Cerebellar Involvement in Ataxia and Generalized Epilepsy

__Abstract__ The work described in this thesis was performed in order to elucidate the role of different cerebellar modules in ataxia and generalized epilepsy using various techniques including in vivo electrophysiology, optogenetics, pharmacological interventions, immunohistology and behavioral measurements. The majority of experiments were executed in mice with mutations in the Cacna1a gene which encodes the poreforming subunit of Cav2.1 calcium channels. Expression of this gene is particularly high in the cerebellum and mutations or ablation of this gene can result in cerebellar ataxia, dystonia and generalized epilepsy. In Chapter 2 we showed that PC specific deletion of this gene is sufficient to cause cerebellar ataxia and widespread PC degeneration. Interestingly, the ataxic phenotype became apparent well before any morphological or degenerative changes occurred. This suggests that, in line with other studies, aberrant PC activity rather than PC atrophy or morphological anomalies may play a crucial role in cerebellar ataxia. Next we investigated potential cerebellar involvement in generalized epilepsy using a global Cacna1a mutant (tottering) and tested whether manipulation of either cerebellar nuclei or cerebellar cortex activity could influence seizure occurrence. In Chapters 3 and 5 we demonstrate that both CN neurons and PCs show GSWD related firing pattern modulation. Furthermore, whereas pharmacological manipulation of CN activity had a pronounced impact on seizure occurrence, stopping action potential firing in a large area of the cerebellar cortex had no impact on GSWD occurrence. Considering the promising effects of these pharmacological interventions in the CN, we next described the use of a closed-loop seizure detection and stimulation system with the aim of disrupting epileptic thalamocortical activity through optogenetic CN stimulation in Chapters 3 and 4. We showed that this form of on-demand neurostimulation is highly effective and stopped 75-100% of the seizures within a few hundred milliseconds. To exclude specificity of these results for this particular mouse model we confirmed our main outcomes in an unrelated absence epilepsy mouse model. In Chapter 6 we discuss potential mechanisms underlying the effects of pharmacological and optogenetic CN modulation and found that thalamic neurons indeed showed a change in activity upon CN manipulations. Chapter 7 provided conclusive remarks and a discussion of the implications of these results and suggestions for future research

Increased susceptibility to cortical spreading depression and epileptiform activity in a mouse model for FHM2

Migraine is a highly prevalent, debilitating, episodic headache disorder affecting roughly 15% of the population. Familial hemiplegic migraine type 2 (FHM2) is a rare subtype of migraine caused by mutations in the ATP1A2 gene, encoding the α2 isoform of the Na+/K+-ATPase, predominantly expressed in astrocytes. Differential comorbidities such as epilepsy and psychiatric disorders manifest in patients. Using a mouse model harboring the G301R disease-mutation in the α2 isoform, we set to unravel whether α2 +/G301R mice show an increased susceptibility for epilepsy and cortical spreading depression (CSD). We performed in vivo experiments involving cortical application of KCl in awake head-restrained male and female mice of different age groups (adult and aged). Interestingly, α2 +/G301R mice indeed showed an increased susceptibility to both CSD and epileptiform activity, closely replicating symptoms in FHM2 patients harboring the G301R and other FHM2-causing mutations. Additionally, this epileptiform activity was superimposed on CSDs. The age-related alteration towards CSD indicates the influence of female sex hormones on migraine pathophysiology. Therefore, the FHM2, α2 +/G301R mouse model can be utilized to broaden our understanding of generalized epilepsy and comorbidity hereof in migraine, and may be utilized toward future selection of possible treatment options for migraine

Purkinje cell-specific ablation of CaV2.1 Channels is sufficient to cause cerebellar ataxia in mice

The Cacna1a gene encodes the α1A subunit of voltage-gated CaV2.1 Ca2+ channels that are involved in neurotransmission at central synapses. CaV2.1-α1- knockout (α1KO) mice, which lack CaV2.1 channels in all neurons, have a very severe phenotype of cerebellar ataxia and dystonia, and usually die around postnatal day 20. This early lethality, combined with the wide expression of CaV2.1 channels throughout the cerebellar cortex and nuclei, prohibited determination of the contribution of particular cerebellar cell types to the development of the severe neurobiological phenotype in Cacna1a mutant mice. Here, we crossed conditional Cacna1a mice with transgenic mice expressing Cre recombinase, driven by the Purkinje cell-specific Pcp2 promoter, to specifically ablate the CaV2.1- α1A subunit and thereby CaV2.1 channels in Purkinje cells. Purkinje cell CaV2.1-α1A-knockout (PCα1KO) mice aged without difficulties, rescuing the lethal phenotype seen in α1KO mice. PCα1KO mice exhibited cerebellar ataxia starting around P12, much earlier than the first signs of progressive Purkinje cell loss, which appears in these mice between P30 and P45. Secondary cell loss was observed in the granular and molecular layers of the cerebellum and the volume of all individual cerebellar nuclei was reduced. In this mouse model with a cell type-specific ablation of CaV2.1 channels, we show that ablation of CaV2.1 channels restricted to Purkinje cells is sufficient to cause cerebellar ataxia. We demonstrate that spatial ablation of CaV2.1 channels may help in unraveling mechanisms of human disease

Cerebellar purkinje cells can differentially modulate coherence between sensory and motor cortex depending on region and behavior

Activity of sensory and motor cortices is essential for sensorimotor integration. In particular, coherence between these areas may indicate binding of critical functions like perception, motor planning, action, or sleep. Evidence is accumulating that cerebellar output modulates cortical activity and coherence, but how, when, and where it does so is unclear. We studied activity in and coherence between S1 and M1 cortices during whisker stimulation in the absence and presence of optogenetic Purkinje cell stimulation in crus 1 and 2 of awake mice, eliciting strong simple spike rate modulation. Without Purkinje cell stimulation, whisker stimulation triggers fast responses in S1 and M1 involving transient coherence in a broad spectrum. Simultaneous stimulation of Purkinje cells and whiskers affects amplitude and kinetics of sensory responses in S1 and M1 and alters the estimated S1–M1 coherence in theta and gamma bands, allowing bidirectional control dependent on behavioral context. These effects are absent when Purkinje cell activation is delayed by 20 ms. Focal stimulation of Purkinje cells revealed site specificity, with cells in medial crus 2 showing the most prominent and selective impact on estimated coherence, i.e., a strong suppression in the gamma but not the theta band. Granger causality analyses and computational modeling of the involved networks suggest that Purkinje cells control S1–M1 phase consistency predominantly via ventrolateral thalamus and M1. Our results indicate that activity of sensorimotor cortices can be dynamically and functionally modulated by specific cerebellar inputs, highlighting a widespread role of the cerebellum in coordinating sensorimotor behavior

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

PRRT2-dependent dyskinesia: cerebellar, paroxysmal and persistent

In an elegant publication in Cell Research, Tan and colleagues showed that ablation of PRRT2 in cerebellar granule cells is sufficient to induce paroxysmal kinesigenic dyskinesia. PRRT2 turns out to downregulate the presynaptic SNARE complex in granule cell axons, which in turn controls the activity patterns of Purkinje cells, the sole output of the cerebellar cortex