($-$)Deprenyl is an irreversible inhibitor of monoamine oxidase B (MAO-B) frequently used as an adjuvant therapy in the treatments of Parkinson's and Alzheimer's Disease (PD and AD). Recent evidence, however, has found that certain deprenyl metabolites are associated with an anti-apoptotic action within some neuronal populations. Interestingly, deprenyl's anti-apoptotic actions do not depend upon the inhibition of MAO-B. Due to a paucity of information surrounding ($-$)deprenyl's ability to spare neurons in vivo, a series of studies were conducted to further investigate this phenomenon in two diverse models of apoptotic neuronal death: hypoxia/ischemia and kainic acid induced excitotoxicity. Results indicated that ($-$)deprenyl reduced delayed neuronal death in a model of unilateral global ischemia/hypoxia within the CA1 CA3 and CA4 subfields of the hippocampus as compared to saline-treated subjects, and that the observed parameters were consistent with an anti-apoptotic action of ($-$)deprenyl, but inconsistent with MAO-B inhibition. Similarly, within the kainic acid model of apoptotic neuronal death, data revealed that ($-$)deprenyl increased hippocampal neuronal numbers compared to saline-matched controls. Furthermore, it was discovered that ($-$)deprenyl treatment could be stopped 14 days following CNS insult by kainate, with evidence of neuronal sparing still present by day 28, and that ($-$)deprenyl treatment can produce functional recovery of normal exploratory behaviour within an open-field paradigm following kainate administration. Given deprenyl's anti-apoptotic actions, it is proposed that ($-$)deprenyl may be beneficial in the treatment of a variety of neurodegenerative diseases where evidence of apoptosis exists, such as PD and AD, by slowing the disease process itself.

This thesis is on chronic neck pain after a rear impact car injury, so called whiplash associated disorder (WAD). Three empirical studies using positron emission tomography (PET) with different radioligands have been performed. The first study evaluated resting state regional cerebral blood flow (rCBF) in WAD patients and in healthy, pain-free controls, by use of oxygen-15 labeled water. Patients had heightened resting rCBF bilaterally in the posterior parahippocampal and the posterior cingulate gyri, in the right thalamus and in the right medial prefrontal gyrus. Attenuated tempero-occipital blood flow was also observed in the patient group as compared to healthy controls. Alterations in rCBF were related to patients’ neck disability ratings. Study I suggests an involvement of the posterior cingulate, the parahippocampal and the medial prefrontal gyri in WAD. This altered resting state neural activity may be linked to an increased self-relevant evaluation of pain and stress. The second study evaluated central expression of the neurokinin-1 (NK1) receptor in WAD patients and healthy controls. Using a carbon-11 labeled specific NK1 antagonist, the receptor availability was measured. Patients displayed lowered NK1 receptor availability in the insula, anterior cingulate, frontal lobe, hippocampus, amygdala and in the periaqueductal gray matter, consistent with results from animal models of chronic pain. NK1 receptor availability was most reduced in the ventromedial orbitofrontal cortex, where attenuations were linearly related to patients fear and avoidance of movement. Thirdly, carbon-11 labeled D-deprenyl was used to investigate the presence of locally inflamed soft tissue in the cervical neck in WAD patients. Although the retention mechanism of [11C]D-deprenyl is not known, the results suggest that WAD patients have chronic inflammatory processes in the neck, most commonly in the adipose tissue at the spineous process of the second vertebra. In summary, this thesis provides evidence for altered central blood flow and receptor characteristics in WAD patients. Further, WAD patients may also have signs of persistent peripheral tissue damage. Both central and peripheral pain mechanisms have been demonstrated and visualized in patients with whiplash associated disorder.

