Περιγεννητικές ψυχικές διαταραχές

Ο βασικός σκοπός αυτής της διπλωματικής εργασίας είναι να προβάλλει όσο πιο λεπτομερώς γίνεται τις ψυχικές διαταραχές που μπορεί να εμφανιστούν κατά την κύηση έως και τον πρώτο χρόνο μετά την γέννα. Είναι σημαντικό να αναφερθεί η ανάγκη για περισσότερες μελέτες και η ενημέρωση για την πρόληψη, την διάγνωση, τα συμπτώματα και την θεραπεία των περιγεννητικών ψυχικών διαταραχών, όπως αυτή αναλύεται μέσα από την διερεύνηση της συναφής βιβλιογραφίας. Μέσα από την παρούσα εργασία επιχειρείται να δοθεί έμφαση στην διαφορική διάγνωση των ψυχικών διαταραχών, καθώς ενέχουν ίδια συμπτώματα με αυτά της κύησης. Στον ψυχισμό της εγκύου επιδρούν ποικίλοι παράγοντες εκτός της κύησης, οι οποίοι παρουσιάζουν διαφορές σε κάθε περίπτωση. Η ανάλυση της αιτίας των περιγεννητικών ψυχικών διαταραχών αποδεικνύεται από την μελέτη των παραγόντων κινδύνου εμφάνισης μια ψυχικής διαταραχής, τομέας που διατηρεί κύρια θέση στην παρούσα εργασία. Επιπρόσθετα, δεν μπορεί να λείπει η σημαντικότητα μια κατάλληλης θεραπείας που εξατομικεύεται σε κάθε περίπτωση (Flynn et al., 2004). Η μετάβαση στη γονεικότητα είναι αδιάψευστα εξαιρετική στιγμή της ζωής της γυναίκας. Η γέννηση ενός παιδιού αν και κατά κύριο λόγο συνδέεται με συναισθήματα χαράς και ευτυχίας, κάποιες φορές μπορεί να φέρει στην επιφάνεια συναισθηματικές διαταραχές, που μπορεί να προκαλέσουν δυσκολίες στην μετάβαση στη γονεικότητα (O’ Hara και Swain, 1996). Τέλος, σύμφωνα με όσα αναφέρει ο Πλάτων: «είναι υψίστης σημασίας να προσέχει κανείς τις γυναίκες ιδιαίτερα κατά της διάρκεια της κύησης, ώστε να μην βρεθεί ούτε με πολλές οδύνες, ούτε με πολλά πάθη, ούτε με λύπες, αλλά να διανύει αυτή τη περίοδο, τιμώντας την, με χαρά και καλή ψυχική διάθεση» (Πλάτων νόμοι, 792 Ε).The main aim of this dissertation is to present in a thorough way the psychic dimensions of the perinatal period, especially that of the perinatal mental disorders. It seeks to highlight and stress the need for additional research and information about the symptoms, prognosis, and diagnosis as well as the approach-treatment of mental disorders that may appear during pregnancy and the postpartum period, through a review of the relevant, contemporary, international-literature. It attempts to emphasize issues of clinical and social interest that are very often being confused or overlooked, due to the common symptoms they share with pregnancy itself. It finds that the mental health of pregnant women is affected by many factors other than pregnancy itself that vary from case to case. The analysis of the factors plays a fundamental role in this study, highlighting the broad spectrum of the causes of perinatal mental disorders as well as underlining its importance during the process of identifying an appropriate personalised approach-treatment (Flynn et al., 2004) The period of maternity is undoubtedly an important aspect in the life of a woman. Pregnancy and giving birth are complex events that are accompanied by biological, social, and emotional changes. Even though in most cases they are accompanied by feelings of happiness and fulfillment, they may sometimes cause psycho-emotional issues and subsequent difficulties in adapting to parenthood (O’ Hara και Swain, 1996). To end, as Plato says: “women with child, above all others, should be cared for during their years of pregnancy, lest any of them should indulge in repeated and intense pleasures or pains, instead of cultivating, during the whole of that period, a cheerful, bright and calm demeanor” (Plato, Laws, 792E)

The role of BM88/Cend1 molecule in the proliferation and differentiation of neural precursor cells derived from the subventricular zone of the adult mouse

