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Les neurones des couches superficielles du collicule supérieur et du cortex visuel primaire du rat adulte sont sensibles à de basses fréquences spatiales de haut contraste défilant à des vitesses élevées. Entre les jours post-nataux 27-30 et l’âge adulte, les fréquences temporelles optimales des neurones du cortex visuel primaire augmentent, tandis que leurs seuils de contraste diminuent. Cependant, les fréquences spatiales optimales, les valeurs de résolution spatiale et les bandes passantes spatiales de ces neurones sont, dès l’ouverture des paupières, similaires à celles observées chez le rat adulte. Ces profils de réponse neuronale suggèrent que les projections rétino-colliculaires et rétino-géniculo-corticales sont essentiellement issues de neurones ganglionnaires rétinofuges magnocellulaires et koniocellulaires. Les neurones du cortex visuel primaire du rat ayant subi des convulsions hyperthermiques présentent, dès l’ouverture des paupières, de basses fréquences spatiales optimales, de larges bandes passantes directionnelles et temporelles ainsi que des seuils de contraste élevés par rapport aux neurones du rat normal. À l’âge adulte, de basses fréquences temporelles optimales et de larges bandes passantes spatiales sont également observées chez le rat ayant subi des convulsions hyperthermiques. L’altération des profils de réponse des neurones du cortex visuel primaire du rat ayant subi de convulsions hyperthermiques suggère un déséquilibre entre les mécanismes neuronaux excitateurs et inhibiteurs de cette aire corticale. Ces résultats suggèrent également qu’un épisode unique de convulsions fébriles infantiles suffit à altérer le développement des propriétés spatio-temporelles des champs récepteurs des neurones du cortex visuel primaire. / Neurons in superficial layers of the rat superior colliculus and primary visual cortex are sensitive to highly contrasted low spatial frequencies drifting at fast speeds. Between post-natal days 27-30 and adulthood, the optimal temporal frequencies of neurons in the primary visual cortex increase, whereas their contrast thresholds decrease. However, the optimal spatial frequencies, spatial resolution values and spatial bandwidths of these neurons are, soon after eyelid opening, similar to those observed in the adult rat. These neuronal response profiles suggest that the retino-collicular and retino-geniculo-cortical projections are mainly innervated by magnocellular and koniocellular retinal ganglion cells. Neurons in the primary visual cortex of rats having experienced hyperthermic seizures are, soon after eyelid opening, sensitive to low optimal spatial frequencies and show broad directional and temporal bandwidths, as well as elevated contrast thresholds when compared to neurons of normal rats. At adulthood, low optimal temporal frequencies and broad spatial bandwidths are also observed in rats having experienced hyperthermic seizures. The alteration of response profiles of neurons in the primary visual cortex of rats having experienced hyperthermic seizures suggests an unbalance between excitatory and inhibitory mechanisms in this cortical structure. These results also suggest that a single episode of febrile seizures could be sufficient to impede the development of the spatio-temporal receptive field properties of neurons in the primary visual cortex.

Pharmacodynamic processes and disease progression are increasingly characterized with pharmacometric models. However, modelling options for discrete-type responses remain limited, although these response variables are commonly encountered clinical endpoints. Types of data defined as discrete data are generally ordinal, e.g. symptom severity, count, i.e. event frequency, and time-to-event, i.e. event occurrence. Underlying assumptions accompanying discrete data models need investigation and possibly adaptations in order to expand their use. Moreover, because these models are highly non-linear, estimation with linearization-based maximum likelihood methods may be biased. The aim of this thesis was to explore pharmacometric methods and novel models for discrete data through (i) the investigation of benefits of treating discrete data with different modelling approaches, (ii) evaluations of the performance of several estimation methods for discrete models, and (iii) the development of novel models for the handling of complex discrete data recorded during (pre-)clinical studies. A simulation study indicated that approaches such as a truncated Poisson model and a logit-transformed continuous model were adequate for treating ordinal data ranked on a 0-10 scale. Features that handled serial correlation and underdispersion were developed for the models to subsequently fit real pain scores. The performance of nine estimation methods was studied for dose-response continuous models. Other types of serially correlated count models were studied for the analysis of overdispersed data represented by the number of epilepsy seizures per day. For these types of models, the commonly used Laplace estimation method presented a bias, whereas the adaptive Gaussian quadrature method did not. Count models were also compared to repeated time-to-event models when the exact time of gastroesophageal symptom occurrence was known. Two new model structures handling repeated time-to-categorical events, i.e. events with an ordinal severity aspect, were introduced. Laplace and two expectation-maximisation estimation methods were found to be performing well for frequent repeated time-to-event models. In conclusion, this thesis presents approaches, estimation methods, and diagnostics adapted for treating discrete data. Novel models and diagnostics were developed when lacking and applied to biological observations.

