A esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa que afeta os neurônios motores levando a atrofia muscular e morte por insuficiência respiratória. Esta patologia se manifesta de forma esporádica ou familiar, que são indistinguíveis clinicamente. Mutações na enzima antioxidante superóxido dismutase 1 (hSod1) respondem por aproximadamente 20% dos casos familiares de ELA. Além disso, o caráter autossômico dominante destas mutações revela que a hSod1 adquire propriedades tóxicas aos neurônios motores. Atualmente, duas hipóteses não mutuamente excludentes existem para explicar o caráter tóxico das mutantes da hSod1 relacionadas à ELA. A primeira refere-se à produção de oxidantes pela atividade peroxidásica exacerbada das mutantes contribuindo para o estresse oxidativo observado em ELA. A segunda refere-se à agregação de proteínas como ocorre em outras doenças neurodegenerativas. Digno de nota, o radical carbonato produzido na atividade peroxidásica da hSod1 causa a formação de um dímero covalente da proteína análogo a uma espécie de hSod1 frequentemente detectada em modelos experimentais e pacientes da doença e associada à propriedade tóxica das mutantes. Desta forma, o presente trabalho buscou esclarecer o mecanismo de produção do radical carbonato pela hSod1, bem como caracterizar o dímero covalente da proteína para posterior estudo de sua formação em um modelo de ELA em ratos que superexpressam a mutante G93A da hSod1. Os estudos cinéticos da variação do pH sobre os efeitos de bicarbonato/CO2, nitrito e formato na atividade peroxidásica da hSod1, medidos pelo consumo de peróxido de hidrogênio e produção de radical, permitiram excluir o mecanismo de Fenton para explicar o ciclo peroxidativo da enzima em tampão bicarbonato em favor de outros intermediários reativos. Já, os experimentos de 13C RMN, modelagem molecular e cinética de fluxo interrompido com mistura assimétrica demonstraram que o ânion peroxomonocarbonato constitui o precursor do radical carbonato produzido pela hSod1. A caracterização do dímero covalente da hSod1 por proteólise com tripsina seguida de análise por HPLC/UV-vis e HPLC/ESI-MS identificou um peptídeo característico do dímero covalente da hSod1. A digestão enzimática em H2 18O demonstrou de forma inequívoca a natureza dímerica deste peptídeo pela marcação da extremidade C-terminal. Ainda, o sequenciamento do peptídeo dimérico por MS/MS revelou a estrutura primária ESNGPVKVW(ESNGPVKVWGSIK)GSIK, na qual as cadeias polipeptídicas estão ligadas através de um aduto de ditriptofano composto por resíduos Trp32 da proteína. Por fim, este peptídeo dimérico pode ser empregado como marcador bioquímico específico para o estudo do dímero covalente da hSod1 in vivo. A análise do extrato de proteínas das medulas dos ratos modelo de ELA identificou quinze candidatos a dímero covalente da hSod1 por Western-blot, sendo que dois deles foram excluídos por espectrometria de massa, pois tiveram o resíduo Trp32 identificado. O peptídeo ESNGPVKVW(ESNGPVKVWGSIK)GSIK não foi observado, porém as treze espécies restantes permanecem candidatas e deverão ser reexaminadas em trabalhos que darão sequência a esta tese de doutorado. Em suma, o peroxomonocarbonato constitui o intermediário na produção do radical carbonato pela hSod1 e o peptídeo ESNGPVKVW(ESNGPVKVWGSIK)GSIK uma ferramenta importante no estudo da agregação covalente da hSod1 em ELA. / Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of motors neurons that causes muscle atrophy, weakness, and death by respiratory failure. This pathology occurs in both sporadic and familiar forms that are clinically indistinguishable. Mutations in the antioxidant enzyme superoxide dismutase 1 (hSod1) respond to about 20% of the familiar cases of ALS. Besides, the autosomal dominant nature of these hSod1-associated ALS suggests that the mutants gain toxic properties to motor neurons. Currently, two hypotheses exist to explain the toxicity of hSod1 mutants but they do not exclude each other. The first one is related to the production of oxidants by the increased peroxidase activity of the ALS-linked mutants that could contribute to the oxidative stress reported in ALS. The second refers to protein aggregation as proposed in other neurodegenerative diseases. Noteworthy, the carbonate radical produced during hSod1 peroxidase activity leads to the formation of a covalent dimer of the protein similar to a hSod1 species often detected in experimental models and patients of the disease and implicated in the toxic