Introduction et objectifs : Alors que l'effet moteur de la lévodopa (L-dopa) dans la maladie de Parkinson (MP) est clair et établi, son effet sur la cognition demeure incertain. Les troubles cognitifs ont un impact important sur la qualité de vie et les études évaluant l'effet cognitif de ce médicament donnent des résultats encore divergents. L’objectif primaire de cette étude pilote est d’observer l’impact des doses cliniques de lévodopa sur la cognition. Un second objectif sera d'établir une courbe dose-réponse pour observer les différences potentielles. Méthodes : Cinq patients avec MP ont été évalués à l’aide de 2 tests cognitifs (CPT-II et Stroop) et 2 tests moteurs (Finger Tapping et UPDRS-III) en OFF (sevrage minimal de 12 heures) et en ON avec des doses croissantes de lévodopa (commençant à 50mg avec une augmentation de dose de 50mg par visite) jusqu’à l'observation d'une performance cognitive optimale ou d'effets secondaires. Une administration répétée des tests cognitifs a été faite à la première visite pour limiter l’effet d’apprentissage. Résultats : Le temps de réaction (RT) mesuré en millisecondes au CPT-II a augmenté (médiane 3.03%) après la prise de médicament alors que les erreurs ont légèrement diminué (médiane -9.92%). Au Stroop, l’effet d’interférence évalué selon les changements au temps d’inhibition mesuré en secondes était légèrement moindre sans changement dans les erreurs. Avec les doses prescrites, le RT a augmenté de 3,50% et le nombre d’erreurs est resté stable alors que les doses inférieures ont eu une moindre augmentation du RT tout en diminuant les erreurs. Dans le Stroop, les doses faibles ont amélioré le temps de près de 19% alors que les doses prescrites ont quant à elles diminué les erreurs. Malgré une certaine variabilité, la courbe dose-réponse indique que les erreurs diminuaient aux doses faibles et fortes dans le CPT-II alors que le RT augmentait généralement, ce qui pourrait indiquer un style de performance plus prudent. L’effet de la lévodopa sur l’interférence dans le Stroop variait légèrement sans tendances fixes mis à part le bénéfice observé par les doses faibles. Une importante variabilité a été observée dans les évaluations motrices entre les sujets ainsi qu'au sein du même sujet. Conclusion : Ces résultats indiquent qu’en général, le médicament ne semble pas avoir d’effet néfaste important sur l’attention et les fonctions exécutives évaluées auprès de ce groupe de patients parkinsoniens. L'effet cognitif des doses plus faibles semble leur être bénéfique et meilleur que les doses cliniquement prescrites. La relation dose-réponse démontre un effet cognitif variable de la lévodopa entre les doses, n'indiquant toutefois pas de tendances claires. / Background and objectives: While levodopa’s effect on motor symptoms in Parkinson’s disease (PD) has been largely characterized, its cognitive effect still remains without definite conclusion. Since cognitive impairment is an important feature of PD that impacts patients’ quality of life, it is important to establish levodopa’s effect on cognitive functions. Multiple studies regarding this subject remained without specific consensus. The main goal pursued in this study is to observe the effect of clinical doses of levodopa on attention and executive functions. A dose-response curve is also made with the escalating doses evaluated. Methods: Five PD patients were investigated OFF (minimal withdrawal of 12 hours) and ON levodopa (starting dose of 50mg escalating by 50mg per visit) with 2 cognitive (CPT-II and Stroop) and 2 motor (finger tapping and UPDRS-III) tests until reaching an optimal cognitive performance or showing signs of side effects. Practice sessions of the cognitive tests were done at the first visit. Results: While reaction time (RT) in milliseconds increased (median 3.03%), errors slightly decreased (median -9.92%) after medication intake in the CPT-II. Errors however did not change in the Stroop while time evaluated in seconds decreased. The CPT-II showed slowing at the prescribed doses of levodopa (3.5%) while lower doses improved errors with less increase of the RT. These small doses also improved the performance in the Stroop test with a 19% reduction in time while the prescribed doses improved errors instead. The dose-response curve indicates a reduction of errors in the CPT-II for low and high doses while time usually increased, showing a more cautious style. Besides the beneficial effect of low doses, the dose-response curve for the Stroop test did not show any specific tendencies in levodopa’s effect on interference. An important variability was observed in motor evaluations between and within subjects. Conclusion: These results indicate that levodopa does not seem to have an important deleterious effect on attention and executive functions evaluated in this group of parkinsonian patients and that low doses seem to even be beneficial and better than the ones usually taken by the patients. The dose-response curve showed that the cognitive effect of levodopa for these patients varies between the different doses without being clear on the tendencies.

