京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19554号 / 医博第4061号 / 新制||医||1012(附属図書館) / 32590 / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊佐 正, 教授 渡邉 大, 教授 髙橋 良輔 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Major depressive disorder (MDD) and suicide have been associated with elevated indices of oxidative damage in the brain, as well as white matter pathology including reduced myelination by oligodendrocytes. Oligodendrocytes highly populate white matter and are inherently susceptible to oxidative damage. Pathology of white matter oligodendrocytes has been reported to occur in brain regions that process behaviors that are disrupted in MDD and that may contribute to suicidal behavior. The present study was designed to determine whether oligodendrocyte pathology related to oxidative damage extends to brain areas outside of those that are traditionally considered to contribute to the psychopathology of MDD and suicide. Relative telomere lengths and the gene expression of five antioxidant-related genes, SOD1, SOD2, GPX1, CAT, and AGPS were measured in oligodendrocytes laser captured from two non-limbic brain areas: occipital cortical white matter and the brainstem locus coeruleus. Postmortem brain tissues were obtained from brain donors that died by suicide and had an active MDD at the time of death, and from psychiatrically normal control donors. Relative telomere lengths were significantly reduced in oligodendrocytes of both brain regions in MDD donors as compared to control donors. Three antioxidant-related genes (SOD1, SOD2, GPX1) were significantly reduced and one was significantly elevated (AGPS) in oligodendrocytes from both brain regions in MDD as compared to control donors. These findings suggest that oligodendrocyte pathology in MDD and suicide is widespread in the brain and not restricted to brain areas commonly associated with depression psychopathology.

journal's webpage is available at http://www.karger.com/bbe .

To investigate the relationship between maturation of the spheno-occipital synchondrosis (SOS) with cervical vertebrae (CVM), dental development of the canine (DI), chronologic age and intra-rater / inter-rater reliability using retrospective cone-beam computed tomography, seventy-seven subjects were randomly selected into six groups based on age and sex. Spearman correlation coefficients and tabulations between stages of maturation indices were evaluated. SOS maturation was significantly correlated with CVM and age (r > 0.8). A weaker significant correlation coefficient was found between SOS and DI (r > 0.6). All males with fused SOS were in CVM stage 4 or later, while all females were in at least CVM stage 3. No subjects with open SOS were in the post-pubertal growth spurt age group and no subjects with closed SOS were in the pre-pubertal growth spurt age group. SOS maturation showed substantial and significant inter-rater and intra-rater reliability (kappa > 0.7). / February 2015

No description available.

No description available.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal. / L'étude présentée s'inscrit dans le cadre du phénomène de la vision résiduelle, c'est-à-dire les fonctions visuelles qui persistent après une lésion du cortex occipital. De façon plus précise, ces travaux portent sur la caractérisation des propriétés fonctionnelles des neurones du complexe LP-pulvinar suite à l'apparition d'une nouvelle voie rétinothalamique chez des chats ayant subi une ablation chronique du cortex visuel primaire. L'ablation totale ou partielle du cortex visuel primaire entraîne chez la plupart des espèces, une diminution ou perte des capacités visuelles dont la sévérité varie selon l'âge de l'animal et l'étendue de la lésion (Fendrich et al., 1992). Ces déficits sont généralement plus prononcés lorsque la lésion survient chez l'adulte plutôt que chez le jeune en développement. En effet, les animaux cérébrolésés en bas âge présentent un comportement visuel qualifié de quasi normal (Comwell et al., 1989). Chez le chat, une lésion du cortex visuel primaire entraîne l'apparition d'une nouvelle voie visuelle se projetant de la rétine vers la partie latérale du complexe LP-pulvinar (Payne et al., 1993). Le but de l'étude consiste à déterminer le carrelât physiologique de la compensation comportementale observée chez les animaux cérébrolésés au cours du développement et à l'âge adulte. L'hypothèse soulevée est que le maintien de l'intégrité visuelle observé chez les animaux cérébrolésés résulterait de la réorganisation des voies visuelles souscorticales et de façon plus précise, de l'apparition de la nouvelle voie rétine - LP-pulvinar. L'étude consistait à réaliser les ablations chirurgicales du cortex visuel chez des chats adultes et des chatons âgés de 7 à 30 jours. Après un délai suffisant pour permettre la réorganisation neuroanatomique, les animaux étaient anesthésiés et préparés pour les séances d'enregistrement électrophysiologique. Une