properties of hSod1 mutants. Thus, the present work aimed to determine the mechanism of carbonate radical production by hSod1 and to characterize the covalent dimer of the protein in vitro followed by the study of covalent aggregates of hSod1 in a rat model of ALS that overexpresses the G93A mutant of the protein. The kinetic studies of the effect of bicarbonate/CO2, nitrite and formate in the peroxidase activity of hSod1 at various pH, measured by hydrogen peroxide consumption and radical production, permitted to exclude the Fenton mechanism to explain the enzyme peroxidative cycle in bicarbonate buffer in favor of other reactive intermediates. Furthermore, 13C NMR, molecular docking and stopped-flow experiments with asymmetric mixing demonstrated that the anion peroxomonocarbonate is the precursor of the carbonate radical produced by hSod1. The characterization of hSod1 covalent dimer by proteolysis with trypsin followed by HPLC/UV-vis and HPLC/ESI-MS analysis identified a peptide characteristic of the covalent dimer of the protein. The enzymatic digestion in H2 18 O irrefutably demonstrated the dimeric nature of this peptide because of the C-terminal labeling with oxygen-18 isotopes. In addition, sequencing of the dimeric peptide by MS/MS determined the primary structure ESNGPVKVW(ESNGPVKVWGSIK)GSIK, in which the polipeptide chains are crosslinked through a ditryptophan adduct formed by a covalent bond between the Trp32 residues of each subunit. So, this dimeric peptide can be employed as a biochemical marker for studying the hSod1 covalent dimer in vivo. The analysis of protein extracts from the spinal cord of the rat model of ALS by Western-blot identified fifteen candidates to hSod1 covalent dimer, but two of them were excluded by mass spectrometry analysis that identified unmodified Trp32 residues. Moreover, neither the dimeric peptide nor the Trp32 residue were observed in the remaining species. Therefore, these thirteen candidates must be reexamined in subsequent studies. In conclusion, the anion peroxomonocarbonate is the key intermediate in the production of the carbonate radical by hSod1 and the dimeric peptide constitutes a specific tool to study hSod1 covalent aggregation in ALS

The overall objective of this dissertation was to examine exposures to the estrogenic endocrine disrupting chemicals (EEDCs), phthalates, bisphenol-A (BPA), and the metalloestrogens cadmium (Cd), arsenic (As), and manganese (Mn) in an older geriatric aged-population and examine associations with brain health. Given the evidence that EEDCs affect brain health and play a role in the development of cognitive dysfunction and neurodegenerative disease, and the constant environmental exposure through foods and everyday products has led this to becoming a great public health concern. Using a bioinformatic approach to find nuclear respiratory factor 1 (NRF1) gene targets involved in mitochondrial dysfunction, that are both estrogen and EEDC-sensitive, we found several genes involved in the gene pathways of Alzheimer’s disease (AD): APBB2, EIF2S1, ENO1, MAPT, and PAXIP1. Using the Center for Disease Control and Prevention (CDC), National Health and Nutrition Examination Survey (NHANES) 2011-2014 datasets to assess EEDC bioburden and associations with surrogate indicators of brain health, which include cognitive scores, memory questions, and taste and smell data, we found phthalate bioburden to be significantly higher in those with adverse brain health vii and significantly higher in females. In our logistic regression model when controlling for all known and suspected covariates in AD, in females, the phthalates in females ECP, MBP, MOH, MZP, and MIB in males and the phthalates COP, ECP, MBP, MC1, MEP, MHH, MOH, and MIB were significantly associated with poor cognitive test scores, poor memory, and taste and smell dysfunction. Among the metalloestrogens, Cd bioburden was higher in those with poor cognitive performance, poor memory, and taste and smell dysfunction, with the trend more significant in males. Among oral contraceptive (OC) and HRT (hormone replacement therapy) use, in our logistic regression model when controlling for all known and suspected covariates in AD, past OC and HRT use was associated with better cognitive test scores. The study provides further evidence of the complex role EEDCs play in overall brain health through other biological mechanisms and fills a gap in knowledge that demonstrates EEDCs effects on brain health in a geriatric age population.