BM88/Cend1 a préalablement été montrée d'induire la sortie du cycle cellulaire et la différenciation neuronale des précurseurs neuraux dans le système nerveux embryonnaire. Dans ce travail nous démontrons que Cend1 est exprimée de manière endogène dans les régions neurogéniques du cerveau adulte de la souris in vivo. De plus, in vitro Cend1 est capable d'induire la sortie du cycle cellulaire et la différenciation neuronale des cellules progénitrices de neurosphères et d'explants. Cette fonction de Cend1 est potentiellement effectuée par sa participation dans des chemins de spécification neuronale régulés par des gènes proneuraux dans le cerveau adulte, puisque nous avons démontré que le promoteur de Cend1 est directement activé par Neurogenin1 in vitroBM88/Cend1 has already been shown to induce cell cycle exit and neuronal differentiation of neural precursors in the embryonic central nervous system. In this work we present evidence that Cend1 is endogenously expressed in neurogenic regions of the adult mouse brain in vivo. Moreover, Cend1 is capable of inducing cell cycle exit and neuronal differentiation of precursor cells in neurosphere cultures and explants in vitro. This may be done by participation in neuronal specification pathways regulated by proneural genes in the adult brain, as Cend1 promoter was shown to be directly activated by Neurogenin1 in vitroMONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Transplantation of embryonic neural stem/precursor cells overexpressing BM88/Cend1 enhances the generation of neuronal cells in the injured mouse cortex.

International audienceThe intrinsic inability of the central nervous system to efficiently repair traumatic injuries renders transplantation of neural stem/precursor cells (NPCs) a promising approach towards repair of brain lesions. In this study, NPCs derived from embryonic day 14.5 mouse cortex were genetically modified via transduction with a lentiviral vector to overexpress the neuronal lineage-specific regulator BM88/Cend1 that coordinates cell cycle exit and differentiation of neuronal precursors. BM88/Cend1-overexpressing NPCs exhibiting enhanced differentiation into neurons in vitro were transplanted in a mouse model of acute cortical injury and analyzed in comparison with control NPCs. Immunohistochemical analysis revealed that a smaller proportion of BM88/Cend1-overexpressing NPCs, as compared with control NPCs, expressed the neural stem cell marker nestin 1 day after transplantation, while the percentage of nestin-positive cells was significantly reduced thereafter in both types of cells, being almost extinct 1 week post-grafting. Both types of cells did not proliferate up to 4 weeks in vivo, thus minimizing the risk of tumorigenesis. In comparison with control NPCs, Cend1-overexpressing NPCs generated more neurons and less glial cells 1 month after transplantation in the lesioned cortex whereas the majority of graft-derived neurons were identified as GABAergic interneurons. Furthermore, transplantation of Cend1-overexpressing NPCs resulted in a marked reduction of astrogliosis around the lesioned area as compared to grafts of control NPCs. Our results suggest that transplantation of Cend1-overexpressing NPCs exerts beneficial effects on tissue regeneration by enhancing the number of generated neurons and restricting the formation of astroglial scar, in a mouse model of cortical brain injury

BM88/Cend1 expression levels are critical for proliferation and differentiation of subventricular zone-derived neural precursor cells.

International audienceNeural stem cells remain in two areas of the adult mammalian brain, the subventricular zone (SVZ) and the dentate gyrus of the hippocampus. Ongoing neurogenesis via the SVZ-rostral migratory stream pathway maintains neuronal replacement in the olfactory bulb (OB) throughout life. The mechanisms determining how neurogenesis is restricted to only a few regions in the adult, in contrast to its more widespread location during embryogenesis, largely depend on controlling the balance between precursor cell proliferation and differentiation. BM88/Cend1 is a neuronal lineage-specific regulator implicated in cell cycle exit and differentiation of precursor cells in the embryonic neural tube. Here we investigated its role in postnatal neurogenesis. Study of in vivo BM88/Cend1 distribution revealed that it is expressed in low levels in neuronal precursors of the adult SVZ and in high levels in postmitotic OB interneurons. To assess the functional significance of BM88/Cend1 in neuronal lineage progression postnatally, we challenged its expression levels by gain- and loss-of-function approaches using lentiviral gene transfer in SVZ-derived neurospheres. We found that BM88/Cend1 overexpression decreases proliferation and favors neuronal differentiation, whereas its downregulation using new-generation RNA interference vectors yields an opposite phenotype. Our results demonstrate that BM88/Cend1 participates in cell cycle control and neuronal differentiation mechanisms during neonatal SVZ neurogenesis and becomes crucial for the transition from neuroblasts to mature neurons when reaching high levels