Estudos recentes têm sugerido que as imagens de tensor de difusão podem ser úteis para diagnosticar doença de Parkinson (DP). Nosso objetivo foi estimar a exatidão diagnóstica da anisotropia fracionada da substância negra (FA-SN) para o diagnóstico de DP, em uma amostra mais próxima do cenário clínico, incluindo pacientes com tremor essencial (TE) e voluntários sadios (VS). Para uma compreensão mais profunda de nossos achados, também realizamos uma revisão sistemática da literatura e meta-análise para estimar a mudança média da FA-SN induzida pela DP e a precisão diagnóstica dessa medida. Nossa amostra consistiu de 135 pacientes: 72 pacientes com DP, 21 com TE e 42 VS. Dois exames em RM 3T foram realizados em diferentes locais. Em nossa amostra, não encontramos diferenças significativas entre os grupos e a FA-SN não foi útil para o diagnóstico. O maior componente da variabilidade foi a interação sítio-sujeito. Os resultados desta amostra foram fundidos em uma meta-análise que incluiu 1549 indivíduos compostos de 896 pacientes com DP e 653 VS. Utilizaram-se os modelos bivariados e inversos de variância inversa para resumir as medidas de acurácia diagnóstica e as diferenças de médias, respectivamente. A meta-análise estimou uma pequena diminuição nos valores médios da FA-SN na DP (0,03 menor nos pacientes com DP (IC: 0,01 - 0,06)). Apesar disso, sua capacidade discriminatória para o diagnóstico da DP foi baixa. A sensibilidade e a especificidade combinadas foram, respectivamente, 70% (IC: 65 - 74) e 63% (IC: 57 - 69). Houve alta heterogeneidade entre os resultados dos estudos (I2 = 92%). O estudo de caso-controle e a meta-análise das medidas de anisotropia fracionada na substância negra de pacientes com doença de Parkinson e voluntários sadios demonstram que o seu uso como biomarcador de DP não é confiável / Recent studies have suggested that diffusion tensor images can be useful to diagnose Parkinson\'s disease (PD). Our goal was to estimate the diagnostic accuracy of substantia nigra fractional anisotropy (SN-FA) for PD diagnosis in a sample closer to the clinical setting, including patients with essential tremor (ET) and healthy controls (HC). To a deeper understanding of our findings, we also performed a systematic literature review and meta-analysis to estimate mean change of SN-FA induced by PD, and diagnostic accuracy of this measurement. Our sample consisted of 135 subjects: 72 PD and 21 ET patients and 42 HC. Two 3T MRI scans were performed in different sites. In our sample, we did not find significant mean difference between groups and SN-FA was useless for diagnosis. The largest component of explained variability of SN-FA was site-subject interaction. MRI results of this sample were merged in a meta-analysis that included 1549 subjects composed of 896 PD patients and 653 HC. The normal bivariate and the inverse-variance random-effect models were used to summarize diagnostic accuracy measures and mean differences respectively. Meta-analysis estimated a small decrease in mean SN-FA values in PD (0.03 lower in PD patients (CI: 0.01 - 0.06)). Despite this fact, its discriminatory capability to diagnose PD was low. The pooled sensitivity and specificity was respectively 70% (CI: 65 - 74) and 63% (CI: 57 - 69). There was high heterogeneity between studies results (I2 = 92 %). This case-control study and meta-analysis of substantia nigra fractional anisotropy measurements in Parkinson\'s disease and healthy volunteers demonstrate that their use as a PD biomarker is not reliable

Le gène split end (spen) est impliqué dans de nombreuses voies de signalisation et processus biologiques. Durant ma thèse j'ai étudié le rôle de spen dans la mort cellulaire au cours du développement de la rétine de la Drosophile. L'œil de Drosophile est composé de centaines d'unités appelées ommatidies. Chaque ommatidie est composée de huit photorécepteurs entourés de cellules accessoires comprenant quatre cellules cônes et deux cellules pigmentaires primaires, ainsi que douze cellules interommatidiales. Les cellules interommatidiales adoptent une structure hexagonale parfaitement régulière. Des cellules interommatidiales en excès doivent être éliminées par apoptose au cours du développement. J'ai montré que la modulation de spen modifiait radicalement le patron des cellules interommatidiales. L'inactivation de spen conduit à un défaut de cellules interommatidiales alors que sa surexpression