A multimodal approach using TMS and EEG reveals neurophysiological changes in Parkinson's disease

IntroductionAlterations in large scale neural networks leading to neurophysiological changes have been described in Parkinson's disease (PD). The combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has been suggested as a promising tool to identify and quantify neurophysiological mechanisms. The aim of this study was to investigate specific changes in electrical brain activity in response to stimulation of four brain areas in patients with PD.Methods21 healthy controls and 32 patients with PD underwent a combined TMS-EEG assessment that included stimulation of four brain areas: left M1, right M1, left dorso-lateral prefrontal cortex (DLPFC), and right DLPFC. Six measures were calculated to characterize the TMS evoked potentials (TEP) using EEG: (1) wave form adherence (WFA), (2) late phase deflection (LPD), (3) early phase deflection (EPD), (4) short-term plasticity (STP), (5) inter-trial adherence, and (6) connectivity between right and left M1 and DLPFC. A Linear mixed-model was used to compare these measures between groups and areas stimulated.ResultsPatients with PD showed lower WFA (p = 0.052), lower EPD (p = 0.009), lower inter-trial adherence (p < 0.001), and lower connectivity between homologs areas (p = 0.050), compared to healthy controls. LPD and STP measures were not different between the groups. In addition, lower inter-trial adherence correlated with longer disease duration (r = −0.355, p = 0.050).ConclusionsOur findings provide evidence to various alterations in neurophysiological measures in patients with PD. The higher cortical excitability along with increased variability and lower widespread of the evoked potentials in PD can elucidate different aspects related to the pathophysiology of the disease.     

Effects of Sustained‐Release Beraprost in Patients With Primary Glomerular Disease or Nephrosclerosis: CASSIOPEIR Study Results

TRK‐100STP, a sustained‐release preparation of the orally active prostacyclin analogue beraprost sodium, targets renal hypoxia. This study aimed to show the superiority of TRK‐100STP over placebos in patients with chronic kidney disease (with either primary glomerular disease or nephrosclerosis) to determine the recommended dose. CASSIOPEIR (Chronic Renal Failure Asian Study with Oral PGI₂ Derivative for Evaluating Improvement of Renal Function) was a randomized, double‐blind, placebo‐controlled study conducted at 160 sites in seven Asia‐Pacific countries and regions. Eligible patients (n = 892) were randomized to TRK‐100STP 120, 240 μg, or placebo for a treatment period of up to 4 years. The primary efficacy endpoint was time to first occurrence of a renal composite: doubling of serum creatinine or occurrence of end‐stage renal disease. No significant differences were observed in composite endpoints between TRK‐100STP and placebo (P = 0.5674). Hazard ratios (95% CI) in the TRK‐100STP 120 and 240 μg vs. placebo groups were 0.98 (0.78, 1.22) and 0.91 (0.72, 1.14), respectively. The overall incidence of adverse events and adverse drug reactions was comparable between treatment arms.     

毒性试验组织病理学结果有害作用判断概述

药物非临床安全性评价毒性试验有害作用的判断非常重要,因其可为保护临床试验暴露于新化学实体或药物的受试者提供重要信息。毒性试验组织病理学检查可提供受试物毒性作用的形态学数据,帮助分析和确定有害作用和非有害作用及其剂量水平。参照美国毒性病理学会（STP）和欧洲毒性病理学会（ESTP）的推荐最佳实践或建议及其他相关文献,对有害作用的定义、区分有害作用与非有害作用的要素、有害作用数据沟通和使用来评估人类潜在风险等建议等进行简要概述分析,以期为我国非临床药物安全性评价毒性试验中有害作用判定提供参考。     

