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À la suite d’une lésion du système nerveux central tel qu’un accident vasculaire cérébral ou une lésion médullaire incomplète un ensemble de symptômes tel que la parésie, l’hyperactivité musculaire et l’hypo-extensibilité des tissus vont perturber l’organisation locomotrice du patient. Depuis quelques années, l’utilisation de méthodes mathématiques permet d’extraire à partir de l’activité électrique des muscles la commande à l’organisation locomotrice du sujet. L’objectif de ce travail de thèse est d’utiliser ces méthodes pour caractériser les spécificités du patient hémiparétique et paraparétique. Une première étude sur le sujet asymptomatique a permis de valider notre méthodologie..La deuxième étude portant sur les patients paraparétiques montre que l’asymétrie de marche est plutôt expliquée par une expression différente des symptômes plutôt qu’une réelle asymétrie provenant de la commande. Pour conclure, la troisième étude portant sur l’effet d’une anesthésie d’un muscle chez le patient hémiparétique a montré que le cerveau était en mesure de modifier la commande locomotrice pour pallier les perturbations induites par cette anesthésie. En conclusion nos travaux soulignent l’intérêt de ces méthodes comme un outil pertinent dans l’évaluation de l’organisation locomotrice chez le patient présentant une lésion du système nerveux central. / Following a central nervous system injury such as a stroke or incomplete spinal cord injury, a set of symptoms such as paresis, muscle hyperactivity and hypo-extensibility will disrupt the patient’s locomotor organization. In recent years, the use of mathematical methods has made it possible to extract, from the electrical muscle activities, the command of the locomotor organization. This thesis aimed at using these methods to characterize the specificities of the post-stroke patient and the patient with incomplete spinal cord injury. The first study of healthy individuals allowed to validate our methodology.The second study in patients with incomplete spinal cord injury showed that gait asymmetry may be explained by a different expression of symptoms rather than a real asymmetry originating from the control. Finally, the third study has investigated the effect of muscle anesthesia on the post-stroke patient. The results showed that the central nervous system was able to adapt locomotor control to compensate for the disturbances induced by this anesthesia. In conclusion, our work underlines the interest of these methods as a relevant tool in the evaluation of locomotor organization in patients with central nervous system lesions.