entraîne un excès de ces cellules. Ces résultats témoignent d’un rôle anti-apoptotique de spen. Nous avons aussi montré que la perte des cellules interommatidiales dans un contexte mutant pour spen pouvait être entièrement sauvée en exprimant la protéine p35 connue pour bloquer l'activité des caspases. Comme spen est exprimé de manière ubiquitaire, nous avons cherché à déterminer dans quelles cellules spen jouait son rôle de régulateur de la mort cellulaire. Grâce à une analyse clonale, nous avons pu montrer que c'est au niveau des cellules cônes que spen agit. L'inactivation de spen dans les autres cellules accessoires de l'œil n'influence pas la mort des cellules interommatidiales. Nous avons en outre, montré que spen avait un rôle dans la formation des soies de chaque ommatidie. Ces travaux mettent en évidence un rôle de spen dans le contrôle de la mort cellulaire des cellules interommatidiales dans les cellules cônes. Nos résultats montrent, par ailleurs, que spen serait requis pour le relarguage du facteur de survie Spitz (le ligand activateur de la voie EGF) à partir des cellules cônes. En parallèle, nous avons étudiés le rôle de survie de spen dans un modèle neurodégénératif. Nous avons montré que spen était nécessaire dans les cellules gliales pour la résistance au stress oxydatif. De manière intéressante, nous avons trouvé que l'inactivation de spen dans la glie diminuait l'activité de la voie de signalisation NOTCH. Cette résistance pourrait se faire via la modulation de gènes antioxydants. De manière générale, nos travaux démontrent un rôle du gène split ends dans la survie cellulaire. Ce facteur agit de manière non-autonome à partir des cellules supports de différents organes. / In metazoan, the successful development of many organs requires the elimination of supernumerary cells by apoptosis. For example, the elimination of about two thousand interommatidial cells (IOCs) during Drosophila eye development allows the precise rearrangement of ommatidia in a perfect hexagonal array. Maximal apoptosis occurs during pupal life and the remaining IOCs differentiate into secondary and tertiary pigment cells. The precise removal of unwanted IOCs requires coordinated activation of Notch (pro-death) and EGF (pro-survival) pathways. IOCs undergoing apoptosis express the IAP inhibitor Hid, which leads to the activation of initiator and effector caspases. However, the mechanisms that coordinate the death and survival pathways for timed and precise IOC removal are poorly understood.Here, we report that spen encodes a nuclear protein expressed in the pupal eye that is required for IOC survival. We showed that the inhibition of spen, by either RNAi or in spen mutant clones resulted in disorganized ommatidia with missing IOCs. Moreover, overexpression of spen leads to extra IOCs. These results indicate that spen expression promotes IOC survival during eye development. Importantly blocking apoptosis prevents the loss of IOC in a spen mutant retina. Spen is a protein known to be ubiquitous in tissue during development. Indeed, we have shown using an enhancer trap line that spen is expressed in all the cells in the eye pupal disk. To better understand where spen is acting from in this tissue to regulate cell death, we performed a clonal analysis. We found that the inactivation of spen in the cone cells was causing the loss of IOC, indicating that spen is required non-autonomously in cone cell for IOC survival. In parallel we have shown that the inactivation of spen was disrupting eye bristles morphology. Even if studies discuss the role of bristles in the regulation of developmental apoptosis in this context, our clonal analysis excluded this possibility. Furthermore, we found that spitz, the EGFR ligand, accumulate in cone cells upon spen inactivation. Our current hypothesis is that spen is likely to be required for the release of Spitz from the cone cells in order to active the survival signaling pathway EGFR in the IOCs. Also, we examined the protective role of spen in a chemical model of Parkinson disease (paraquat treatment). We showed that the glial expression of spen is protective in this context, which suggest against that spen acts non-autonomously. Interestingly we found that the inactivation of spen in glia downregulates the Notch signaling pathway. Spen is likely to be a key factor integrating cues from different signaling pathways to promote cell survival.