microélectrode était descendue au LP-pulvinar afin d'enregistrer les réponses cellulaires lors de la présentation de différents stimuli visuels. A la fin de l'expérience, le cerveau était prélevé pour les vérifications neuroanatomiques et histo logiques. Les résultats obtenus ont permis de mettre en évidence des changements fonctionnels au niveau des neurones du LP-pulvinar chez les sujets cérébrolésés. Ces changements incluent notamment une modification dans l'organisation des champs récepteurs des cellules du LP-pulvinar. En effet, les cellules du LP-pulvinar des animaux lésés en bas âge présentent un haut niveau de linéarité spatiale et affichent un patron de décharge phasique. Ces nouvelles propriétés des neurones du LP-pulvinar semblent refléter la présence de la nouvelle voie rétino-thalamique qui serait de toute évidence d'origine W-phasique. Les résultats obtenus indiquent donc que le complexe LP-pulvinar participerait vraisemblablement au maintien du comportement visuo-moteur normal dans le phénomène de la vision résiduelle. L'étude présentée est importante, non seulement dans le contexte du rôle du complexe LP-pulvinar dans l'organisation des champs récepteurs chez l'animal cérébrolésé, mais aussi dans le contexte plus large de la plasticité neuronale.

Il est de plus en plus reconnu que les connexions du cerveau jouent un rôle important sur la fonction cérébrale, en particulier les fonctions cognitives supérieures comme le langage. Cependant l’imperfection des techniques traitant les connexions macroscopiques humaines a empêché l’avancement de nos connaissances sur l'anatomie des faisceaux. Nous nous appuyons ainsi aujourd’hui essentiellement sur la littérature du XIXème siècle. Les définitions des trajets et des connexions anatomiques de nombreux faisceaux sont constamment débattues. En utilisant l'imagerie de diffusion, nous réévaluons les anatomies des faisceaux clés dans une grande cohorte saine. Nous utilisons une nouvelle approche de segmentation des faisceaux qui vise à reproduire la méthode introduite par les dissectionistes. Celle-ci définit un tract comme l’ensemble des fibres passant par une même tige, minimisant ainsi l’a priori sur leurs terminaisons. Nous nous concentrons sur les faisceaux d'association des capsules externe et extrême, notamment les faisceaux occipito-frontal inférieur (FOFI) et unciné (FU) impliqués dans le circuit du langage ventral. Nous passons en revue la littérature sur ces tracts, fournissons des descriptions détaillées de leurs connectivités anatomiques et donnons un nouvel éclairage sur leur asymétrie et organisation interne. Dans une première étude, nous confirmons que les deux faisceaux ont de plus vastes projections dans le cortex qu'on ne le pensait, et nous présentons de nouveaux résultats concernant les branches asymétriques des faisceaux. Dans une deuxième étude, nous étudions en profondeur le FU et ses sous composantes. Nous résolvons un débat d’un siècle en exhibant clairement sa frontière avec le FOFI et nous identifions pour chaque sous composante des caractéristiques anatomiques distinctives y compris des asymétries. Ces résultats apportent un éclairage nouveau sur le FOFI et le FU qui sera crucial pour démêler leurs rôles multifonctionnels. / The importance of the brain’s connections for cerebral function is increasingly emphasized especially for higher cognitive functions like language. But the imperfection of the techniques used to address the human macroscopic connections has prevented the advancement of our knowledge on the anatomy of fibre pathways. Thus we rely heavily on XIXth century literature. Controversy surrounding the anatomical course and connections of many fibre pathways persists. Using diffusion imaging, we reevaluate the anatomies of key pathways in a large healthy cohort. We use a novel tract segmentation approach that aims to reproduce the method introduced by dissectionists – defining a tract as all fibers passing through a stem, thus minimizing a priori on their terminations. We focus on the association pathways of the external and extreme capsules, namely the inferior fronto-occipital (IFOF) and uncinate fasciculi (UF), implicated in the ventral language circuitry. We review the literature on these tracts, provide detailed descriptions of their connectional anatomies and present new insights regarding their asymmetry and internal organization. In a first study, we confirm that both tracts have more extensive projections within the cortex than previously thought and present new results regarding asymmetrical tract branches. In a second study we further investigate the UF including its subcomponents. We resolve a century old debate by clarifying its elusive boundary with the IFOF and reveal the distinctive anatomical features including asymmetry patterns of each subcomponent. These results shed new light on the IFOF and UF and will be crucial for disentangling their multifunctional roles.