<div><p>Parkinson’s disease (PD) is a devastating neurodegenerative disorder that affects 10 million people worldwide and is characterized by pronounced motor symptoms. Dementia with Lewy Bodies (DLB) involves both cognitive and motor deficits and affects ~1 million people in the United States. To date there is no cure for PD or DLB, and current treatments address only a subset of the symptoms that define these diseases. PD and DLB are ‘synucleinopathies’, defined as disorders involving the accumulation in patients’ brains of Lewy bodies. Lewy bodies are cellular inclusions that consist largely of aggregated species of alpha-synuclein (aSyn), a presynaptic protein that exists as both cytosolic and membrane-bound forms. Pathophysiological findings suggest that aggregated aSyn is involved in neurodegeneration in PD and DLB. However, mechanisms by which aSyn forms neurotoxic aggregates, and neurotoxic processes that distinguish different synucleinopathies such as PD and DLB, are poorly understood. To address these gaps, we have (i) designed a protocol to establish a primary cell culture model that can recapitulate key neuropathological features of PD, (ii) examined effects of expressing aSyn variants in a rat model of PD, and (iii) examined the expression profiles of neuroprotective genes in PD and DLB brain specimens.</p><p> </p><p>In the first part of my thesis, I describe the development of an optimized protocol to prepare primary midbrain and cortical cultures from rat embryonic brains for the study of PD and other synucleinopathies. The establishment of cellular models that simulate specific aspects of neuropathology can enable the characterization of molecular perturbations that lead to dopaminergic (DA) neuronal death. Our primary midbrain mixed culture model provides an outstanding opportunity to explore therapeutic strategies to rescue DA neurons from toxicity elicited by a range of PD-related insults. In addition, our primary cortical mixed cultures can be used to model cortical neuropathology in various CNS disorders including synucleinopathies.</p><p> </p><p>A number of mutations in the gene that codes for aSyn are associated with familial, early-onset forms of PD. A major goal of my thesis research is to characterize neurotoxic effects of a recently discovered familial substitution, A53E. This mutant was chosen based on the rationale that the introduction of a negatively charged residue at position 53 could potentially interfere with aSyn-membrane interactions and favor A53E aggregation, as we described for other familial aSyn mutants. For the first time, we have reproduced the neurotoxicity of A53E seen in human patients by expressing the mutant protein in rat midbrain. Rats injected unilaterally in the substantia nigra (SN) with rAAV encoding A53E and another familial mutant, A53T, but not rAAV encoding WT aSyn or a vector-control (‘stuffer’) virus, exhibited a significant motor impairment. Immunohistochemical analysis at 14 weeks after the viral injection revealed that brain sections from aSyn-expressing rats exhibit key features reminiscent of neuropathology in human PD, including nigral dopaminergic neuron loss (confirmed by unbiased stereology), striatal terminal depletion, and aSyn inclusion formation. In addition, it was determined that WT aSyn and the A53E and A53T mutants invaded the non-injected substantia nigra, implying that expressed aSyn protein can spread throughout the brain in the rat rAAV-aSyn model. These results yield insights into the molecular basis for the neurotoxicity of A53E and shed light on a potential role for membrane-induced aSyn aggregation in PD pathogenesis in vivo, thus setting the stage for developing therapies to slow neurodegeneration in the brains of familial and idiopathic PD patients. </p><p> </p><p>aSyn neurotoxicity varies with the expression of neuroprotective proteins, and misfolded aSyn affects cellular functions and gene expression. These observations suggest that differential gene expression patterns can inform us about similarities and differences in pathogenic mechanisms of different synucleinopathy disorders. A third phase of my thesis research was aimed at determining the expression levels of a panel of candidate neuroprotective genes in post-mortem brain samples from DLB and PD patients and age-matched controls (5 individuals in each group). mRNAs encoding the following proteins were quantified via qRT-PCR in homogenates prepared from the frontal cortex and the BA24 region encompassing the cingulate gyrus: DJ-1, a protein with antioxidant and chaperone activities; PGC1α, a master regulator of mitochondrial biogenesis and oxidative metabolism; MsrA, an antioxidant enzyme responsible for repairing oxidatively damaged proteins; and ATP13A2, a lysosomal protein involved in autophagy. In addition to yielding new insights into differential gene expression patterns in cortex versus cingulate gyrus, the data revealed differences in mRNA expression levels in DLB versus non-DLB cortical tissue. Although levels of all four neuroprotective mRNAs were increased (or showed a trend towards being increased) in DLB cortex, Western blot analysis revealed that only the DJ-1 and PGC1α proteins showed a trend towards being up-regulated, whereas levels of ATP13A2 and MsrA were unchanged. These findings suggest that there is a failure to induce cellular antioxidant responses and lysosomal autophagy at the protein level in DLB cortex, and in turn this failure could contribute to neuropathology. Interestingly, analysis of the same panel of neuroprotective genes in PD cortical samples did not show significant differences in mRNA or protein levels compared to control samples, suggesting that different neuroprotective mechanisms are induced in DLB versus PD cortex. These studies shed light on brain-region specific changes in gene expression associated with different synucleinopathy disorders, and they set the stage for developing new diagnostic tests and therapeutic strategies.</p></div><br>

In patients with Parkinson's disease (PD), the associated pathology follows a characteristic pattern involving inter alia the enteric nervous system (ENS), the dorsal motor nucleus of the vagus (DMV), the intermediolateral nucleus of the spinal cord and the substantia nigra, providing the basis for the neuropathological staging of the disease. Here we report that intragastrically administered rotenone, a commonly used pesticide that inhibits Complex I of the mitochondrial respiratory chain, is able to reproduce PD pathological staging as found in patients. Our results show that low doses of chronically and intragastrically administered rotenone induce alpha-synuclein accumulation in all the above-mentioned nervous system structures of wild-type mice. Moreover, we also observed inflammation and alpha-synuclein phosphorylation in the ENS and DMV. HPLC analysis showed no rotenone levels in the systemic blood or the central nervous system (detection limit [rotenone]<20 nM) and mitochondrial Complex I measurements showed no systemic Complex I inhibition after 1.5 months of treatment. These alterations are sequential, appearing only in synaptically connected nervous structures, treatment time-dependent and accompanied by inflammatory signs and motor dysfunctions. These results strongly suggest that the local effect of pesticides on the ENS might be sufficient to induce PD-like progression and to reproduce the neuroanatomical and neurochemical features of PD staging. It provides new insight into how environmental factors could trigger PD and suggests a transsynaptic mechanism by which PD might spread throughout the central nervous system.