No description available.

Protein (mis)folding into highly ordered, fibrillar structures, amyloid fibrils, is a hallmark of several, mainly neurodegenerative, disorders. The mechanism of this supra-molecular self-assembly reaction, as well as its relationship to protein folding are not well understood. In particular, the molecular origin of the metastability of the soluble state of proteins with respect to the aggregated states has not been clearly established. In this dissertation, it is demonstrated, that highly accurate kinetic experiments, using a novel biosensing method, can yield fundamental insight into the dynamics of proteins in the region of the free energy landscape corresponding to protein aggregation. First, a section on Method development describes the extension and elaboration of the previously established kinetic assay relying on quartz crystal microbalance measurements for the study of amyloid fibril elongation (Chapter 3). This methodology is then applied in order to study in great detail the origin of the various contributions to the free energy barriers separating the soluble state of a protein from its aggregated state. In particular, the relative importance of residual structure, hydrophobicity (Chapter 4) and electrostatic interactions (Chapter 5) for the total free energy of activation are discussed. In the last part of this thesis (Chapter 6), it is demonstrated that this biosensing method can also be used to study the binding of small molecules to amyloid fibrils, a very useful feature in the framework of the quest for potential inhibitors of amyloid formation. In addition, it is shown that Thioflavin T, to-date the most frequently employed fluorescent label molecule for bulk solution kinetic studies, can in the presence of potential amyloid inhibitor candidates be highly unreliable as a means to quantify the effect of the inhibitor on amyloid formation kinetics. In summary, the work in this thesis contributes to both the fundamental and the applied aspects of the field of protein aggregation.

Made available in DSpace on 2014-12-17T15:16:20Z (GMT). No. of bitstreams: 1 RhayssaRR_DISSERT.pdf: 1850202 bytes, checksum: e1b72b8aa8b2d29def6a785660dc5cb9 (MD5) Previous issue date: 2013-03-08 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Avaliar os efeitos da t?cnica Breath-Stacking (BS) e da espirometria de incentivo (EI) sobre os volumes da caixa tor?cica imediatamente ap?s e em at? trinta minutos ap?s as t?cnicas em pacientes com doen?a de Parkinson (DP). M?todos: Trata-se de um estudo do tipo cross-over. Fizeram parte do estudo 14 pacientes com DP de leve a moderada. Os indiv?duos realizaram a t?cnica Breath-Stacking, espirometria de incentivo a volume e participaram de uma fase controle de acordo com a randomiza??o. Os volunt?rios foram avaliados pela pletismografia ?ptoeletr?nica sempre antes, imediatamente ap?s, quinze e trinta minutos ap?s a realiza??o das t?cnicas. Foi utilizado a ANOVA de medidas repetidas com p?s-hoc de Tukey para as vari?veis param?tricas, e o teste de Friedman com p?s-hoc de Dunns para as vari?veis n?o param?tricas. O n?vel de signific?ncia adotado foi de 5%, com p<0,05. Resultados: Ap?s a utiliza??o das t?cnicas BS e do EI foi observado um aumento do volume corrente e do volume minuto dos volunt?rios (p<0,05), sem altera??es significativas durante a fase controle (p>0,05). Ap?s o uso do EI foi observado maior participa??o dos compartimentos pulmonar (Vc, Ctp) e abdominal (Vc, Cta), sem altera??es significativas ap?s a BS e C. Os efeitos das t?cnicas n?o permaneceram ap?s quinze minutos da realiza??o. N?o foi observada diferen?a significativa em rela??o ao volume inspirat?rio alcan?ado durante as t?cnicas. Conclus?o: a t?cnica Breath-Stacking e a espirometria de incentivo promovem ganho imediato no volume corrente e no volume minuto dos pacientes com DP em estadiamento leve a moderado, entretanto o efeito das t?cnicas n?o permanece ap?s quinze minutos. Os efeitos das duas t?cnicas na gera??o de volumes inspirat?rios na DP s?o equivalentes. Na pr?tica cl?nica estes resultados sugerem que estas t?cnicas de reexpans?o podem ser usadas como um recurso terap?utico para prevenir ou reverter ?reas de atelectasia nestes pacientes