INTRODUÇÃO: Apesar da importância dos medicamentos antidepressivos no tratamento dos transtornos de humor e de ansiedade, sua ação sobre sistemas cerebrais responsáveis pela expressão emocional ainda não foram claramente estabelecidos. Estudos recentes têm examinando o sinal dependente de nível de oxigenação sanguínea (do inglês, \"BOLD\") durante estímulos emocionais em indivíduos saudáveis sob uso de antidepressivos. Nesse estudo, pretendemos estender essa avaliação às alterações do humor e comportamento emocional devido ao uso prolongado de um antidepressivo bloqueador de serotonina e noradrenalina em pessoas saudáveis. MÉTODOS: foram selecionados dezesseis voluntários, sem antecedentes psiquiátricos pessoais ou familiares, que participaram de um ensaio farmacológico simples-cego de quatro semanas de doses baixas de clomipramina (até 40 mg/dia). Ao final desse período, dez sujeitos foram selecionados como não responsivos, e os restantes seis sujeitos foram selecionados como responsivos por apresentarem claras mudanças em três dos quatro seguintes critérios: tolerância interpessoal, eficiência, bem estar, e mudança substancial em sua auto percepção. O grupo de sujeitos classificados como responsivos foram submetidos a um ensaio controlado duplo-cego confirmatório. A aquisição de imagens cerebrais ocorreu após quatro semanas de uso de medicação (simples cego) e quatro semanas após a sua suspensão, ao final da participação no ensaio farmacológico. O imageamento cerebral foi realizado durante a indução de estados afetivos de felicidade, irritabilidade e neutros por relatos autobiográficos. A resposta emocional desses estados foi obtida por escalas de auto avaliação de ansiedade, irritabilidade e felicidade. As diferenças de sinal entre os estados afetivos foram utilizadas para a análise estatística da interação dos efeitos estado medicamentoso e grupo por testes ANOVA. RESULTADOS: Foi encontrada uma interação significativa entre o efeito de grupo e o estado medicamentoso sobre os estados afetivos de irritabilidade, mas não sobre os de felicidade. Se observou redução na auto avaliação de ansiedade no grupo responsivo com o uso de medicação na diferença entre os estados induzidos de irritabilidade e felicidade, em comparação com o efeito no grupo não responsivo; e também, redução na auto avaliação de felicidade com o uso de clomipramina na totalidade da amostra, na diferença entre o estados induzidos de irritabilidade e neutro. A alteração sobre o efeito BOLD (p < 0,005) foi localizada em regiões adjacentes à junção frontoparietal para a indução de irritabilidade em relação à felicidade e em relação aos estados neutros, no grupo responsivo em relação ao não responsivo, durante o período em uso relativo àquele sem uso de clomipramina, e na junção têmporo-paríeto-occipital, exclusivamente para a diferença irritabilidade-felicidade. CONCLUSÕES: a modificação favorável que sujeitos saudáveis apresentaram ao uso prolongado de um antidepressivo bloqueador da serotonina e noradrenalina, pode estar relacionada à modificação no processamento cerebral da memória autobiográfica de emoções negativas / INTRODUCTION: despite the importance of antidepressant agents to the treatment of anxiety and depressive disorders, there is not yet a clear understanding of their actions upon specific brain systems relevant to emotional processing. Recent studies have examined blood oxygen level dependent (BOLD) signal during emotion stimuli in healthy individuals in antidepressant use. The study intends to extend these measures to the changes over mood and emotional behavior by prolonged use of a serotonin and noradrenaline blocker antidepressant. METHODS: we selected sixteen subjects, with no personal or family history of psychiatric disorders, which participated of a four-week single-blind trial with low doses of clomipramine (up to 40mg/day). After this period, ten subjects were classified as non responsives, the remaining six subjects being