neurodegenerative disorder in Canada. It is mainly characterized by important motor symptoms such as slow movement, tremor, rigidity and problems with locomotion, but non-motor symptoms (NMS) such as cognitive dysfunctions are also present early in the disease. Inadvertently, the heterogeneous nature of PD’s symptoms may lead to an unintentional sedentary behaviour both at the physical and mental level. To date, the most common forms of PD treatments remain pharmacological and neurosurgical in nature. Most recently, however, studies have demonstrated benefits of aerobic exercise training (AET) as a non-pharmaceutical treatment with significant effects on PD’s motor symptoms. Nevertheless, the effects of exercise on cognitive and motor learning function in PD remain unknown. Thus, this thesis project aims at studying cognitive and motor changes following AET. Most specifically, the first study intended to assess behavioural changes related to aerobic capacity, cognitive (executive) functions and procedural learning following three months of AET. The second article used functional magnetic resonance imaging (fMRI) to identify the neural correlates associated with the effect of AET on motor learning. Twenty healthy controls (HC) and 19 early PD individuals, aged 40-80 years old, participated in a supervised high intensity stationary recumbent bike training program (3 times/week; 12 weeks). Exercise prescription started at 20 minutes (+5 minutes/week up to 40 minutes) based on participants’ maximal volume of oxygen uptake (pre and post training). Several physical (VO2peak, blood pressure, heart rate) and cognitive (Stroop and Trail making tests (TMT)) measures were used pre and post AET. Importantly, participants’ procedural learning skill (implicit motor learning) was evaluated using a version of the Serial Reaction Time Task (SRT) during the acquisition of functional neuroimaging data. AET program was effective as indicated by a significant improvement in aerobic capacity in all participants. At the behavioural level, AET improved inhibition (Stroop) and motor learning (SRT), but not flexibility (TMT). Brain imaging data revealed pre-post MSL-related increases in functional activity in the hippocampus, striatum and cerebellum in PD patients as compared to controls. Importantly, functional brain changes in PD individuals correlated with changes in aerobic capacity: a positive relationship was found with increased activity in the hippocampus and striatum, while a negative relationship was observed with the cerebellar activity. This project is one of the first to elucidate the clinical impact of such non-pharmaceutical treatment targeting motor and non-motor aspects of PD. Accordingly, it is believed that the results will be of use for clinical settings and for the population of patients with PD, as they give evidence in favour of an efficient and economical therapeutic solution for PD.

Einleitung: Tiermodelle spielen für die Aufklärung pathophysiologischer Mechanismen und die Entwicklung erfolgsversprechender Therapieoptionen zentralnervöser Bewegungsstörungen eine unverzichtbare Rolle. Die Identifizierung von Gendefekten für die Parkinson-Krankheit und Dystonien ermöglichte die Generierung von Tiermodellen mit einer hohen „construct validity“. Weibliche transgene Thy1-aSyn Mäuse sowie DYT1 Knock-in (KI) Mäuse zeigen jedoch keine motorischen Störungen. In der vorliegenden Arbeit sollten zur Aufdeckung sensomotorischer Beeinträchtigungen, die bei Parkinson- und Dystoniepatienten beobachtet werden, detaillierte Untersuchungen des Verhaltens an diesen beiden Mausmodellen durchgeführt werden. Zielstellung: Zunächst sollte ein sensitiver Verhaltenstest konstruiert und entwickelt werden, bei dem sich ändernde sensorische Stimuli während der Ausübung der motorischen Aufgabe impliziert werden. Bei der Etablierung dieses sogenannten „adaptiven rotierenden Balkentests“ (ARB-Test) sollte auch der Einfluss des genetischen Hintergrunds bei Wildtyp-Mäusen evaluiert werden. Daraufhin sollte überprüft werden, ob dieser Test den Endophänotyp der weiblichen Thy1-aSyn Mäuse aufdecken kann. In dem DYT1 KI Mausmodell sollte der Frage nachgegangen werden, ob die Tiere Verhaltensdefizite in spezifischen Tests zeigen, die sensomotorische Verschaltungen untersuchen. Material und Methoden: Die mRNA-Expression von α-Synuclein in der Substantia nigra bei männlichen und weiblichen Thy1-aSyn Mäusen wurde mithilfe der quantitativen Echtzeit-PCR (qPCR) ermittelt. Im Anschluss an die Entwicklung des neuen Verhaltensapparates für den ARB-Test wurden Thy1-aSyn Tiere beider Geschlechter in diesem Versuch getestet und ihre Leistung den Ergebnissen auf etablierten motorischen Verhaltenstests („challenging beam test“, „pole test“) gegenübergestellt. Um den Einfluss des Hintergrundstammes auf das Verhalten der Tiere auf dem ARB-Test zu untersuchen, wurden Wildtypen der reinen C57BL/6J-Linie sowie Hybrid-Tiere des Stammes C57Bl/6J × DBA2 (BDF1) allen drei o. g. Versuchen unterzogen. Bei den Mäusen des DYT1 KI Modells wurde der „adhesive removal test“ und der ARB-Test zur Analyse der Sensomotorik durchgeführt. Im Vergleich dazu wurden vielfältige Verhaltensparameter in einer Reihe vorwiegend motorischer (Offenfeld-Test, „challenging beam test“, „pole test“, Zylinder-Test, Block-Test, Nestbau-Test) und kognitiver („y-maze test“) Verhaltenstests ausgewertet. Ergebnisse: Bei den weiblichen Thy1-aSyn Mäusen wurde eine geringere Expression des Transgens im Vergleich zu den männlichen Tieren festgestellt. Der neue ARB-Test wurde erfolgreich etabliert und konnte signifikante Verhaltensdefizite der weiblichen und männlichen Mutanten des Parkinson-Modells im Vergleich zu den Kontrolltieren aufdecken. Der genetische Hintergrund beeinflusste die Leistung der Wildtypen auf diesem Balkentest. Während die DYT1 KI Tiere in den rein motorischen und kognitiven Versuchen keine Beeinträchtigungen des Verhaltens zeigten, konnten der „adhesive removal test“ sowie der neue ARB-Test signifikante sensomotorische Defizite der KI Mäuse im Unterschied zu den Wildtypen zum Vorschein bringen. Schlussfolgerung: Im Thy1-aSyn Mausmodell konnte die Bedeutung der sensomotorischen Integration für die Ausprägung motorischer Defizite sowie für eine mögliche Kompensation solcher motorischen Beeinträchtigungen demonstriert werden. Hierfür hat sich der neu entwickelte, sensitive ARB-Test als geeignet herausgestellt. Die Aufdeckung von Beeinträchtigungen der Sensomotorik spricht auch bei den DYT1 KI Tieren für den Einfluss einer gestörten sensomotorischen Integration bei der Ausprägung der Symptomatik. Damit eignet sich dieses Mausmodell für die Untersuchung weiterer Parameter, die Auswirkungen auf die Aufdeckung des Phänotyps und die Penetranz der Erkrankung haben sowie um die zugrunde liegenden pathophysiologischen Mechanismen zu erforschen.