Trinucleotide repeat (TNR) instability including repeat expansions and repeat deletions is the cause of more than 40 inherited incurable neurodegenerative diseases and cancer. TNR instability is associated with DNA damage and base excision repair (BER). In this dissertation research, we explored the mechanisms of BER-mediated TNR instability via biochemical analysis of the BER protein activities, DNA structures, protein-protein interaction, and protein-DNA interaction by reconstructing BER in vitro using synthesized oligonucleotide TNR substrates and purified human proteins. First, we evaluated a germline DNA polymerase β (pol β) polymorphic variant, pol βR137Q, in leading TNR instability-mediated cancers or neurodegenerative diseases. We find that the pol βR137Q has slightly weaker DNA synthesis activity compared to that of wild-type (WT) pol β. Because of the similar abilities between pol βR137Q and WT pol β in bypassing a template loop structure, both pol βR137Q and WT pol β induces similar amount of repeat deletion. We conclude that the slightly weaker DNA synthesis activity of pol βR137Q does not alter the TNR instability compared to that of WT pol β, suggesting that the pol βR137Q carriers do not have an altered risk in developing TNR instability-mediated human diseases. We then investigated the role of DNA synthesis activities of DNA polymerases in modulating TNR instability. We find that pol βY265C and pol ν with very weak DNA synthesis activities predominantly promote TNR deletions. We identify that the sequences of TNRs may also affect DNA synthesis and alter the outcomes of TNR instability. By inhibiting the DNA synthesis activity of pol β using a pol β inhibitor, we find that the outcome of TNR instability is shifted toward repeat deletions. The results provide the direct evidence that DNA synthesis activity of DNA polymerases can be utilized as a potential therapeutic target for treating TNR expansion diseases. Finally, we explored the role of post-translational modification (PTM) of proliferating cell nuclear antigen (PCNA) on TNR instability. We find that ubiquitinated PCNA (ub-PCNA) stimulates Fanconi associated nuclease 1 (FAN1) 5’-3’ exonucleolytic activities directly on hairpin structures, coordinating flap endonuclease 1 (FEN1) in removing difficult secondary structures, thereby suppressing TNR expansions. The results suggest a role of mono-ubiquitination of PCNA in maintaining TNR stability by regulating nucleases switching. Our results suggest enzymatic activities of DNA polymerases and nucleases and the regulation of the activities by PTM play important roles in BER-mediated TNR instability. This research provides the molecular basis for future development of new therapeutic strategies for prevention and treatment of TNR-mediated neurodegenerative diseases.