classified as responsives because clomipramine provided positive changes in three of four of the following criteria: interpersonal tolerance, self-efficacy, mood and self-perception of a substantial change. Responsives were included in a placebo-controlled confirmatory trial. Imaging sessions occurred at the end of the four-week course of clomipramine and again after a four-week clomipramine washout period, at the end of pharmacological trial. Subjects were scanned during the induction of irritability, happiness and neutral affective states by autobiographical recall. Self-report assessment was performed for each induction by anxiety, irritability and happiness scales. Inter-condition differences (affective induction) were used in the analysis of interaction of medication status and group effects by ANOVA tests. RESULTS: A significant interaction was found between group and treatment during irritability, but not during happiness emotions. It was observed a reduction in the scale of self-evaluation of anxiety in responsive group with the use of medication to the difference between irritability-happiness states, compared to the non responsive group; and a reduction in auto evaluation of happiness, in the totality of the sample in use of clomipramine, in difference irritability-neutral. There was a significant increase of BOLD effect in the responsive group during use relative to the period without use of clomipramine, compared to the effect on non-responsive group (p < 0.005). This effect was located in regions that surround the frontoparietal junction to the irritability relative to happiness and to irritability relative to neutral induction, and in the temporo-parieto-occipital junction, exclusively to the irritability relative to happiness induction. CONCLUSIONS: The favorably changes in healthy subjects who respond to prolonged serotonin and noradrenaline blocker use, may relate to changes in neural processes of autobiographical memory of negative emotions

INTRODUÇÃO: Apesar da importância dos medicamentos antidepressivos no tratamento dos transtornos de humor e de ansiedade, sua ação sobre sistemas cerebrais responsáveis pela expressão emocional ainda não foram claramente estabelecidos. Estudos recentes têm examinando o sinal dependente de nível de oxigenação sanguínea (do inglês, \"BOLD\") durante estímulos emocionais em indivíduos saudáveis sob uso de antidepressivos. Nesse estudo, pretendemos estender essa avaliação às alterações do humor e comportamento emocional devido ao uso prolongado de um antidepressivo bloqueador de serotonina e noradrenalina em pessoas saudáveis. MÉTODOS: foram selecionados dezesseis voluntários, sem antecedentes psiquiátricos pessoais ou familiares, que participaram de um ensaio farmacológico simples-cego de quatro semanas de doses baixas de clomipramina (até 40 mg/dia). Ao final desse período, dez sujeitos foram selecionados como não responsivos, e os restantes seis sujeitos foram selecionados como responsivos por apresentarem claras mudanças em três dos quatro seguintes critérios: tolerância interpessoal, eficiência, bem estar, e mudança substancial em sua auto percepção. O grupo de sujeitos classificados como responsivos foram submetidos a um ensaio controlado duplo-cego confirmatório. A aquisição de imagens cerebrais ocorreu após quatro semanas de uso de medicação (simples cego) e quatro semanas após a sua suspensão, ao final da participação no ensaio farmacológico. O imageamento cerebral foi realizado durante a indução de estados afetivos de felicidade, irritabilidade e neutros por relatos autobiográficos. A resposta emocional desses estados foi obtida por escalas de auto avaliação de ansiedade, irritabilidade e felicidade. As diferenças de sinal entre os estados afetivos foram utilizadas para a análise estatística da interação dos efeitos estado medicamentoso e grupo por testes ANOVA. RESULTADOS: Foi encontrada uma interação significativa entre o efeito de grupo e o estado