Epilepsy is a common neurological disease affecting 6 million people in Europe. Early prevention and accurate diagnosis and treatment are of importance to obtain seizure freedom. In this thesis new applications of carbon-11-labelled tracers in PET and autoradiographic studies were explored in focal epilepsy. Patients with low-grade gliomas often experience epileptic seizures. A retrospective PET-study assessing seizure activity, metabolic rate measured with 11C-methionine and other known prognostic factors was performed in patients with glioma. No correlation was found between seizure activity and uptake of methionine. The presence and termination of early seizures was a favourable prognostic factor. Activation of the neurokinin-1 (NK1) receptor by substance P (SP) induces epileptic activity. PET with the NK1 receptor antagonist GR205171 was performed in patients with temporal lobe epilepsy (TLE) and healthy controls. In TLE patients an increased NK1 receptor availability was found in both hemispheres, most pronounced in anterior cingulate gyrus ipsilateral to seizure onset. A positive correlation between NK1 receptors and seizure frequency was observed in ipsilateral medial structures consistent with an intrinsic network using the NK1-SP receptor system for transmission of seizure activity. The uptake of 18F-fluoro-deoxy-glucose (FDG) is related to cerebral blood flow (CBF). Previously, methods to estimate blood flow from dynamic PET data have been described. A retrospective study was conducted in 15 patients undergoing epilepsy surgery investigation, including PET with 11C-FDG and 11C-Flumazenil (FMZ). The dynamic FMZ dataset and pharmacokinetic modeling with a multilinear reference tissue model were used to determine images of relative CBF. Agreement between data of FDG and CBF was analyzed showing a close association between interictal brain metabolism and relative CBF. Epilepsy often occurs after traumatic brain injuries. Changes in glia and inhibitory neuronal cells contribute to the chain of events leading to seizures. Autoradiography with 11C-PK11195, 11C-L-deprenyl and 11C-Flumazenil in an animal model of posttraumatic epilepsy studied the temporal and spatial distribution of microglia, astrocytes and GABAergic neurons. Results showed an instant increase in microglial activity that subsequently normalized, a late formation of astrogliosis and an instant and prolonged decease in GABA binding. The model can be used to visualize pathophysiological events during the epileptogenesis.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O trabalho mostra o tratamento e os efeitos do l-deprenil (DEP), no aprendizado, na memÃria e na peroxidaÃÃo lipÃdica em cÃrebros de ratos submetidos à isquemia cerebral transitÃria (ICT). Os animais (ratos Wistar, fÃmeas, 200-250g) foram submetidos à isquemia cerebral transitÃria pela oclusÃo de ambas as artÃrias carÃtidas durante 20 minutos e tratados durante 5 dias com DEP (5 e 10 mg/kg). A temperatura retal foi monitorada e mantida em torno de 37ÂC atravÃs de uma luz incandescente. O mesmo procedimento foi feito no grupo controle + salina, Falso-operado + salina (FO) com exceÃÃo do clampeamento das artÃrias carÃtidas. No 6 dia apÃs a induÃÃo da isquemia, os animais foram submetidos aos testes de atividade locomotora e memÃria (esquiva passiva, labirinto em T elevado e labirinto aquÃtico de Morris), a seguir foram sacrificados e os cÃrebros dissecados sobre gelo (hipocampo e cÃrtex temporal) para as determinaÃÃes de MDA, nitrito/nitrato e atividade da catalase e atividade da protease caspase-3. No protocolo de avaliaÃÃo da Ãrea total do infarto encontramos apÃs 1 hora de ICT uma Ãrea de infarto 38,01  3,44% da Ãrea total do cÃrebro, e apÃs 24 horas de ICT uma Ãrea de infarto 22,00  2,90% da Ãrea total do cÃrebro. Os parÃmetros fisiolÃgicos estudados nÃo mostraram alteraÃÃes entre os grupos ICT e FO. Nenhuma alteraÃÃo na atividade locomotora foi detectada nos grupos FO, ICT, Dep 10 + ICT. PorÃm, um aumento na atividade locomotora foi observado no grupo Dep 5 + ICT (7,37  1, 77, p< 0,02) quando comparado com o grupo FO, tratado com salina, (4,66  1,54). No teste do Labirinto em T elevado (T Maze) a