Lipids are important for structural and physiological functions of neuronal cell membranes. They exhibit a range of biological effects many are bioactive lipid mediators derived from polyunsaturated fatty acids such as sphingolipids, fatty acid ethanolamides (FA-EA) and endocannabinoids (EC). These lipid mediators and oxysterols elicit potent bioactive functions in many physiological and pathological processes of the brain and neuronal tissues. They have been investigated for biomarker discovery of ageing, neuroinflammation and neurodegenerative disorders. The n-3 fatty acids EPA and DPA are thought to exhibit a range of neuroprotective effects many of which are mediated through production of such lipid mediators. The aims of this study were to evaluate the effects of n-3 EPA and n-3 DPA supplementation on RBC membranes and in this way assess dietary compliance and to investigate brain sphingomyelin species of adult and aged rats supplemented with n-3 EPA and n-3 DPA to evaluate the effects and benefits on age-related changes in the brain. Furthermore, to study the effects of lithium on the brain FA-EAs and ECs to further understand the neuroprotective effects of lithium neuroprotective action on neuroinflammation as induced by LPS. Finally to examine if circulating oxysterols are linked to the prevalence of ALS and whether RBC fatty acids are markers of this action in relation to age and disease stages. These analytes were extracted from tissue samples and analysed with GC, LC/ESI-MS/MS and GC-MS. It was found that aged rats exhibited a significant increase in brain AA and decrease in Σn-3 and Σn-6 PUFAs when compared to adult animals. The observed increase of brain AA was reversed following n-3 EPA and n-3 DPA supplementation. Sphingomyelin was significantly increased when aged animals were supplemented with n-3 DPA. LPS treatment following lithium supplementation increased LA-EA and ALA-EA, while it decreased DHA-EA. Both oxysterols 24-OH and 27-OH increased in ALS patients and SOD1-mice. Eicosadienoic acid was different in ASL-patients compared to aged SOD1-mice. These studies demonstrated that dietary intake of n-3 EPA and n-3DPA significantly altered RBC fatty acids and sphingolipids in rat brain. They suggest that n-3 DPA can be a potential storage form for EPA, as shown by retro-conversion of n-3 DPA into EPA in erythrocyte membranes, ensuring supply of n-3 EPA. Also, n-3 EPA and n-3 DPA supplementation can contribute to an increase in brain sphingomyelin species with implications for age effects and regulation of brain development. Effects of lithium highlight novel anti-neuroinflammatory treatment pathways. Both 24-hydroxycholesterol and eicosadienoic acid may be used as biomarkers in ALS thereby possibly helping to manage the progressive stages of disease.

No description available.

No description available.

Le trouble comportemental en sommeil paradoxal (TCSP) se caractérise par une perte de l’atonie musculaire en sommeil paradoxal et par des manifestations motrices élaborées souvent associées au contenu onirique. Le TCSP peut apparaître sous une forme idiopathique (TCSPi), mais il est fréquemment lié à certains désordres neurodégénératifs, dont les synucléinopathies. Des marqueurs biologiques des synucléinopathies, tels que la présence d’anomalies au plan de la motricité, de la détection des odeurs ainsi que de la discrimination des couleurs, ont été retrouvés dans le TCSPi. De plus, des perturbations de l’activité cérébrale en neuroimagerie ainsi que du fonctionnement cognitif ont été observées chez ces patients. Des études ont démontré que le TCSPi pouvait précéder l’apparition d’une maladie de Parkinson (MP) ou d’une démence à corps de Lewy (DCL). Ceci suggère que le TCSPi représenterait un facteur de risque des synucléinopathies. L’objectif principal du présent projet est d’étudier les anomalies du débit sanguin cérébral régional (DSCr) de repos avec la tomographie par émission monophotonique (TEM) dans le TCSPi. Deux études ont été réalisées. La première visait à comparer le DSCr entre des patients avec un TCSPi et des sujets sains, puis d’explorer la relation entre l’activité cérébrale et la présence de marqueurs biologiques des synucléinopathies. Les résultats ont montré une diminution de la perfusion cérébrale dans les régions frontales et pariétales ainsi qu’une augmentation de la perfusion au niveau du pont, du putamen et des hippocampes chez les patients avec un TCSPi. Une relation significative entre la performance des sujets avec