Friedreich's Ataxia (FA) is an autosomal-recessive, neurodegenerative disease characterized by progressive lower extremity muscle weakness and sensory loss, balance deficits, limb and gait ataxia, and dysarthria. FA is considered a sensory ataxia because the dorsal root ganglia and spinal cord dorsal columns are involved early in the disease, whereas the cerebellum is affected later. Balance deficits and gait ataxia are often evaluated clinically and in research using clinical rating scales. Recently, quantitative tools such as the Biodex Balance System SD and the GAITRite Walkway System have become available to objectively assess balance and gait, respectively. However, there are limited studies using instrumented measures to quantitatively assess and characterize balance and gait disturbances in FA, and longitudinal, quantitative analyses of both balance and gait have not been investigated in this patient cohort. The purpose of the present study was to characterize gait patterns of adults with FA and to identify changes in gait and balance over time using clinical rating scales and quantitative measures. Additionally, this study investigated the relationship between disease duration, clinical rating scale scores and objective measures of gait and balance. This study used a longitudinal research design to investigate changes in balance and gait in 8 adults with genetically confirmed FA and 8 healthy controls matched for gender, age, height, and weight. Subjects with FA were evaluated using the Berg Balance Scale (BBS), the Friedreich's Ataxia Rating Scale (FARS) and instrumented gait and balance measures at baseline, 6 months, 12 months and 24 months. Controls underwent the same tests at baseline and 12 months. Gait parameters were measured utilizing the GAITRite Walkway system with a focus on gait velocity, cadence, step and stride lengths, step and stride length variability and percent of the gait cycle in swing, stance and double limb support. Balance was assessed using the BBS and the Biodex Balance System; the latter included tests of postural stability and limits of stability. At baseline, there were significant differences in gait and balance parameters, BBS scores and FARS total scores between FA subjects and controls as determined using paired t-tests (p This is the first longitudinal study to demonstrate changes over time in gait and balance of adults with FA using both quantitative measures and clinical rating scales. This study provided a detailed characterization of the gait pattern and balance of adults with FA. The GAITRite Walkway system proved to be a sensitive measure, and able to detect subtle changes in gait parameters over time in adults with FA. In addition, the BBS was an appropriate and sensitive assessment to detect changes in static and dynamic balance in this patient cohort. Finally, results revealed a strong and consistent relationship between clinical rating scale scores, postural stability indices, limits of stability scores, and step and stride length variability in individuals with FA.

<p>Apoptosis is a type of cell death with a specific morphology and molecular program, which is essential for the development of the nervous system. However, inappropriate cell death has been implicated in several neurodegenerative diseases. The Bcl-2 protein family is a class of proteins, which can regulate the cell death program in either a positive (pro-apoptotic family members) or a negative (anti-apoptotic family members) way. </p><p> This thesis further elucidates the role of Bcl-2 family members in the nervous system. Special focus has been put on the anti-apoptotic family member Bcl-w, whose function in the nervous system was previously unknown, and the pro-apoptotic family member Bad which serves as a link between growth factor signalling and apoptosis.</p><p> Bcl-w mRNA was found to be upregulated during rat brain development suggesting increasing importance of Bcl-w with age in the nervous system. In contrast, mRNA levels encoding the anti-apoptotic protein Bcl-x were downregulated during development. Bcl-w was also found to have an anti-apoptotic function in neurons, rescuing sympathetic neurons from cell death after nerve growth factor deprivation.</p><p> To further elucidate the mechanism by which Bcl-w exerts its function, we screened a yeast two-hybrid library for proteins interacting with Bcl-w. Two of the isolated positive clones encoded the pro-apoptotic protein Bad and a novel splice variant of Bad with a different carboxyterminal sequence. Both isoforms of Bad induced cell death in sympathetic neurons, which could be counteracted by Bcl-w, indicating that Bcl-w and Bad can interact both physically and functionally.</p><p> Further studies on the genomic structure of the Bad gene suggested the presence of an additional splice variant, not expressing the first exon. Immunohistochemical analysis indicates that the isoform(s) not expressing the first exon is more widely expressed in adult rat brain than the known forms.</p><p> Finally, we show that high cell density can enhance survival of cerebellar granule neurons and that bcl-2 and bcl-x mRNA levels are upregulated in high density cultures.</p>