Ce travail de recherche s'intéresse à la vectorisation au système nerveux central de la MIBG d'une part et de la FLT d'autre part. Pour cela, nous utiliserons des systèmes disposant d'une structure 1,4- dihydoquinoléine comme vecteurs. La synthèse des systèmes de vectorisation a tout d'abord été réalisée en chimie non radioactive. Concernant la MIBG, les résultats obtenus lors de précédents travaux nous ont conduit à envisager l'élaboration d'un système de vectorisation comportant un groupement espaceur entre le vecteur et la MIBG. Dans le cas de la FLT, nous nous sommes consacrés au développement d'un système dans lequel la FLT serait directement liée au vecteur par une liaison ester. Afin de pouvoir moduler les propriétés rédox de nos systèmes de vectorisation, nous avons synthétisé des 1,4-dihydroquinoléines présentant en position 6 et/ou 7 des groupements électroattracteurs ou électrodonneurs. Une étude en milieu acétonitrile/tampon PBS, pour évaluer l'influence de ces groupements sur la libération de la FLT, a été réalisée par un suivi CLHP. La radiosynthèse de ces systèmes a ensuite été menée afin d'évaluer la capacité des vecteurs 1,4- dihydroquinoléines à transporter la MIBG ou la FLT à travers la barrière hématoencéphalique (BHE). Ainsi, nous avons radiomarqué au carbone-11 les systèmes de vectorisation pour valider le passage de la BHE. Des études ex vivo chez le petit animal ont permis de suivre la pénétration cérébrale ainsi que la cinétique d'oxydation au niveau cérébral et en périphérie. / This research work focuses on targeting MIBG or FLT to the central nervous system. The synthesis of 1,4-dihydroquinoline carriers was first carried out in a non-radioactive manner. Previous results led us to consider the use of a linker to connect MIBG to the carrier. Regarding FLT, we focused our interest in the development of a carrier system connected directly to FLT via an ester function. For modulating the redox properties of our delivery systems, we synthesized 1,4-dihydroquinolines having electron-donating or electron-withdrawing groups at position 6 and/or 7. A study in acetonitrile/PBS buffer to determine the influence of these groups on the release of FLT was performed by HPLC. The radiosynthesis of these targeting systems was then conducted to evaluate the ability of 1,4- dihydroquinolines to deliver MIBG or FLT across the blood brain barrier (BBB). Thus, using carbon-11, we radiolabeled the delivery systems to validate the BBB crossing. Small animais were used for ex vivo studies to monitor the brain penetration and the kinetics of oxidation in the brain and periphery.

Les LPSNC représentent une localisation rare des lymphomes B diffus à grandes cellules (LBDGC), d’immunophénotype post-GC, dont la tumorigenèse reste mal connue.Notre objectif était de caractériser les altérations moléculaires des LPSNC à l’aide de techniques d’analyse haut débit.Notre projet a montré comme principaux résultats : 1/ la haute fréquence de mutations touchant des gènes impliqués dans la voie de signalisation BCR/TLR/NF-κB, en particulier MYD88, CD79B et TBL1XR1 ; 2/ des déséquilibres chromosomiques récurrents, en particulier la perte du 6q22 et du 6p (locus HLA) ; 3/ des mutations du promoteur de TERT et 4/ des transcrits de fusions ETV6-IGH.Plusieurs altérations semblent être des biomarqueurs pronostiques (i.e perte du 6q22 et délétions homozygotes de CDKN2A), prédictifs de réponse au traitement ou des cibles prometteuses pour des thérapies innovantes.En conclusion, il existe une grande similitude entre le profil moléculaire des LPSNC et celui des LBDGC extra-cérébraux avec néanmoins quelques spécificités. Les LPSNC peuvent résulter d’une tumorigenèse propre mais aussi de son microenvironnement singulier. / PCNSL represent a rare extranodal diffuse large B cell lymphoma (DLBCL) with a post-GC phenotype whose tumorigenesis is still poorly unknown.Our objective was to characterize the molecular genetic alterations of PCNSL using high throughput technologies.Results: We demonstrated 1/ a high incidence of somatic mutations in genes involved in the BCR/TLR/NF-κB pathway, especially MYD88, CD79B and TBL1XR1; 2/ recurrent chromosome imbalances such as 6q22 loss and 6q (HLA locus) homozygous deletions; 3/ TERT promoter mutations and 4/ gene fusions such as ETV6-IGH. Several alterations are associated with a prognostic impact (6q22 loss and CDKN2A homozygous deletions) or are promising targets for novel therapies.To conclude, PCNSL and extracerebral DLBCL share many similarities in terms of molecular genetic profile despite some specificities. PCNSL may result from a specific tumorigenesis but also from its peculiar microenvironment.

Hipotherapy is a complex therapy, broaden and recently very sought after rehabilitation method, which is being more and more recognized by experts for its broaden scene. It is a complex therapy thanks to involving medicine, psychology, pedagogy and also a social sphere. That's why is this method indicated at many different levels of disablement. It's being used with pacients with children's cerebral palsy, diverse level of cerebral dysfunction and multiple sclerosis. And it's the therapy's effect on multiple sclerosis that this thesis paper discusses. It also applies to brain and spinal traumas, scoliosis, back pain, orthopedic defects, cardiovascular disease, degenerative muscle disease, obesity, as well as it provides help at emotional and mental aspect, e.g. children with behavioral disorders and many others. At hipotherapy is being used a three dimensional (multidimensional) horse motion. Horse's spine moves up - down, forward - backward, right - left. Imitating a mechanisms of human walking, which leads to relaxation of spasticity. Impulses are transmitted onto back which brings interaction of impeller and back muscles, stand up pose, and posture interference. All this brings a walking improvements, movements coordination, balance and consolidation of a flabby muscles. Each horse has a different nature...