un TCSPi à une épreuve de discrimination des couleurs et la perfusion cérébrale au niveau des régions frontales et occipitales a été mise en évidence. Dans l’ensemble, ces résultats ont démontré des anomalies du DSCr chez les patients avec un TCSPi qui sont similaires à celles observées par d’autres études en neuroimagerie dans la MP. Ceci suggère des atteintes neuroanatomiques semblables entre ces pathologies. La seconde étude en TEM a été effectuée dans le but d’examiner les modifications du DSCr associées aux perturbations du fonctionnement cognitif dans le TCSPi. Pour ce faire, le DSCr a été comparé entre un sous-groupe de patients avec un TCSPi et un trouble cognitif léger (TCL), un sous-groupe de patients avec un TCSPi sans TCL et un groupe de sujets sains. Les résultats ont montré que seuls les patients avec un TCSPi et un TCL présentaient une diminution de la perfusion cérébrale dans les aires corticales postérieures (occipitales et temporo-pariétales). Ces observations sont similaires à celles rapportées dans la MP avec démence et la DCL dans les études en neuroimagerie. En conclusion, les résultats de ces deux études ont montré des perturbations du DSCr dans le TCSPi, similaires à celles observées dans les synucléinopathies. Par ailleurs, nos résultats ont mis en évidence que les patients avec un TCSPi et un TCL présentaient les mêmes anomalies de la perfusion cérébrale que les patients avec une MP avec démence et/ou une DCL. La présence de tels marqueurs des synucléinopathies dans le TCSPi suggère que ces patients pourraient être plus à risque d’évoluer vers ce type de maladie neurodégénérative. / Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by intermittent loss of normal atonia during REM sleep and elaborate motor activity associated with dreams. RBD may occur in an idiopathic form (iRBD), but is frequent in neurodegenerative diseases characterized by alpha-synuclein deposition such as Parkinson’s disease (PD) and dementia with Lewy bodjes (DLB). Biomarkers of synucleinopathies, such as motor, olfaction and color discrimination dysfunctions have been found in patients with iRBD. Moreover, impaired cerebral activities with neuroimaging and cognitive perturbations have also been detected in those patients. Longitudinal studies have demonstrated that iRBD might precede PD or DLB by several years. This suggests that iRBD could represent a risk factor of synucleinopathies. The goal of the present research was to investigate the resting regional cerebral blood flow (rCBF) in an iRBD sample using single photon emission computerized tomography (SPECT) neuroimaging. This led to two different studies. The aim of the first study was to compare the rCBF between a group of patients with iRBD and a group of healthy control subjects, and to explore correlations between rCBF of iRBD patients and markers of synucleinopathies. The results of this study showed that compared to controls, iRBD patients had decreased perfusion in frontal and parietal cortical regions and an increased perfusion in pons, putamen and hippocampus bilaterally. Moreover, a significant correlation between brain perfusion in frontal and occipital cortex and performance on a color discrimination test was found in iRBD patients. The brain perfusion anomalies observed in our iRBD patients are similar to those observed in PD in functional neuroimaging studies, suggesting similar neuroanatomic basis between these two pathologies. The objective of the second study was to investigate brain perfusion changes associated with mild cognitive impairment (MCI) in iRBD. We compared rCBF of a sub-group of patients with iRBD and MCI, a sub-group of patients with iRBD without MCI and a group of healthy control subjects. The results showed that only iRBD with MCI showed decreased perfusion in posterior brain regions, in occipital and temporo-parietal areas. These anomalies found in iRBD with MCI are similar to those reported in other studies in PD patients with dementia (PDD) and DLB in neuroimaging studies. To conclude, the results of this research showed brain perfusion abnormalities in iRBD patients similar to those found in synucleinopathies. One of our studies demonstrated a specific pattern of cerebral anomalies with SPECT, similar to those found in PDD and DLB, in patients with iRBD and MCI compared to iRBD without MCI. These biomarkers of synucleinopathies in iRBD suggest that these patients might be at higher risk to develop a neurodegenerative disease associated with alpha synuclein deposition.