Apoptosis is a type of cell death with a specific morphology and molecular program, which is essential for the development of the nervous system. However, inappropriate cell death has been implicated in several neurodegenerative diseases. The Bcl-2 protein family is a class of proteins, which can regulate the cell death program in either a positive (pro-apoptotic family members) or a negative (anti-apoptotic family members) way. This thesis further elucidates the role of Bcl-2 family members in the nervous system. Special focus has been put on the anti-apoptotic family member Bcl-w, whose function in the nervous system was previously unknown, and the pro-apoptotic family member Bad which serves as a link between growth factor signalling and apoptosis. Bcl-w mRNA was found to be upregulated during rat brain development suggesting increasing importance of Bcl-w with age in the nervous system. In contrast, mRNA levels encoding the anti-apoptotic protein Bcl-x were downregulated during development. Bcl-w was also found to have an anti-apoptotic function in neurons, rescuing sympathetic neurons from cell death after nerve growth factor deprivation. To further elucidate the mechanism by which Bcl-w exerts its function, we screened a yeast two-hybrid library for proteins interacting with Bcl-w. Two of the isolated positive clones encoded the pro-apoptotic protein Bad and a novel splice variant of Bad with a different carboxyterminal sequence. Both isoforms of Bad induced cell death in sympathetic neurons, which could be counteracted by Bcl-w, indicating that Bcl-w and Bad can interact both physically and functionally. Further studies on the genomic structure of the Bad gene suggested the presence of an additional splice variant, not expressing the first exon. Immunohistochemical analysis indicates that the isoform(s) not expressing the first exon is more widely expressed in adult rat brain than the known forms. Finally, we show that high cell density can enhance survival of cerebellar granule neurons and that bcl-2 and bcl-x mRNA levels are upregulated in high density cultures.

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O enriquecimento ambiental (EA) é um modelo experimental capaz de promover a melhora no aprendizado e na formação de memórias hipocampo-dependentes, bem como a redução de manifestações comportamentais relacionadas ao estresse, incluindo a ansiedade. Embora a relação causal entre estresse e ansiedade ainda não está esclarecida, algumas evidências apontem para a importância da sinalização de hormônios glicocorticoides (via receptores GR e MR) no sistema nervoso central, principalmente na amígdala e no hipocampo, além do fator neurotrófico BDNF e de algumas vias de sinalização intracelular, como proteínas quinases MAPK e o fator de transcrição CREB. No presente trabalho verificamos que o EA previne o surgimento de sintomas do tipo ansioso desencadeado por estresse agudo em ratos, efeito verificado imediatamente após o estresse, e que tal efeito pode estar relacionado à modulação, no complexo amigdalóide basolateral, da sinalização nuclear de GR, da atividade de ERK (pertencente à família das MAPK) e de CREB, bem como à alteração na expressão do receptor de BDNF. / Environmental enrichment (EE) is an experimental model that promotes improvements in learning and memory, as well as reduction in stress-induced behaviors, including anxiety. Although the casual relationship between stress and anxiety remains unclear, some studies show the importance of glucocorticoids hormones signaling (via GR and MR receptors) in the central nervous system, primarily in the amygdala and the hippocampus. In addition, the significance of the neurotrophic factor BDNF and some intracellular signaling pathways, such as protein kinases MAPK and the transcription factor CREB, has been described. In this study we found that EE prevents the emergence of anxiety-related behavior triggered by acute stress in rats, an effect observed just after the stress stimulus. This effect may be related to the modulation, in the basolateral amygdala, of nuclear GR signaling, ERK (a MAPK protein) and CREB activity, as well as to changes in the expression of BDNF receptor.