ICT afetou os processos de aquisiÃÃo e retenÃÃo de memÃria quando os animais foram testados no mesmo dia (esquiva 1 e 2) quando comparados com o grupo controle (FO). O teste de Kruskall-Wallis mostrou alteraÃÃo significativa na latÃncia da esquiva inibitÃria (esquiva 1 e 2 quando comparados com o treino) no falso-operado (FO - treino: 20,34  3,43 s; esquiva 1 - 231,6  34,81 s; esquiva 2 â 247,8  27,25 s; KW = 19,62, p< 0,001), e no grupo l-deprenil (5 e 10 mg/kg) + isquemia (Dep 5 â treino: 110,8  56,16 s; esquiva 1 - 299,8  0,16 s; esquiva 2 â 260  40,00 s; KW = 9,16, p< 0,01. Dep 10 â treino: 29,15  8,64 s; esquiva 1 â 299,80  0,25 s; esquiva 2 299,8  0,25 s; KW = 6,98, p< 0,05). Isto indica uma boa aquisiÃÃo de memÃria. Portanto, o resultado do grupo ICT + salina indicou um dÃficit da memÃria (ICT â treino: 37,75  11,52 s; esquiva 1 â 116,30  65,46 s; treino 2 â 195,00  64,10 s; KW = 3,90, p< 0,141). AlÃm disso, existiu uma diferenÃa significativa (Teste Mann-Whitney) entre os grupos na esquiva 3 (retenÃÃo) quando comparados com o grupo ICT (Dep 5, MW (3) = 18,483, p< 0,0003, Dep 10, MW (3) = 18,483, p< 0,003) significando que a retenÃÃo da memÃria foi aumentada pelo tratamento com a droga. No teste da esquiva passiva os animais do grupo controle (FO + salina) apresentaram uma boa retenÃÃo da memÃria, tanto na fase imediata (memÃria recente - MR), quanto na fase de consolidaÃÃo (memÃria tardia - MT), quando comparadas ao treino (ANOVA) (FO + salina (n-7)- treino - 15,94  4,40 s, MR - 138,84  34,60 s, MT - 196,32  34, 71, p< 0,006). Por outro lado, os animais que sofreram ICT nÃo apresentaram diferenÃa no tempo de latÃncia de entrada no lado escuro quando comparado com o treino, significando um dÃficit na aprendizagem e memÃria (ICT (n-7)- treino - 34,37  10,16 s, MR - 105,54  35,21 s, MT - 96,20  33, 44, p< 0,33), e, portanto dano na aquisiÃÃo e retenÃÃo da memÃria. Comparando os tratamentos observamos um aumento significativo, no tempo de latÃncia de entrada no lado escuro do aparelho, nos ratos tratados com l-deprenil 5 mg/kg quando avaliados na MR (FO + salina- 138,84  34,60s; ICT - 105,54  35,21; ICT + Dep 5- 198,88  38,42s; ICT + Dep 10- 188,06  34,60s; Kruskall-Wallis, KW-9,66, p<0,05, Mann-Whitney, Dep 5 vs ICT, p<0,05), enquanto na MT foi observada uma diminuiÃÃo significativa, no tempo de latÃncia de entrada no lado escuro do aparelho, nos ratos tratados com l-deprenil (5 e 10 mg/kg) (FO + salina- 196,32  34,71s; ICT - 96,20  33,44s; ICT + Dep 5- 299,83  0,16s; ICT + Dep 10- 264,70  35,28 s; Kruskall-Wallis, KW-14,57, p<0,05, Mann-Whitney, Dep 5 e Dep 10 vs ICT, p<0,05), significando melhora no aprendizado do animal fazendo-o lembrar o choque recebido durante o treino e indicando uma reversÃo da lesÃo sofrida com a ICT. No teste do Labirinto AquÃtico (Water Maze) a ICT promoveu um dano da retenÃÃo na memÃria dos animais em relaÃÃo ao grupo controle (FO), porÃm o l-deprenil conseguiu reverter o dano na aquisiÃÃo da memÃria induzida pela ICT em ambas as doses (5 e 10 mg/kg), observamos tambÃm que o grupo Dep 5 obteve um melhor desempenho na aquisiÃÃo da memÃria quando comparado com o grupo Dep 10. (FO (n-10): 5,4  0,84s; FO + DEP 10 (n-10): 9,7  2,28s; ICT (n-9): 32,44  2,95s; ICT + DEP 5 (n-8): 12,88  1,4s; ICT + DEP 10 (n-8): 4,5  0,70s; Kruskall-Wallis, KW-29,07, p<0,05, Mann-Whitney, FO + DEP 10, Dep 5 e Dep 10 vs ICT, p<0,05). Os ratos submetidos a ICT mostraram um aumento de 71% nos nÃveis de MDA no hipocampo quando comparados com o grupo controle (FO), e o tratamento com l-deprenil reverteu significativamente este efeito (p<0,05). Os valores dos nÃveis de MDA foram trazidos prÃximos aqueles valores do grupo controle (FO) em relaÃÃo aos grupos (ICT + DEP 5 e ICT + DEP 10, 34 e 38%, respectivamente) com ambas as doses de l-deprenil mais ICT (Hipocampo - FO (n-7): 45,4  4,45; ICT (n-7): 77,6  8,97; ICT + DEP 5 (n-7): 51,2  1,68; ICT + DEP 10 (n-7): 48,5  6,70 nmoles/g; p<0,05, ANOVA e Teste de Tukey). No cÃrtex temporal, a ICT nÃo aumentou os nÃveis de MDA quando comparados com o grupo controle. Portanto, os ratos submetidos a ICT e tratados com altas doses de l-deprenil (10 mg/kg) apresentaram nÃveis de MDA 30% menor que