This study investigates the characteristics of and the interrelationships between disease, disability, service use and social support in a random sample of 647 community dwellers aged 75 years and over. The two broad objectives of the study are: to examine the physical aspects and manifestations of health by investigating disease and disability and the interrelationships between these two factors, and; to examine the social aspects of health by investigating service use and social support and the interrelationships between these two factors. Given the dramatic population ageing in Australia, particularly in the very old age groups, the health, well-being and quality of life of older Australians are of paramount importance and will be well into the future. The proportion of the population with diseases and disabilities increases significantly with age. As the physical aspects of health are manifested with increasing age the social aspects of health also become increasingly important. Older adults, particularly those in advanced old age, are disproportionately high users of health and community services. Despite the high use of services in this age group, far more older adults living in the community rely on their families, friends and neighbours for social support and many older adults use a combination of formal services and informal social support. Little is known about people aged 75 years and over living in the community in Australia. In particular, significant knowledge gaps exist with regard to the relationship between disease and disability and that between service use and social support. The characteristics of social support in this group of older adults are also largely unknown. The papers presented in this thesis are based on data collected in The Sydney Older Persons Study (SOPS). This is a large longitudinal multidisciplinary project which began in 1991 in order to investigate the health and service use patterns of people aged 75 years and over living in the community in the Central Sydney Health Area. The initial sample consisted of two groups: first, the Australian Bureau of Statistics (ABS) selected census districts with probability proportional to size and 9271 households were door-knocked to obtain a random sub-sample of the general community (n=320, response rate 73%); second, community-living veterans and war widows residing in the Central Sydney Health Area were selected at random from a list provided by the Department of Veterans Affairs to obtain a veteran/war widow sub-sample (n=327, response rate 82%). Respondents participated in both an interview conducted by a social scientist and a medical assessment performed by a medical practitioner with experience in geriatric medicine. An informant was sought for each respondent and this informant participated in a phone interview conducted by a social scientist. The first paper in this thesis investigates the characteristics of diseases (neurodegenerative, systemic and psychiatric) including their prevalence and association with age. The second paper extends the first by examining the nature of the relationship between disease and disability and in particular which individual diseases and groups of diseases have the greatest impact on disability. The third paper expands the analysis in the second paper by focusing in greater detail on the relationship between disease and disability. The contribution of clinically-diagnosed individual diseases and groups of diseases to three different measures of disability (clinician-rated, informant-rated or proxy and self-report) is investigated here. The fourth paper examines the possibility of disease and disability being the major predictors of service use and social support. It focuses on the determinants of service use and social support using Andersen's behavioral model. The fifth paper investigates the characteristics of social support, in particular gender differences and the socio-demographic variables associated with social support. This is an important research area because lower levels of social support have been found to predict mortality, disease and lower levels of well-being. Finally, the sixth paper links the major themes of the fourth and fifth papers by investigating the relationship between service use and social support. This paper tests Cantor's 'hierarchical-compensatory' mechanism, which predicts a negative association between service use and social support, and the 'bridging' mechanism which predicts a positive association between these two factors. Thus it assesses the extent to which demands for service use and for social support are made together or in a compensatory fashion for respondents of equal disease and disability. The presented work demonstrates that neurodegenerative diseases [dementia, cognitive impairment, parkinsonism, instability (gait ataxia), immobility (gait slowing) and motivation loss/behaviour change] have the largest and most significant increases with age of all disease groups. Therefore the hypothesis made in paper one that neurodegenerative diseases will come to dominate the health care needs of older adults, particularly when combined with population ageing, is supported. Further, results of papers two and three indicate that neurodegenerative diseases result in greater levels of disability, lending credence to the finding that it is these neurodegenerative diseases that are of central importance to the future of the health care needs of older adults of advanced age. While systemic diseases play an important role in disability, the neurodegenerative diseases are under-recognised by self-report and yet are most strongly associated with severe disability. A major recommendation of this study is that assessments and diagnosis of neurodegenerative diseases be included in disability assessments. With regard to the social aspects of health, the fourth paper finds that disease and disability are the main predictors of service use and social support. The fifth paper highlights important gender differences in social support and also finds that lower levels of social support are associated with increased age, male gender, single marital status and lower socioeconomic status. Because it is widely accepted that social support is protective against adverse health outcomes and low levels of wellbeing, these groups of older adults are at risk of poorer health and wellbeing. Finally the sixth paper fills some knowledge gaps with regard to the relationship between service use and social support. It shows that with regard to IADL (instrumental activities of daily living) services and IADL social support, Cantor's 'hierarchical-compensatory' mechanism (negative correlation) applies but with regard to medical services and both ADL (activities of daily living) and IADL social support the 'bridging' mechanism (positive correlation) is supported. These complex interrelationships between disease, disability, service use and social support are summarised schematically in a model. In light of significant population ageing, substantial resources in the form of medical and community services and social support from carers, family, friends and neighbours will need to be devoted to older adults with diseases, in particular neurodegenerative diseases, and to those with disabilities. Given the increasing importance of disease, disability, service use and social support in very old age, it is crucial that knowledge and understanding of these factors and their interrelationships be advanced in order to better allocate and sustain resources and to ultimately improve the health, well-being and quality of life of very old adults.