Hipotherapy is a complex therapy, broaden and recently very sought after rehabilitation method, which is being more and more recognized by experts for its broaden scene. It is a complex therapy thanks to involving medicine, psychology, pedagogy and also a social sphere. That's why is this method indicated at many different levels of disablement. It's being used with pacients with children's cerebral palsy, diverse level of cerebral dysfunction and multiple sclerosis. And it's the therapy's effect on multiple sclerosis that this thesis paper discusses. It also applies to brain and spinal traumas, scoliosis, back pain, orthopedic defects, cardiovascular disease, degenerative muscle disease, obesity, as well as it provides help at emotional and mental aspect, e.g. children with behavioral disorders and many others. At hipotherapy is being used a three dimensional (multidimensional) horse motion. Horse's spine moves up - down, forward - backward, right - left. Imitating a mechanisms of human walking, which leads to relaxation of spasticity. Impulses are transmitted onto back which brings interaction of impeller and back muscles, stand up pose, and posture interference. All this brings a walking improvements, movements coordination, balance and consolidation of a flabby muscles. Each horse has a different nature...

Background and Purpose: In 2007, the WHO classification of brain tumors was extended by three new entities of glioneuronal tumors: papillary glioneuronal tumor (PGNT), rosette-forming glioneuronal tumor of the fourth ventricle (RGNT) and glioneuronal tumor with neuropil-like islands (GNTNI). Focusing on clinical characteristics and outcome, the authors performed a comprehensive individual patient data (IPD) meta-analysis of the cases reported in literature until December 2012. Methods: PubMed, Embase and Web of Science were searched for peer-reviewed articles reporting on PGNT, RGNT, and GNTNI using predefined keywords. Results: 95 publications reported on 182 patients (PGNT, 71; GNTNI, 26; RGNT, 85). Median age at diagnosis was 23 years (range 4–75) for PGNT, 27 years (range 6–79) for RGNT, and 40 years (range 2–65) for GNTNI. Ninety-seven percent of PGNT and 69% of GNTNI were located in the supratentorial region, 23% of GNTNI were in the spinal cord, and 80% of RGNT were localized in the posterior fossa. Complete resection was reported in 52 PGNT (73%), 36 RGNT (42%), and 7 GNTNI (27%) patients. Eight PGNT, 3 RGNT, and 12 GNTNI patients were treated with chemo- and/or radiotherapy as the primary postoperative treatment. Follow-up data were available for 132 cases. After a median follow-up time of 1.5 years (range 0.2–25) across all patients, 1.5-year progression-free survival rates were 52±12% for GNTNI, 86±5% for PGNT, and 100% for RGNT. The 1.5-year overall-survival were 95±5%, 98±2%, and 100%, respectively. Conclusions: The clinical understanding of the three new entities of glioneuronal tumors, PGNT, RGNT and GNTNI, is currently emerging. The present meta-analysis will hopefully contribute to a delineation of their diagnostic, therapeutic, and prognostic profiles. However, the available data do not provide a solid basis to define the optimum treatment approach. Hence, a central register should be established.

Neurological disorders – disorders of the brain, spine and associated nerves – are a leading contributor to global disease burden with a sizable economic cost. Adeno-associated viral (AAV) vectors have emerged as an effective platform for CNS gene therapy and have shown early promise in clinical trials. These trials involve direct infusion into brain parenchyma, an approach that may be suboptimal for treatment of neurodegenerative disorders, which often involve more than a single structure in the CNS. However, overall neuronal transduction efficiency of vectors derived from naturally occurring AAV capsids after systemic administration is relatively low. We have developed novel capsids AAV-AS and AAV-B1 that lead to widespread gene delivery throughout the brain and spinal cord, particularly to neuronal populations. Both transduce the adult mouse brain >10-fold more efficiently than the clinical gold standard AAV9 upon intravascular infusion, with gene transfer to multiple neuronal sub-populations. These vectors are also capable of neuronal transduction in a normal cat. We have demonstrated the efficacy of AAV-AS in the context of Huntington's disease by knocking down huntingtin mRNA 33-50% after a single intravenous injection, which is better than what can be achieved by AAV9 at the particular dose. AAVB1 additionally transduces muscle, beta cells, pulmonary alveoli and retinal vasculature at high efficiency, and has reduced sensitivity to neutralizing antibodies in human sera. Generation of this vector toolbox represents a major step towards gaining genetic access to the entire CNS, and provides a platform to develop new gene therapies for neurodegenerative disorders.