La synaptogenèse est un processus précis : chaque type d'afférences innerve des domaines subcellulaires post-synaptiques spécifiques sur leur cible neuronale. Pour tester si cette spécificité est contrôlée par une combinaison unique de molécules à chaque synapse, j'ai utilisé le système olivo-cérébelleux comme modèle. Deux afférences excitatrices, les fibres parallèles issues des grains et les fibres grimpantes issues des neurones de l'olive inférieure, innervent des territoires distincts sur la même cible, la cellule de Purkinje. Une analyse comparative des profils d'expressions génique des grains et des neurones olivaires a montré que ces derniers expriment une plus grande diversité de protéines membranaires et sécrétées liées au système immunitaire. De plus, chaque type d'afférences exprime une combinaison spécifique de gènes liés à la voie du complément du système immunitaire inné. Parmi ceux-ci, la protéine sécrétée C1QL1, de la famille C1Q, joue un rôle instructif pour l'établissement du territoire d'innervation des fibres grimpantes sur les cellules de Purkinje. La protéine membranaire liée au complément SUSD4 assure, quant à elle, la maturation fonctionnelle et la stabilisation de ces synapses. Sachant que la protéine CBLN1 de la famille C1Q contrôle la synaptogenèse des fibres parallèles, ces résultats montrent que les différents membres de la famille C1Q sont des déterminants importants de l'identité et de la connectivité spécifique de chaque synapse excitatrice dans le cortex cérébelleux. Cette étude porte un nouvel éclairage sur l'hypothèse de la " chemoaffinité " et de sa participation à la formation de circuits neuronaux spécifiques et précis. / Synapse connectivity occurs in a precise manner such that no two types of afferents innervate the same postsynaptic subcellular domain. To test whether this specificity is controlled by a unique combination of molecules at each synapse, I used the olivo-cerebellar circuit as a model. There, two excitatory inputs, the Parallel fibers originating from granule cells and Climbing fibers originating from inferior olivary neurons, innervate distinct territories on the same target neuron, the Purkinje cell. Comparative gene expression analysis of these two inputs showed that the inferior olivary neurons express a greater diversity of genes encoding membrane and secreted proteins belonging to immune system-related pathways. Moreover, each input expresses a specific combination of complement-related genes. Among these, I identified the functional roles of two novel candidate genes specifically expressed by inferior olivary neurons. Secreted C1Q-related protein C1QL1 plays an instructive role in specifying Climbing fiber innervation territory on Purkinje cells, while membrane-bound complement control-related protein SUSD4 ensures the acquisition of proper functional properties of Climbing fiber synapses and their long-term stability. Given that C1Q-related CBLN1 promotes Parallel fiber synaptogenesis, these results show that different members of the C1Q family are important determinants of the identity and specific connectivity of each excitatory synapse in the cerebellar cortex. This study provides novel insights into the “chemoaffinity code” that controls subcellular specificity at each synapse type during the formation of neural circuits.

Les neurones sont des cellules excitables capables de coder et transmettre l’information sous forme d’oscillations du potentiel membranaire. Cette activité électrique est produite par une modification des flux ioniques transmembranaires. Les neurones constituent un exemple d’oscillateur cellulaire dont la dynamique non linéaire permet l’apparition d’une activité électrique complexe. Dans ce système, les ions calciques sont des messagers intracellulaires importants. Ils servent de médiateur entre un signal électrique et un signal chimique, par une modulation de l’activité enzymatique de certaines protéines. Ils interviennent dans de nombreuses fonctions neuronales, dont l’excitabilité électrique. Un des mécanismes mis en place par les neurones pour contrôler l’homéostasie du calcium intracellulaire provient de protéines cytoplasmiques capables de lier les ions calciques. Ces protéines jouent un rôle de « tampon » du calcium. Cependant, toutes leurs fonctions n’ont pas encore été mises en évidence. C’est l’objectif de notre travail. Nous avons voulu comprendre le rôle joué par une protéine « tampon » particulière, la calrétinine, sur le mode de décharge électrique d’un