药物非临床毒性试验周围神经系统组织病理学评估研究进展

药物非临床毒性试验周围神经系统（peripheral nervous system,PNS）组织病理学评估分为4种情况：未知或预期无神经毒性的一般毒性试验、可能有躯体神经毒性的一般毒性试验、可能有自主神经病的一般毒性试验以及预期有神经毒性作用的专门神经毒性试验。美国毒性病理学会（Society of Toxicologic Pathology,STP）推荐最佳实践建议的目的是确保在药物非临床一般毒性试验和专门神经毒性试验的4种情况下,对PNS组织进行一致性、高效率取材、处理和评估。综述了PNS解剖的基本结构、PNS毒性试验情况分类及取材建议、PNS毒性试验不同情况下最佳实践建议、PNS神经病理学评估分析策略以及评估结果的记录,以期为我国药物非临床毒性试验中周围神经系统组织病理学评估提供一定参考。     

蝎皮蛋白质组分对正常小鼠免疫功能的影响

目的研究蝎皮蛋白质组分对正常小鼠免疫功能的影响,为蝎皮开发利用和发现新的活性物质提供实验依据。方法采用刃天青和M TT法检测蝎皮水溶性总蛋白(STP)、总角蛋白(STKP)及水溶性蛋白组分Ⅱ(STPⅡ)对正常小鼠T、B淋巴细胞转化、NK细胞杀伤活性的作用。结果STP和STKP ig给药后,小鼠脾T淋巴细胞增殖反应高于正常对照组,但只有STP小剂量组与对照组比较差异显著(P<0.001)。B淋巴细胞增殖反应结果显示STKP大、小剂量均可加强增殖反应,与对照组比较差异极显著(P<0.05、0.01)。STP和STKP大、小剂量组NK细胞杀伤活性与对照组相比有升高趋势。STPⅡ两个剂量组100、200 m g/kg ig给药均能明显抑制正常小鼠T、B淋巴细胞增殖反应,与对照组相比差异极显著。STPⅡ大剂量组NK细胞杀伤活性与对照组相比有降低趋势,但无统计学意义。结论STP和STKP具有一定的提高免疫功能的作用,STPⅡ则具有抑制免疫功能的活性。揭示蝎皮蛋白质组分具有免疫调节药理活性,值得深入研究。     

Simultaneous thrombin and plasmin generation capacities in normal and abnormal states of coagulation and fibrinolysis in children and adults

Introduction

Thrombin and plasmin are the key enzymes involved in coagulation and fibrinolysis, respectively. Plasma coagulative and fibrinolytic potentials in normal children and adults, and in representative pathologically altered hemostatic states, were evaluated via simultaneous assessment of thrombin and plasmin generation.

Materials and Methods

An assay of Simultaneous Thrombin and Plasmin generation (STP) was developed to measure thrombin and plasmin in plasma using individual fluorometric substrates. Coagulation is initiated with dilute tissue factor, phospholipid, and calcium in platelet-poor plasma; fibrinolysis is accelerated via tissue plasminogen activator (tPA). Abnormal states of hemostasis were investigated.

Results

STP assay reproducibility and normal adult and pediatric values for measured and calculated parameters have been established. Onset of both thrombin and plasmin generation was significantly delayed in children relative to adults (p < 0.001) and the maximum amplitudes of thrombin and plasmin generation were less in children than adults (p < 0.01). No significant differences were measured among pediatric age groups. The most profound impairments in thrombin generation were observed for extrinsic and common pathway factor deficiencies, with the exception of afibrinogenemia. Plasmin generation was severely impaired in deficiencies of fibrinogen and plasminogen as well as with decreased tPA reagent concentration and addition of aminocaproic acid. Plasmin generation was greatly enhanced by alpha-2-antiplasmin deficiency and excess tPA reagent.

Conclusion

Simultaneous assessment of thrombin and plasmin generation in plasma shows promise for affording an enhanced understanding of overall coagulative and fibrinolytic functions in physiological and pathologically altered states of hemostasis in children and adults.     