Univ., Diss.--Frankfurt (Main), 2005.

Text in Afrikaans / "Free people expect much from their police. In such societies the police stand at the point of balance on the one hand securing human rights on the other exercising their lawful powers given to them by Governments in the name of the people, to protect people and their institutions" (J Alderson Human Rights and Police Rights. Publication of the Council of Europe.) This is no small expectation. It means that the police are expected to maintain and secure the principles of democracy and human rights, the principles upon which our Constitution is based. At the same time it is the duty of a police service to maintain law and order which sometimes require the exercise of power and the use of force which on the face of it may appear to violate human dignity and certain rights and freedoms which a police force is expected to maintain in a democratic society. The manner of exercising that power has an impact on the credibility and effectiveness of the police. Human rights law internationally accepts that a police service needs to be given the power to, at times restrict certain individual freedoms in the interests of the security of the community at large. These restrictions may take place only in a constitutional way. If it takes place in an unconstitutional way the courts must have the right to exclude evidence which is unconstitutionally obtained. At this stage the courts have to formulate such a qualified exclusionary rule, but the ultimate goal must be to include such an exclusionary rule in a future Constitution. / Department of Criminal and Procedural Law / LL.M.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As convulsÃes dialÃpticas tÃm como principais alteraÃÃes ictais as alteraÃÃes de consciÃncia que sÃo independentes das manifestaÃÃes ictais no eletroencefalograma. Essa classificaÃÃo de convulsÃes epilÃpticas foi proposta por LÃders et al em 1998 e tem como base exclusivamente a semiologia ictal. O presente estudo avalia um total de 59 eventos dialÃpticos de 27 pacientes. Os eventos foram retrospectivamente avaliados e classificados em: crises dialÃpticas parciais complexas, crises dialÃpticas parciais simples, e eventos dialÃpticos nÃo epilÃpticos. à de amplo conhecimento que a regulaÃÃo cardiovascular à uma funÃÃo da atividade neuronal no cÃrtex cerebral, na amÃgdala e na formaÃÃo reticular do bulbo e que a ativaÃÃo seletiva dos centros cardÃacos nessas Ãreas produz aumento ou diminuiÃÃo da freqÃÃncia cardÃaca. Esse estudo analisou as alteraÃÃes da freqÃÃncia cardÃaca 1 hora antes, durante e 1 hora depois de cada evento dialÃptico. Foi observado que a freqÃÃncia cardÃaca do perÃodo basal era semelhante nos grupos de crises parciais complexas e de crises nÃo epilÃpticas. TambÃm foi observado que a freqÃÃncia cardÃaca basal està aumentada no grupo de pacientes com crises parciais simples (P<0,05). Por sua vez, a freqÃÃncia cardÃaca no perÃodo ictal nÃo aumentou no grupo de crises nÃo epilÃpticas, bem como no grupo de crises parciais simples. Foi observado um aumento da freqÃÃncia cardÃaca (taquicardia) em cada crise dialÃptica parcial complexa (P<0,05), com o retorno da freqÃÃncia cardÃaca aos nÃveis basais no perÃodo pÃs ictal. Esses achados indicam que a taquicardia mediada por vias centrais à uma caracterÃstica das crises dialÃpticas parciais complexas. Na segunda parte do estudo, foram analisada as alteraÃÃes da freqÃÃncia cardÃaca induzidas pelo movimento em crises epilÃpticas e nÃo epilÃpticas. Foi demonstrado que em nenhuma crise nÃo epilÃptica moderada houve um aumento da freqÃÃncia cardÃaca durante a fase ictal acima de 39,3%, comparando-se com a freqÃÃncia cardÃaca do perÃodo basal. NÃo houve aumento da freqÃÃncia cardÃaca em nenhuma crise nÃo epilÃptica leve acima de 16,3% durante a fase ictal, bem como nenhuma crise parcial simples apresentou um aumento da FC acima de 20,6%, comparando-se com o perÃodo basal. Foi verificado que a utilizaÃÃo de uma escala para gradaÃÃo da quantidade de movimento pode ser usada como ferramenta na verificaÃÃo de uma tendÃncia de alteraÃÃo da freqÃÃncia cardÃaca de acordo com a quantidade de alteraÃÃo de movimento. Assim, a anÃlise da freqÃÃncia cardÃaca pode ser usada como critÃrio para exclusÃo de eventos psicogÃnicos / Dialeptic seizures are characterized by ictal loss of consciouness, that is independent of the EEG correlate. This classification of epileptic seizures is based only on ictal semiology and was proposed by LÃders et al in 1998. We studied 59 dialeptic events of 27 patients. The events were retrospectively analyzed