Les maladies neurodégénératives (MND) comprennent principalement les maladies neuromusculaires, dont la sclérose latérale amyotrophique (SLA), les démences, dont la maladie d’Alzheimer, la maladie de Parkinson, la sclérose en plaques, la maladie de Huntington. Du fait de la multiplicité des facteurs à l’origine d’une perte pondérale, les MND sont à risque de dénutrition, ce qui peut altérer l’évolution de ces pathologies et la qualité de vie des patients. Le but de ce travail était d’étudier le statut nutritionnel et/ou l’effet de la prise en charge de patients atteints de SLA et de troubles cognitifs (démence vraie et/ou Mild Cognitive Impairment [MCI]) en France dans le cadre d’un réseau de santé, mais aussi en Afrique Centrale. Le réseau de santé Limousin Nutrition (LINUT) réalise des évaluations et interventions nutritionnelles au domicile de patients atteints de SLA et pour les résidents d’Etablissements d’Hébergement pour Personnes Agées Dépendantes (EHPAD). La première évaluation par le réseau des patients à domicile atteints de SLA retrouvait plus de troubles de la déglutition qu’en consultation spécialisée (60,0% vs 47,5%) ainsi que des troubles du goût (43,8%), non encore décrits lors de la SLA. Des améliorations de pratiques étaient proposées. Le réseau évaluait également des résidents en EHPAD, déments ou non déments, à la fois initialement et après un suivi d’environ 4 mois. La dénutrition touchait plus souvent les patients déments (56,1% vs 46,4% p=0,004), et les apports énergétiques de tous les résidents (26,4 ± 8,8 kcal/kg/j) étaient inférieurs aux recommandations. L’intervention du réseau permettait d’améliorer le statut nutritionnel des patients déments (+0,29 ± 0,07 point de MNA®/mois, p=0,003) ainsi que les apports énergétiques de tous les résidents à 4 mois. Les études « Epidémiologie de la Démence en Afrique Centrale » (EDAC) et « Epidemiology of Dementia in Central Africa » (EPIDEMCA) étaient menées en République Centrafricaine (RCA) et au Congo. Dans ces deux études, les personnes âgées démentes étaient plus souvent dénutries que les non démentes (EDAC : 34,7% vs 17,7%, p<0,0001 ; EPIDEMCA : 60,0% vs 31,3%, p<0,001). Dans l’étude EDAC, le fait de ne consommer qu’un repas par jour constituait un risque de dénutrition chez les déments (OR=7,23 [IC95% : 1,65-31,7, p=0,003]. De plus, les déments consommaient moins de fruits que les non déments (aucune consommation : 54,0% vs 36,7%, p=0,008). Dans l’étude EPIDEMCA, en RCA, une faible consommation d’oléagineux en zone rurale était associée à la présence d’une démence (OR=2,80 [IC95% : 1,02-7,70, p=0,046]), et une consommation d’alcool (quantités non étudiées) en population générale était négativement associée (OR=0,34 [IC95% : 0,14-0,83, p=0,018]). Aucune association n’était retrouvée au Congo. Des facteurs nutritionnels associés aux troubles cognitifs étaient identifiés : un Indice de Masse Corporelle <18,5kg/m2 , un périmètre brachial <24cm et une circonférence musculaire brachiale <5èmepercentile étaient associés en RCA à la démence (OR=2,66 [IC95% : 1,39-5,07, p=0,003] ; OR=1,97 [IC95% : 1,03-3,77, p=0,041] ; OR=2,94 [IC95% : 1,34-6,45, p=0,007], respectivement), et au Congo seule la circonférence musculaire brachiale <5èmepercentile était associée aux MCI (OR=3,61 [IC95% : 1,70-7,64, p=0,001]). Ces différents travaux permettent de disposer de nouvelles données concernant les patients atteints de SLA et de troubles