NUR77 est un récepteur nucléaire (RN) orphelin impliqué dans la régulation de processus biologiques dont la mort cellulaire, notamment dans la maladie de Parkinson (MP), découlant de la perte de neurones dopaminergiques, et dans le cancer du sein, résultant de la prolifération de cellules mammaires. NUR77 est impliqué dans le déclenchement et la protection de la mort cellulaire et son activité serait indépendante de la liaison d’un ligand. Nous avons émis l’hypothèse que l’activité de NUR77 est influencée par ses modifications post-traductionnelles (MPTs) et ses partenaires d’interactions. L’objectif général de cette thèse était de caractériser les MPTs et les partenaires d’interaction modulant l’activité de NUR77, dans des modèles de cellules en culture, afin de mieux comprendre ses fonctions biologiques - notamment dans la mort cellulaire. Le premier objectif de ce doctorat était de caractériser le rôle de la SUMOylation, une modification modulant l’activité des RN, chez NUR77, par des essais rapporteurs dans les cellules Human Embryonic Kidney 293 (HEK293). La surexpression de la E3 SUMO ligase PIASγ et/ou de l’isoforme 2 de la SUMO, protéines importantes dans la régulation de la SUMOylation chez les RN, a engendré un effet répresseur sur l’activité transcriptionnelle de NUR77. L’effet de PIASγ sur l’activité de NUR77 est modulé par la Sentrin SUMO-specific protease 1, qui hydrolyse la liaison des SUMO. Les mutations des résidus lysine dans des sites consensus de SUMOylation, de NUR77 (K102 et K577), empêchant cette MPT, ont causé des effets opposés sur son activité transcriptionnelle, suggérant le recrutement différent de corégulateurs de la transcription. Ces résultats combinés indiquent que la SUMOylation et les PIASγ et SUMO2 sont, respectivement, une MPT et des corégulateurs importants dans l’activité de NUR77. Le deuxième objectif de cette thèse était de caractériser l’interactome de NUR77 dans des HEK293 vivantes afin d’identifier les interacteurs pouvant moduler son activité, à l’aide d’une méthode de marquage des protéines proximales avec la biotine basée sur la peroxydase APEX2, combinée à la spectrométrie de masse. Ce procédé a identifié 336 potentiels interacteurs de NUR77, dont plusieurs connus. Des essais de coimmunoprécipitation et de coimmunofluorescence menés dans les HEK293 et dans les cellules du cancer du sein MCF-7 ont montré, respectivement, que la protéine régulatrice de l’apoptose Apoptosis Inhibitor 5 (API5), interagissait et colocalisait avec NUR77. La privation de sérum dans le milieu de culture des cellules et la diminution de l’expression de API5 a conduit à une augmentation des niveaux protéiques et de l’activité de NUR77 et à une diminution de la survie cellulaire. Ces données suggèrent que API5 constitue un régulateur de NUR77 dans les voies de signalisation associées à la mort cellulaire et que cette interaction pourrait constituer une cible pour moduler l’apoptose. Elles valident également l’approche d’identification d’interacteurs de NUR77. Les travaux de cette thèse ont donc permis de générer des outils pour caractériser l’activité de NUR77 et ont révélé des corégulateurs de cette activité. La poursuite de ces projets pourrait révéler le caractère opportun de cibler NUR77 comme modulateur de la mort cellulaire, notamment dans la MP et le cancer du sein. / NUR77 is an orphan nuclear receptor (NR) involved in the regulation of multiple cell biology processes including cell death, in particular in Parkinson's disease (PD), which results of the loss of dopaminergic neurons, and in breast cancer (BC), which is caused by the proliferation of mammary epithelial cells. NUR77 is involved in triggering and inhibiting cell death and its activity is believed to be independent of a ligand binding. We hypothesized that the regulation of NUR77 activity does not occur through a ligand, but through the influence of its post-translational modifications (PTMs) and its interaction partners. The general objective of this PhD project was to characterize the PTMs and the interacting partners that modulate the activity of NUR77 in cultured cell models, to better understand its physiological roles, in particular in the regulation of cell death. The first objective of this thesis was to characterize the role of SUMOylation, a modification that regulates NR activity, in