and classified in: dialeptic complex partial seizures, dialeptic simple partial seizures and dialeptic non epileptic events. It is well known that cardiovascular regulation is a function of neuronal activity in the cerebral cortex, amygdala, and reticular formation in the medulla, and that selective activation of cardiac centers in theses areas is responsible for changes in the heart rate. Our study analyzed the heart rate changes 1 hour prior, during and 1 hour after each dialeptic event. It was shown that the heart rate of the basal period was similar in the complex partial seizures group and in the non epileptic group. The basal heart rate was increased in the simple partial seizures group (P<0.05). The ictal heart rate did not increase in the non epileptic group, as well as in the simple partial seizures group. We showed an increase in the heart rate in each dialeptic complex partial seizure (P<0.05), and the heart rate returned to normal in the post-ictal period. Our study showed that central mediated tachycardia is a feature of dialeptic complex partial seizures. In the second part of our study, the heart rate changes secondary to movement in epileptic and non epileptic seizures were analyzed. It was shown that none of the moderate non epileptic seizures had an increase in the ictal heart rate above 39.3% when compared to the heart rate in the basal period. There wasnât any heart rate increase in any of the mild non epileptic seizures greater than 16.3% in the ictal period. None of the simple partial seizures showed heart rate increase above 20.6% of the basal period. We showed that a scale for movement quantification allow us to show a tendency of heart rate changes secondary to different degrees of body movement. Therefore, heart rate analysis can be used as an additional criterion for exclusion of psychogenic events

O presente estudo comparou o fluxo sanguíneo cerebral regional avaliado através da tomografia por emissão de fóton simples (SPECT) de pacientes com crises epilépticas temporais com pacientes com crises não epilépticas psicogênicas (CNEP). Todos os SPECT foram realizado no período ictal, tendo as CNEP sido induzidas por métodos sugestivos e de hipnose. Os grupos de pacientes com epilepsia e CNEP foram ainda comparados com um terceiro grupo, denominado grupo de sujeitos saudáveis. As comparações dos SPECT foram feitas através da análise visual (radiologista cego ao estudo) e semiquantitativa pelo programa Statistical Parametric Mapping (SPM). Os objetivos do estudo foram: (1) estabelecer a sensibilidade e a especificidade do SPECT ictal para o diagnóstico diferencial entre CNEP e crises epilépticas parciais complexas em pacientes com epilepsia do lobo temporal, em comparação com o VEEG associado a técnicas de hipnose; (2) avaliar através da análise quantitativa voxel a voxel do SPECT as alterações de perfusão cerebral dos pacientes com CNEP em relação aos pacientes com epilepsia, dos pacientes com CNEP em relação a um grupo controle de sujeitos normais e dos pacientes com epilepsia em relação a um grupo controle de sujeitos saudáveis. Foram estudados 30 pacientes no grupo com CNEP, 22 pacientes no grupo com epilepsia e 29 sujeitos saudáveis. Os resultados mostram que os SPECT ictais dos pacientes do grupo CNEP foram diferentes dos SPECT ictais dos pacientes com epilepsia. Na análise visual o SPECT ictal apresentou sensibilidade de 50% e especificidade de 91% para o diagnóstico de CNEP . Na análise comparativa voxel a voxel entre os grupos os resultados revelaram que: (a) houve aumento de perfusão cerebral em lobo temporal esquerdo e tronco cerebral nos pacientes do grupo epilepsia em relação ao grupo controle normal; (b) houve diminuição de perfusão cerebral no lobo frontal esquerdo e córtex anterior do cíngulo nos pacientes do grupo epilepsia em relação ao grupo controle normal; (c) houve aumento de perfusão cerebral no giro do cíngulo e precuneus á direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (d) houve diminuição perfusão cerebral em amígdala direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (e) houve aumento de perfusão cerebral na cauda do núcleo caudado esquerdo, giro précentral esquerdo e tálamo direito nos pacientes do grupo CNEP em relação ao grupo controle normal. Desta forma, após a análise estatística dos resultados concluímos que na análise visual, um SPECT ictal positivo em um paciente com suspeita de CNEP não confirma nem afasta tal suspeita, já que a sensibilidade do método foi baixa (50%). Na análise visual, um SPECT ictal negativo em um paciente com suspeita de CNEP afasta a