medicamentoso sobre os estados afetivos de irritabilidade, mas não sobre os de felicidade. Se observou redução na auto avaliação de ansiedade no grupo responsivo com o uso de medicação na diferença entre os estados induzidos de irritabilidade e felicidade, em comparação com o efeito no grupo não responsivo; e também, redução na auto avaliação de felicidade com o uso de clomipramina na totalidade da amostra, na diferença entre o estados induzidos de irritabilidade e neutro. A alteração sobre o efeito BOLD (p < 0,005) foi localizada em regiões adjacentes à junção frontoparietal para a indução de irritabilidade em relação à felicidade e em relação aos estados neutros, no grupo responsivo em relação ao não responsivo, durante o período em uso relativo àquele sem uso de clomipramina, e na junção têmporo-paríeto-occipital, exclusivamente para a diferença irritabilidade-felicidade. CONCLUSÕES: a modificação favorável que sujeitos saudáveis apresentaram ao uso prolongado de um antidepressivo bloqueador da serotonina e noradrenalina, pode estar relacionada à modificação no processamento cerebral da memória autobiográfica de emoções negativas / INTRODUCTION: despite the importance of antidepressant agents to the treatment of anxiety and depressive disorders, there is not yet a clear understanding of their actions upon specific brain systems relevant to emotional processing. Recent studies have examined blood oxygen level dependent (BOLD) signal during emotion stimuli in healthy individuals in antidepressant use. The study intends to extend these measures to the changes over mood and emotional behavior by prolonged use of a serotonin and noradrenaline blocker antidepressant. METHODS: we selected sixteen subjects, with no personal or family history of psychiatric disorders, which participated of a four-week single-blind trial with low doses of clomipramine (up to 40mg/day). After this period, ten subjects were classified as non responsives, the remaining six subjects being classified as responsives because clomipramine provided positive changes in three of four of the following criteria: interpersonal tolerance, self-efficacy, mood and self-perception of a substantial change. Responsives were included in a placebo-controlled confirmatory trial. Imaging sessions occurred at the end of the four-week course of clomipramine and again after a four-week clomipramine washout period, at the end of pharmacological trial. Subjects were scanned during the induction of irritability, happiness and neutral affective states by autobiographical recall. Self-report assessment was performed for each induction by anxiety, irritability and happiness scales. Inter-condition differences (affective induction) were used in the analysis of interaction of medication status and group effects by ANOVA tests. RESULTS: A significant interaction was found between group and treatment during irritability, but not during happiness emotions. It was observed a reduction in the scale of self-evaluation of anxiety in responsive group with the use of medication to the difference between irritability-happiness states, compared to the non responsive group; and a reduction in auto evaluation of happiness, in the totality of the sample in use of clomipramine, in difference irritability-neutral. There was a significant increase of BOLD effect in the responsive group during use relative to the period without use of clomipramine, compared to the effect on non-responsive group (p < 0.005). This effect was located in regions that surround the frontoparietal junction to the irritability relative to happiness and to irritability relative to neutral induction, and in the temporo-parieto-occipital junction, exclusively to the irritability relative to happiness induction. CONCLUSIONS: The favorably changes in healthy subjects who respond to prolonged serotonin and noradrenaline blocker use, may relate to changes in neural processes of autobiographical memory of negative emotions