aqueles mostrados por ambos os grupos FO e ICT (CÃrtex temporal - FO (n-7): 46,8  4,36; ICT (n-7): 48,7  1,33; ICT + DEP 5 (n-7): 52,5  3,74; ICT + DEP 10 (n-7): 33,4  2,98 nmoles/g; p<0,05, ANOVA e Teste de Tukey). No hipocampo, os nÃveis de nitrito foram significativamente aumentados apÃs a ICT quando comparados com o grupo controle FO (82% aumento). O DEP 10 reverteu este efeito e os valores foram trazidos para aqueles do controle. Por outro lado, a isquemia nÃo afetou os nÃveis de nitrito no cÃrtex, entretanto o DEP 5 diminui significativamente os nÃveis de nitrito quando comparados com os grupos controle e ICT. A ICT mostrou um aumento em 50 % da atividade da protease caspase-3 no hipocampo; e o tratamento com l-deprenil (10 mg/kg) reverteu este efeito trazendo os valores prÃximos aos do grupo controle (FO), porÃm o tratamento com DEP 5 nÃo mostrou o mesmo (Valor da AbsorbÃncia: FO â 0,083  0,006; ICT - 0,124  0,017; ICT + DEP 10 â 0,080  0,007; ICT + DEP 5 â 0,125  0,007), porÃm nos animais controle que receberam tratamento com DEP 10 (FO + DEP 10) a atividade da caspase â 3 diminui em 99% em relaÃÃo ao grupo ICT. Em conclusÃo mostramos que a administraÃÃo do l-deprenil diariamente por 5 dias melhorou os danos da memÃria observados apÃs a isquemia cerebral transitÃria em ratos. A droga protegeu o cÃrebro contra a hiperperoxidaÃÃo e formaÃÃo de radicais livres observados apÃs o dano isquÃmico, como diminui a atividade da caspase â 3. Pelo menos parte desses efeitos à devido ao efeito antioxidante e conseqÃentemente inibiÃÃo da ativaÃÃo da produÃÃo de radicais livres pelo l-deprenil. / The present work shows the effects of l-deprenyl (DEP, 5 and 10 mg/kg, po) on memory, as well as on rat brain free radical formation after transient cerebral ischemia (TCI). Wistar rats were anesthetized and submitted to TCI by occlusion of both carotid arteries for 20 minutes. In another experiment, animals were submitted to surgery without ischemia (sham-operated). After surgery, ischaemic rats were treated with DEP (DEP, 5 and 10 mg/kg, po) once and daily for 5 days. One group of animals was left untreated (controls). The parameters studied were, memory acquisition and memory retention, locomotor activity and tiobarbituric acid reactive substances, as an index of lipid peroxidation. After treatment all, animals were submitted to passive avoidance test, water maze test and elevated T maze test, and 24 h later sacrificed and their hippocampi and temporal cortex dissected for evaluation of lipid peroxidation and used for catalase activity determinations. The protein concentration was measured according to the method described by Lowry (1951). In another set of experiments the animals were sacrificied forty eight hours after ischemia for caspase activity evaluation. Results show that DEP significantly reversed ischaemia-induced memory deficits. l-Deprenyl treatment significantly improved memory deficits as compared to ischemic group as measured by The elevated T maze and Water maze tests. A similar result was observed on the passive avoidance test where l-deprenyl improved late but not early memory as compared to the ischemic group. Except for an increased locomotor activity observed in the group treated with 5 mg/kg, no other alteration was detected in this behavioral test. Rats submitted to transient cerebral ischemia (and without l-deprenyl) showed an increase im MDA levels in the hippocampus and the treatment with l-deprenyl (5 and 10 mg/kg) significantly reversed this effect bringing values close to those of the sham-operated controls. A similar profile was observed with nitrite levels. Rats submitted to transient cerebral ischemia show an increase in caspase activity in the hippocampus and the treatment with l-deprenil (10 mg/kg) significantly reversed this effect bringing values close to those of the sham-operated controls. Moreover catalase activity in the hippocampi was not altered by ischemia. In conclusion, the work showed a signifant protective effect of l-deprenyl on memory deficits and lipid hyperperoxidation observed after cerebral ischemia. Possibly, the drug is acting at least in part through its antioxidant and antiapoptotic activities.