possibilidade de epilepsia do lobo temporal com 91% de acerto (especificidade do método). O resultado da análise visual do SPECT ictal de CNEP revelou valor de sensibilidade abaixo do encontrado na literatura, e valor de especificidade superior ao encontrado na literatura. A análise quantitativa dos SPECT de crise epiléptica em comparação com os de sujeitos saudáveis em repouso, mostrou concordância com a análise visual em relação à lateralidade. Tal comparação revelou ainda ativação de áreas compatíveis com o que se encontra na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os do grupo epilepsia revelou ativação de estruturas cerebrais posteriores (precuneus e giro cíngulo), não havendo comparação semelhante na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os de sujeitos saudáveis em repouso, mostrou ativação do sistema estriatotalamocortical, achado em concordância com a literatura. A ativação do sistema estriatotalamocortical nos pacientes com CNEP mostrou ser um correlato neuroanatômico clinicamente relevante, com forte associação estatística. / The study compared regional cerebral blood flow assessed by positron emission tomography single photon (SPECT) in patients with temporal lobe epilepsy and patients with psychogenic nonepileptic seizures (PNES). All SPECT were performed in the ictal period, PNES having been induced by and suggestive methods of hypnosis. The groups of patients with epilepsy and PNES were compared with a third group, called group of healthy subjects. SPECT comparisons were made by visual analysis (radiologist blinded to the study) and semiquantitative analysis by Statistical Parametric Mapping (SPM). The study objectives were: (1) to establish the sensitivity and specificity of ictal SPECT for the differential diagnosis between PNES and complex partial seizures in patients with temporal lobe epilepsy, compared with VEEG associated with hypnosis techniques, (2) to assess by quantitative analysis of SPECT voxel to voxel changes in cerebral perfusion of patients with PNES compared to patients with epilepsy, patients with PNES compared to a control group of normal subjects and patients with epilepsy compared to a control group of healthy subjects. We studied 30 patients in the PNES group, 22 patients in the group with epilepsy and 29 healthy subjects. The results show that ictal SPECT of patients in the PNES group were different from the ictal SPECT of patients with epilepsy. The visual analysis of ictal SPECT had a sensitivity of 50% and specificity of 91% for the diagnosis of PNES. In the voxel voxel comparative analysis between the groups the results showed that: (a) increased cerebral perfusion in the left temporal lobe and brain stem in patients of epilepsy group compared to normal control group, (b) a decrease in cerebral perfusion in the left frontal lobe and anterior cingulate cortex in patients of epilepsy group compared to normal control group, (c) increased cerebral perfusion in the cingulate gyrus and precuneus in the right group of PNES patients compared to epilepsy group, (d) decreased cerebral perfusion in the right amygdala in patients PNES group compared to the epilepsy group, (e) increased cerebral perfusion in the left tail of the caudate nucleus, left pre-central gyrus and right thalamus in patients in the PNES group compared to group normal control. Therefore, after statistical analysis of the results we conclude that in visual analysis, a positive ictal SPECT in a patient with suspected PNES neither confirms nor removes the suspicion, since the sensitivity was low (50%). In visual analysis, a negative ictal SPECT in a patient with suspected PNES rules out the possibility of temporal lobe epilepsy with 91% accuracy (specificity of the method). The result of visual analysis of ictal SPECT of PNES revealed sensitivity value below that found in the literature and specificity value higher than that found in the literature. The quantitative analysis of SPECT of seizures compared with those of healthy subjects at rest, showed agreement with visual analysis in relation to laterality. This comparison also revealed activation in areas consistent with that found in the literature. The quantitative analysis of SPECT ictal PNES group compared with the epilepsy group showed activation of posterior brain structures (cingulate gyrus and precuneus), with no similar comparison in the literature. The quantitative analysis of SPECT ictal PNES group compared to healthy subjects at rest, showed activation of the estriatotalamocortical, a finding in agreement with the literature. The activation of the estriatotalamocortical circuit in patients with PNES proved to be a neuroanatomical correlate clinically relevant, with strong statistical association