neurone où elle est exprimée en abondance, le grain cérébelleux. Pour cela, nous avons utilisé une approche théorique et expérimentale. Au niveau théorique, nous avons élaboré un modèle mathématique de l’activité électrique du grain cérébelleux, prenant en compte la chélation du calcium intracellulaire. Il permet de clarifier le rôle de la chélation du calcium intracellulaire sur les oscillations du potentiel membranaire. La modélisation de l’activité électrique du grain cérébelleux repose sur le formalisme développé par Hodgkin et Huxley pour l’axone géant de calmar. Dans ce contexte, l’application de la conservation de la charge au circuit équivalent de la membrane cellulaire fournit un système d’équations différentielles ordinaires, non linéaires. Dès lors, notre modèle nous a permis d’étudier l’impact des variations de la concentration de chélateur calcique sur les oscillations du potentiel membranaire. Nous avons ainsi pu constater qu’une diminution de la concentration en chélateur calcique induisait une augmentation de l’excitabilité électrique du grain cérébelleux, sans altérer le régime d’oscillations. Par contre, en augmentant fortement la concentration en chélateur calcique, nous avons montré que le grain cérébelleux changeait de dynamique oscillatoire, montrant des transitions d’un mode de décharge périodique régulier vers des oscillations en salve du potentiel membranaire. Au niveau expérimental, nous avons vérifié les résultats prévus par le modèle théorique. Nous avons ainsi montré que des grains de souris transgéniques déficientes en calrétinine présentaient une excitabilité électrique accrue par rapport aux grains contrôles. Puis, en restaurant un niveau de chélation calcique normal dans ces grains, par perfusion intracellulaire de chélateur calcique, nous montrons qu’ils retrouvent un niveau d’excitabilité normal. Ensuite, nous avons introduit dans des grains cérébelleux de souris sauvages, une forte concentration en chélateur calcique exogène. Conformément aux résultats théoriques, nous avons pu observer des transitions vers des oscillations en salve du potentiel membranaire. Enfin, nous avons montré que l’absence de calrétinine affecte les paramètres morphologiques du grain cérébelleux des souris transgéniques déficientes en calrétinine. En conclusion, ces résultats suggèrent que le mode de décharge des cellules excitables peut être modulé d’une façon importante par les protéines liant le calcium. De ce fait, des changements dans le niveau d’expression et/ou dans la localisation subcellulaire des protéines liant le calcium pourraient aussi jouer un rôle critique dans la régulation de processus physiologiques contrôlés par l’excitabilité membranaire. De plus, les mécanismes que nous avons mis en évidence pourraient être à l’origine d’un nouveau principe de régulation de la signalisation dans les circuits neuronaux et pourraient jouer un rôle fonctionnel dans le contrôle du codage de l’information et de son stockage dans le système nerveux central.

Nous présentons ici la description clinique et génétique d’un syndrome neurocutané unique. Le laboratoire du Dr Cossette a entrepris la caractérisation clinique et génétique d'une famille canadienne-française qui a été identifiée par les Drs Giroux et Barbeau en 1972 et qui comprend plus de 100 personnes sur six générations. Les membres atteints de cette famille présentent des lésions typiques d'érythrokératodermie (EK) (OMIM 133190, EKV1 et EKV2), associées à une ataxie spinocérébelleuse pure. Dans cette famille, l'ataxie est caractérisée par des troubles de la coordination et de la démarche causés par une dégénérescence du cervelet et de la moelle épinière. Cette ataxie est transmise selon un mode autosomique dominant. Une étude antérieure de cette variante d'EK avec ataxie avait suggéré une liaison sur le chromosome 1p34-p35, soit la même région que les formes EKV de type 1 et 2, causées respectivement par des mutations dans les gènes connexin-31 (GJB3; OMIM 603324) et connexin-30.3 (GJB4; OMIM 605425). Cependant, aucune mutation n'a été retrouvée dans ces gènes pour la famille canadienne-française. Nous avons récemment recontacté la famille et effectué des examens détaillés, incluant une imagerie par résonance magnétique (IRM) et un électromyogramme (EMG). Les manifestations neurologiques des individus atteints sont compatibles avec une nouvelle forme d’ataxie cérébelleuse pure à transmission autosomique dominante (ADCA de type III dans la classification de Harding) que nous avons appelée