New biomarkers are needed to improve knowledge about pathophysiology, in order to provide earlier correct diagnosis and to follow disease progression of the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD). The aim of this thesis was to find new biomarkers for these diseases. First, increased serum levels and unchanged levels in postmortal spinal cord of vascular endothelial growth factor (VEGF) were demonstrated. VEGF was not detected in cerebrospinal fluid (CSF) in ALS. Second, increased levels of fibroblast growth factor 2 were found in the CSF and serum of ALS patients. Both studies used enzyme-linked immunoassays. Third, a proteomics method for CSF analysis was explored, based on tryptic digestion and subsequent separation and detection of the peptides by on-line liquid chromatography-Fourier transform ion cyclotron resonance mass spectrometry. ALS-specific patterns were observed. Four out of five samples were correctly assigned, but no single protein biomarker could be identified. Fourth, [11C](L)-deprenyl-D2 (DED) positron emission tomography (PET) demonstrated increased retention in the pons and white matter in ALS. DED binds to monoamino oxidase B, which in the brain is primarily located in astrocytes. Thus evidence was provided that astrocytosis may be detected in vivo in ALS. Fifth, normal [11C]-PIB binding in five nondemented patients with PD was reported, in contrast to previous findings of increased retention in Alzheimer's disease reflecting amyloid aggregation. Finally, the combined use of fluorodeoxyglucose and L-[β 11C]-DOPA PET for the differential diagnosis of parkinsonian syndromes was evaluated. PET provided support for the clinical diagnosis in 62 out of 75 patients, and served to exclude suspected diagnoses in another five patients.

The pathological process behind abdominal aortic aneurysm (AAA) formation is poorly understood and difficult to study. The aim of the thesis was to study the pathophysiology of AAA formation with positron emission tomography (PET) technology, a molecular imaging technique, allowing in vivo studies of pathophysiological changes. In study I 18F-FDG, a glucose analogue, was tested. It had previously been reported as a useful tracer studying inflammation in AAAs. These studies included, however, foremost large, symptomatic, and inflammatory AAAs. In the present study on five small and seven large asymptomatic AAAs, no increase in 18F-FDG uptake could be revealed in vivo. In study II 11C-PK11195, a macrophage tracer, and 11C-D-deprenyl, an unspecific inflammatory tracer, previously never tested on asymptomatic AAAs, were tested in vivo on five and 10 AAA-patients respectively, without signs of increased levels of inflammatory activity in the aorta. In study III several tracers were screened in vitro through autoradiography on AAA tissue. [18F]fluciclatide, targeting the integrin αVβ3 receptor upregulated in angiogenesis, was the only tracer with an increased uptake. In study IV [18F]fluciclatide-autoradiography was performed on AAA tissue from five patients and non-aneurysmal aortic tissue obtained from five age and sex matched organ donors. The study showed a 56% increased specific uptake in AAA, although not significant (P=0.136). Immunohistochemical revealed inflammatory cell foci in close relation to the vessels. In conclusion, PET has potential to elucidate the pathophysiology of AAA formation. For the large group of small asymptomatic AAAs, 18F-FDG is not suitable, as the chronic inflammation in asymptomatic AAA is not sufficiently metabolically active. Furthermore, 11C-PK11195 and 11C-D-deprenyl were unable to show the chronic inflammation seen in asymptomatic AAA. The interesting finding with uptake of [18F]fluciclatide showed that angiogenesis may be imaged in large asymptomatic AAAs in vitro, through the integrin αVβ3 receptor. Thus, it is likely that future studies of the role of angiogenesis in AAA formation in vivo, in small AAAs, could use this target site. The development of an integrin αVβ3 receptor tracer, preferably with higher affinity, is in progress for further in vitro and in vivo studies.