cognitifs dans deux régions du globe. En France, une prise en charge par un réseau de santé est possible et semble améliorer le statut nutritionnel des personnes atteintes de MND. En Afrique Centrale, plusieurs facteurs associés aux troubles cognitifs ont été identifiés. Ces premiers résultats doivent être confirmés afin de proposer des moyens de prévention ciblés. / Neurodegenerative diseases (NDD) mainly concern neuromuscular diseases, including amyotrophic lateral sclerosis (ALS), dementia, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, Huntington's disease. Due to the multiplicity of factors inducing a weight loss, the NDD are at risk of malnutrition, which can alter the evolution of these diseases and the quality of life of patients. The purpose of this work was to assess the nutritional status and / or the effect of treatment of patients with ALS and cognitive disorders (dementia and / or mild cognitive impairment [MCI]) in France with a health network, but also in Central Africa. The health network Limousin Nutrition (LINUT) realizes assessments and nutritional interventions in ALS patients at home and in residents of nursing homes (NH). The first evaluation by the network of ALS patients found more swallowing disorders than specialized consultation (60.0% vs. 47.5%) and taste disorders (43.8%), not further described in ALS. Improvements of practices were proposed. The network assessed also residents in NH, with or without dementia, initially and after a 4 months follow-up. Malnutrition affected more often demented patients (56.1% vs. 46.4% p=0.004), and energy intakes of all residents (26.4 ± 8.8 kcal/kg/d) were below the recommendations. The network intervention improved the nutritional status of patients with dementia (+0.29 ± 0.07 point of MNA®/month, p=0.003) and energy intake of all residents at 4 months. Two studies named

Magister Scientiae - MSc / Neurological diseases are socially disabling and often mortal. To efficiently combat these diseases, a deep understanding of involved cellular processes, gene functions and anatomy is required. However, differential regulation of genes across anatomy is not sufficiently well understood. This study utilized large-scale gene expression data to define the regulatory networks of genes expressing in the hippocampus to which multiple disease pathologies may be associated. Specific aims were: ident i fy key regulatory transcription factors (TFs) responsible for observed gene expression patterns, reconstruct transcription regulatory networks, and prioritize likely TFs responsible for anatomically restricted gene expression. Most of the analysis was restricted to the CA3 sub-region of Ammon’s horn within the hippocampus. We identified 155 core genes expressing throughout the CA3 sub-region and predicted corresponding TF binding site (TFBS) distributions. Our analysis shows plausible transcription regulatory networks for twelve clusters of co-expressed genes. We demonstrate the validity of the predictions by re-clustering genes based on TFBS distributions and found that genes tend to be correctly assigned to groups of previously identified co-expressing genes with sensitivity of 67.74% and positive predictive value of 100%. Taken together, this study represents one of the first to merge anatomical architecture, expression profiles and transcription regulatory potential on such a large scale in hippocampal sub-anatomy. / South Africa