SCA34. Une cartographie complète du génome nous a permis de localiser le gène SCA34 sur le chromosome 6p12.3-q16.2. Également, en collaboration avec les Drs Alexis Brice (Hôpital Pitié-La Salpêtrière, Paris) et Alfredo Brusco (Hôpital San Giovanni Battista di Torino, Italie), nous avons confirmé que trois autres familles européennes avec SCA inexpliquée étaient également liées au locus SCA34. Notre laboratoire a récemment entrepris la recherche des mutations responsables de SCA34. Les résultats de ce criblage de gènes candidats sont présentés dans le chapitre 3 de cette thèse. / We present here the clinical and genetic description of a unique neuro-cutaneous syndrome. Dr. Cossette’s laboratory began the clinical and genetic characterization of a French-Canadian family who was identified by Drs. Giroux and Barbeau in 1972 and includes more than 100 people over six generations. The affected members of this family have typical lesions of erythrokeratodermia (EK) (OMIM 133190, and EKV1 EKV2), associated with pure spinocerebellar ataxia. In this family, the clinical phenotype is characterized by gait ataxia caused by degeneration of the cerebellum and spinal cord and the pattern of inheritance is compatible with an autosomal dominant trait. In a previous study of this variant of ataxia with EK, putative linkage was found on chromosome 1p34-p35, the same chromosomal region of EKV1 and EKV2 that are respectively caused by mutations in the connexin-31 gene (GJB3, OMIM 603324) and connexin -30.3 (GJB4, OMIM 605425). However, no mutations have been found in these latter genes for the French-Canadian family. We recently contacted the family and carried out detailed examinations, including a magnetic resonance imaging (MRI) and electromyography (EMG). Neurological manifestations of affected individuals are consistent with a new form of pure autosomal dominant cerebellar ataxia, (ADCA type III in the classification of Harding) that we named SCA34. A whole genome scan allowed us to map the gene on chromosome 6p12.3-q16.2. Interestingly, in collaboration with Dr. Alexis Brice (Hôpital Pitié-La Salpêtrière, Paris), and Alfredo Brusco (San Giovanni Battista Hospital, Turin, Italy), we found that three additional European families with unexplained SCA were also linked to the SCA34 locus. Our laboratory has recently begun the search for mutations causing SCA34. The results of this screening of candidate genes are presented in Chapter 3 of this thesis.

This study involved the effects of a perceptual motor enrichment program upon the motor skills of a six year old boy with cerebellar brain damage, who, with a control group of ten normal six year olds, was given a pre-test of motor skills. He and a child from the control group participated in a perceptual-motor enrichment program. The motor skills of both subjects were tested halfway through the program. Following the program, the experimental child, the control child, and the control group were post-tested on their motor skills. The testings showed that the greatest gains in motor skills were obtained by the experimental child, followed by the control child. The control group displayed little increase in motor skill performance.

Introduction: Biofeedback based on sensory substitution is a new method to treat patients with postural disorders. BrainPort provides tongue electrotactile stimulation. This innovative technique was developed for vestibular dysfunction of peripheral origin. Primarily for patients who had no benefits from conventional rehabilitation. Tongue electrotactile stimulation seems to be useful for central vestibula dysfunction as well. We are dealing with effect of BrainPort in therapy of degenerative cerebellar ataxia. We are interested in whether the effects persist for one month after the rehabilitation program. Methods: The methods are applied in 6 patients with degenerative cerebellar ataxia, verified by clinical testing, posturography, and genetic testing or verification of cerebellar lesions by MRI. Patients underwent an 12-day intensive rehabilitation program with BrainPort. Treatment was carried out 2 times a day. Patients were learning appropriate postural corrections to maintain signal in the middle of the tongue. To assess the effect of therapy we used posturography, standardized clinical tests - BESTest, Dynamic Gait Index (DGI) and standardized questionnaires - The Activities-Specific Balance Confidence Scale (ABC) and Dizzines Inventroy Handicap (DHI). The examination was performed before...