regulating NUR77 transcriptional activity in reporter assays in Human Embryonic Kidney (HEK293) cells. Overexpression of the E3 SUMO ligase PIASγ or/and the isoform 2 of SUMO, both important regulators in SUMOylation of the NUR77 homolog NURR1, produced a repressive effect on the transcriptional activity of NUR77. The effect of PIASγ on the activity of NUR77 was shown to be modulated by the Sentrin SUMO-specific protease 1 protein, which removes SUMO tags on target proteins. In addition, mutations of lysine residues in SUMO consensus sites in NUR77 (K102 and K577) had opposite effects on its transcriptional activity, suggesting different recruitment of coregulators of transcription in the regions. The combination of these results indicates that SUMOylation is an important PTM for the regulation of NUR77 activity and that PIASγ and SUMO2 proteins are important transcriptional coregulators of NUR77. The second objective of this thesis was to evaluate NUR77 interactome in HEK293 living cells to identify the interactors that can modulate its activity, using a biotin-labelling method for proximal proteins based on the APEX2 peroxidase combined with mass spectrometry. This approach identified 336 potential interactors of NUR77, some that are consistent with the literature. Coimmunoprecipitation and coimmunofluorescence assays carried out in HEK293 cells and in MCF-7 breast cancer cell line have shown that the regulator of apoptosis Apoptosis Inhibitor 5 vi (API5), interacted and colocalized with NUR77. By depriving cells of serum and decreasing API5 expression, increased protein levels and activity of NUR77 was observed, as well as a decrease in cell viability. These data support that API5 is a regulator of NUR77 in its involvement in signalling pathways associated with cell death and that this interaction could be a target for modulating apoptosis. More generally, they validate the APEX2 tool which can be used to identify novel NUR77 interactors. In conclusion, the work of this thesis resulted in the generation of tools to better understand the activity of NUR77 and revealed important coregulators in this activity. The continued characterization of these interactors may provide opportunities to target NUR77 as a regulator of cell death, particularly in PD and in breast cancer.

Le rythme est un aspect important du mouvement et de la perception de l’environnement. Lorsque l’on danse, la pulsation musicale induit une activité neurale oscillatoire qui permet au système nerveux d’anticiper les évènements musicaux à venir. Le système moteur peut alors s’y synchroniser. Cette thèse développe de nouvelles techniques d’investigation des rythmes neuraux non strictement périodiques, tels que ceux qui régulent le tempo naturellement variable de la marche ou la perception rythmes musicaux. Elle étudie des réponses neurales reflétant la discordance entre ce que le système nerveux anticipe et ce qu’il perçoit, et qui sont nécessaire pour adapter la synchronisation de mouvements à un environnement variable. Elle montre aussi comment l’activité neurale évoquée par un rythme musical complexe est renforcée par les mouvements qui y sont synchronisés. Enfin, elle s’intéresse à ces rythmes neuraux chez des patients ayant des troubles de la marche ou de la conscience. / Rhythms are central in human behaviours spanning from locomotion to music performance. In dance, self-sustaining and dynamically adapting neural oscillations entrain to the regular auditory inputs that is the musical beat. This entrainment leads to anticipation of forthcoming sensory events, which in turn allows synchronization of movements to the perceived environment. This dissertation develops novel technical approaches to investigate neural rhythms that are not strictly periodic, such as naturally tempo-varying locomotion movements and rhythms of music. It studies neural responses reflecting the discordance between what the nervous system anticipates and the actual timing of events, and that are critical for synchronizing movements to a changing environment. It also shows how the neural activity elicited by a musical rhythm is shaped by how we move. Finally, it investigates such neural rhythms in patient with gait or consciousness disorders.

No description available.

No description available.