Apresentamos dados e argumentos que indicam que: a) as crises epilépticas apresentadas por Trinomys yonenagae em campo e em cativeiro são espontâneas e idiopáticas; e b) elas podem ser decorrentes de processos evolutivos. A epilepsia nesta espécie foi caracterizada em cativeiro a partir de um cadastro iniciado há 16 anos, formado por progenitores e descendentes de seis colônias de T. yonenagae, coletados na Caatinga de Ibiraba (BA), e adultos (129,90 ± 5,92g) e filhotes nascidos em cativeiro num total de 295 indivíduos. A prevalência e a incidência em indivíduos epilépticos (EE) foram estimadas e as crises epilépticas foram analisadas por meio das manifestações comportamentais, baseando-se na escala de Racine. Aspectos da procriação (n=11), a locomoção, a ansiedade (testes de arena, n= 35) e índices fisiológicos (balanço hídrico-alimentar, n=6), importantes ao fitness, foram mensurados. Somente duas colônias apresentaram EE representando 9% e 28% dos nascimentos. Do total de indivíduos (165 e 130) 9,8% são EE (n=29; 14 e 15), sendo que as representam 52% e os 48%. A prevalência é de 20 a 30% e a incidência variou de 2 a 10 casos/ano, nos últimos cinco anos. As crises são observadas somente em adultos (n=24) a menor latência é de 13m e a frequência é variável (1 a 24 em seis anos). A maioria iniciou-se por congelamento e 50% atingiram o estágio 5 da escala de Racine. Em todos os casais, de 5 a 50% dos filhotes são EE e ocorreu estro pós-parto, como esperado para a espécie. Os filhotes são saudáveis e tanto a média de filhotes por ninhada (1,9±0,3), como a média do número de ninhadas por casal (6,5±5,0) é igual à de casais não epilépticos (NE). O teste de arena indica que descendentes de EE (DE) e as EE são menos ansiosas que as NE. Não há diferença entre os grupos dos índices fisiológicos estimados. A diferença no número de EE nas colônias, a alta prevalência e % de filhotes EE, e a diferença de comportamento das fêmeas DE indicam a base genética desta epilepsia. Neste contexto, consideramos que em Trinomys yonenagae, a epilepsia límbica não compromete o fitness, o que abre possibilidades de ser decorrente de processos evolutivos envolvendo o escalonamento de respostas de anti-predação / We present data and discuss the possibility that: a) the seizures presented by Trinomys yonenagae in the wild and in captivity are spontaneous and idiopathic, and b) they may be due to evolutionary processes. Epilepsy was characterized in this species in captivity from a survey started 16 years ago, made up of parents and descendants from six colonies of T. yonenagae collected in the Caatinga of Ibiraba (BA), and adults (129.90 ± 5.92 g) and pups born in captivity in a total of 295 individuals. The prevalence and incidence in individuals with epilepsy (EE) were estimated and seizures were analyzed by behavioral manifestations, based on Racine´s scale. Locomotion and anxiety indexes (open-field test, n = 35), as well as aspects of breeding (n = 11) and physiological indicators (balance food and water, n = 6), important to fitness were measured. Only two colonies showed EE, representing 9% and 28% of births. Approximately 10% of total individuals (165 and 130 ) are EE (n = 29, 14 and 15 ), and the represent 52 and 48%. In the last five years prevalence is 20-30%, and incidence ranged from 2 to 10 cases/ year. Seizures are only observed in adults (n = 24), the lowest latency is 13 months and the frequency is variable (1 to 24 in six years). The first stage is freezing and 50% reached stage 5 of Racine´s scale. In all couples, 5-50% of puppies are EE and occurred postpartum estrus, as expected for the species. The puppies are healthy and both the average offspring per litter (1.9 ± 0.3), as well as the average number of litters per couple (6.5 ± 5.0) is equal to values presented by non-epileptic couples (NE). The open-field test indicates that descendants of EE (DE) and EE are less anxious than NE. There is no difference between EE and NE regarding food and water intake. The difference in the number of EE in the colonies, the high percentage of EE pups, and the difference in the behavior of DE indicate the genetic basis of this epilepsy. In this context, we consider that in Trinomys yonenagae the limbic epilepsy seems to not compromise the fitness, which opens possibilities to be the result of evolutionary processes involving the escalation of antipredator responses

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