C-Deoxyglucose mapping of the monkey brain during reaching to visual targets

The strategies used by the macaca monkey brain in controlling the performance of a reaching movement to a visual target have been studied by the quantitative autoradiographic ¹⁴C-DG method.Experiments on visually intact monkeys reaching to a visual target indicate that V1 and V2 convey visuomotor information to the cortex of the superior temporal and parietoccipital sulci which may encode the position of the moving forelimb, and to the cortex in the ventral part and lateral bank of the intraparietal sulcus which may encode the location of the visual target. The involvement of the medial bank of the intraparietal sulcus in proprioceptive guidance of movement is also suggested on the basis of the parallel metabolic effects estimated in this region and in the forelimb representations of the primary somatosensory and motor cortices. The network including the inferior postarcuate skeletomotor and prearcuate oculomotor cortical fields and the caudal periprincipal area 46 may participate in sensory-to-motor and oculomotor-to-skeletomotor transformations, in parallel with the medial and lateral intraparietal cortices.Experiments on split brain monkeys reaching to visual targets revealed that reaching is always controlled by the hemisphere contralateral to the moving forelimb whether it is visually intact or ‘blind'. Two supplementary mechanisms compensate for the ‘blindness' of the hemisphere controlling the moving forelimb. First, the information about the location of the target is derived from head and eye movements and is sent to the ‘blind' hemisphere via inferior parietal cortical areas, while the information about the forelimb position is derived from proprioceptive mechanisms and is sent via the somatosensory and superior parietal cortices. Second, the cerebellar hemispheric extensions of vermian lobules V, VI and VIII, ipsilateral to the moving forelimb, combine visual and oculomotor information about the target position, relayed by the ‘seeing' cerebral hemisphere, with sensorimotor information concerning cortical intended and peripheral actual movements of the forelimb, and then send this integrated information back to the motor cortex of the ‘blind' hemisphere, thus enabling it to guide the contralateral forelimb to the target.     

Parallel nature of hippocampal synaptic plasticity

This study demonstrates that the mechanisms involved in the production of long-term potentiation (LTP) in the hippocampus appear to be independent of those which generate shorter-lasting plasticity, but that both processes are activated concurrently following an LTP-inducing stimulus. Adult male Sprague-Dawley rats were anesthetized using either pentobarbital or secobarbital to record extracellular field potentials from the hippocampal CA1 pyramidal cell layer in response to stimulation of commissural afferents. Plasticity was generated by the delivery of a five-pulse patterned stimulus train, consisting of one priming pulse followed 170 milliseconds later by a burst of four pulses at 200 Hz. While similar LTP was observed in both groups, short-term plasticity was absent in the secobarbital-anesthetized animals. This result suggests that different plasticity mechanisms in the hippocampus are activated in parallel by the triggering stimulus. Synapse 30:112–115, 1998. © 1998 Wiley-Liss, Inc.     

Calcium lignosulphonate: Re-evaluation of relevant endpoints to re-confirm validity and NOAEL of a 90-day feeding study in rats

A 90-day feeding study in Han/Wistar rats with calcium lignosulphonate was evaluated by the EFSA. The study was considered to be inadequate due to potentially impaired health status of the animals based upon a high incidence of minimal lymphoid hyperplasia in mesenteric/mandibular lymph nodes and Peyer’s patches, and minimal lymphoid cell infiltration in the liver in all animals. The EFSA Panel further disagreed with the conclusion that the treatment-related observation of foamy histiocytosis in mesenteric lymph nodes was non-adverse and asked whether this observation would progress to something more adverse over time. A PWG was convened to assess the sections of lymph nodes, Peyer’s patches and liver. In addition, all lymphoid tissues were re-examined. The clinical pathology and animal colony health screening data were re-evaluated. The question whether the foamy histiocytosis could progress to an adverse finding with increasing exposure duration was addressed by read-across. In conclusion, the animals on the 90-day feeding study were in good health, the study was adequate for safety evaluation, and the foamy histiocytes in the mesenteric lymph nodes were not considered adverse, but rather an adaptive response that was considered unlikely to progress to an adverse condition with time. The NOAEL was re-affirmed to be 2000 mg/kg bw/d.