La maladie de Parkinson (PD) a été uniquement considérée pour ses endommagements sur les circuits moteurs dans le cerveau. Il est maintenant considéré comme un trouble multisystèmique, avec aspects multiples non moteurs y compris les dommages intérêts pour les circuits cognitifs. La présence d’un trouble léger de la cognition (TCL) de PD a été liée avec des changements structurels de la matière grise, matière blanche ainsi que des changements fonctionnels du cerveau. En particulier, une activité significativement réduite a été observée dans la boucle corticostriatale ‘cognitive’ chez des patients atteints de PD-TCL vs. PD non-TCL en utilisant IRMf. On sait peu de cours de ces modèles fonctionnels au fil du temps. Dans cette étude, nous présentons un suivi longitudinal de 24 patients de PD non démente qui a subi une enquête neuropsychologique, et ont été séparés en deux groupes - avec et sans TCL (TCL n = 11, non-TCL n = 13) en fonction du niveau 2 des recommandations de la Movement Disrders Society pour le diagnostic de PD-TCL. Ensuite, chaque participant a subi une IRMf en effectuant la tâche de Wisconsin pendant deux sessions, 19 mois d'intervalle. Nos résultats longitudinaux montrent qu'au cours de la planification de période de la tâche, les patients PD non-TCL engageant les ressources normales du cortex mais ils ont activé en plus les zones corticales qui sont liés à la prise de décision tel que cortex médial préfrontal (PFC), lobe pariétal et le PFC supérieure, tandis que les PD-TCL ont échoué pour engager ces zones en temps 2. Le striatum n'était pas engagé pour les deux groupes en temps 1 et pour le groupe TCL en temps 2. En outre, les structures médiales du lobe temporal étaient au fil du temps sous recrutés pour TCL et Non-TCL et étaient positivement corrélés avec les scores de MoCA. Le cortex pariétal, PFC antérieur, PFC supérieure et putamen postérieur étaient négativement corrélés avec les scores de MoCA en fil du temps. Ces résultats révèlent une altération fonctionnelle pour l’axe ganglial-thalamo-corticale au début de PD, ainsi que des niveaux différents de participation corticale pendant une déficience cognitive. Cette différence de recrutement corticale des ressources pourrait refléter longitudinalement des circuits déficients distincts de trouble cognitive légère dans PD. / PD was traditionally thought of as purely a movement disorder, now it is considered a multisystem disorder, with multiple non-motor aspects including damages to the cognitive circuits. Mild cognitive impairment (MCI) in PD has been linked with structural gray matter, white matter as well as functional brain changes. Specifically, significantly reduced activity was observed in the ‘cognitive’ corticostriatal loop in patients with PD-MCI vs. PD non-MCI using fMRI. Little is known regarding the course of these functional patterns over time. In this study we present longitudinal follow up of 24 non-demented PD who underwent neuropsychological investigation and were separated in two groups - with and without MCI (MCI n=11, Non-MCI n=13) according to the MDS level 2 recommendation for diagnosis of PD-MCI. Afterwards, each participant underwent an fMRI investigation by performing the Wisconsin Card Sorting Task over two sessions, 19 months apart. Our longitudinal results show that during planning set-shift period of the task, PD Non-MCI patients were engaging the normal cortical resources but they also activated more cortical areas at time 2 that are related to decision-making such as the medial prefrontal cortex (PFC), parietal lobe and the superior PFC, whilst the patients with MCI failed to engage these areas at both time points. The striatum was not engaged for both groups at time 2 and for MCI group at time 1. Furthermore, medial temporal lobe structures (MTLS) were under-recruited overtime for both the MCI and Non-MCI PD patients, and were positively correlated with MoCA scores over time. Parietal cortex, anterior PFC, superior PFC, and posterior putamen were negatively correlated with MoCA scores. These results reveal functional alteration along the basal ganglial-thalamo-cortical axis in early PD, as well as different cortical involvement levels along the course cognitive impairment. This discrepancy in cortical resources recruitment over time might reflect deficient circuitry distinct to cognitive impairment in Parkinson’s disease.