Orbital Apex Syndrome Resulting from Mixed Bacterial Sphenoid Sinusitis

Orbital apex syndrome (OAS) is an uncommon disorder characterized by visual loss, ophthalmoplegia, ptosis and hypoaesthesia of the forehead[1]. OAS may result from a variety of inflammatory, infectious, neoplastic and vascular conditions that cause damage to the superior orbital fissure (with resultant oculomotor (III), trochlear (IV), abducens (VI) and ophthalmic branch of the trigeminal nerve (V1) palsies) and to the optic canal leading to optic nerve (II) dysfunction. This case report describes the clinical development of OAS in a patient with bacterial sphenoid sinusitis

The Chemogenetic Receptor Ligand Clozapine N-Oxide Induces<em> in vivo</em> Neuroreceptor Occupancy and Reduces Striatal Glutamate Levels

Chemogenetic studies with the ligand clozapine N-oxide (CNO) are predicated upon the assumption that CNO is devoid of actions at natural neuroreceptors. However, recent evidence shows that CNO may be converted back to clozapine (CLZ) in vivo, which could yield plasma concentrations that may be sufficient to occupy inter alia dopamine D2=3 and serotonin 5HT2A receptors in living brain. To test this phenomenon, we measured striatal dopamine D2=3 receptor occupancy with [18F]fallypride PET and serotonin 5HT2A occupancy ex vivo using [18F]MH.MZ. We found a CNO dosedependent effect on the availability of both neuroreceptor sites. In parallel MR spectroscopy experiments, we found that CNO reduced creatine C phosphcreatine (CrCPCr) and increased N-acetylaspartate C N-acetylaspartylglutamate (NAACNAAG) signals in the prefrontal cortex, and also reduced the glutamate signal in dorsal striatum, with peak effect at 2 mg/kg. Thus, our findings suggest that conversion of CNO to CLZ in living rats imparts significant occupancy at endogenous neuroreceptors and significant changes to neurometabolite levels

The Chemogenetic Receptor Ligand Clozapine N-Oxide Induces in vivo Neuroreceptor Occupancy and Reduces Striatal Glutamate Levels

Chemogenetic studies with the ligand clozapine N-oxide (CNO) are predicated upon the assumption that CNO is devoid of actions at natural neuroreceptors. However, recent evidence shows that CNO may be converted back to clozapine (CLZ) in vivo, which could yield plasma concentrations that may be sufficient to occupy inter alia dopamine D2/3 and serotonin 5HT2A receptors in living brain. To test this phenomenon, we measured striatal dopamine D2/3 receptor occupancy with [18F]fallypride PET and serotonin 5HT2A occupancy ex vivo using [18F]MH.MZ. We found a CNO dose-dependent effect on the availability of both neuroreceptor sites. In parallel MR spectroscopy experiments, we found that CNO reduced creatine + phosphcreatine (Cr+PCr) and increased N-acetylaspartate + N-acetylaspartylglutamate (NAA+NAAG) signals in the prefrontal cortex, and also reduced the glutamate signal in dorsal striatum, with peak effect at 2 mg/kg. Thus, our findings suggest that conversion of CNO to CLZ in living rats imparts significant occupancy at endogenous neuroreceptors and significant changes to neurometabolite levels

Visualising neurodegeneration in the living brain : Preclinical evaluation of PET radioligands

With an ageing population, the number of people suffering from Alzheimer’s disease (AD) and Parkinson’s disease (PD) escalates yearly. Pathological hallmarks of AD and PD include aggregated proteins and synaptic dysfunction. Developing imaging probes targeting specific pathological hallmarks is highly valuable in aiding early diagnosis and treatment assessment. The thesis focused on evaluating positron emission tomography (PET) imaging probes that can visualise different pathological changes in preclinical models of neurodegeneration. Ligands targeting synaptic vesicle protein 2A (SV2A), alpha-synuclein (αSyn), and amyloid-beta (Aβ) are investigated. In paper I, we compared synaptic density in transgenic AD and PD mouse models to their wild-type age-matched controls using SV2A PET. In the hippocampus, lower synaptic density was found in the PD mice compared to the control. In paper II, we continued using SV2A PET and studied synaptic density in ageing mice. Synaptic density remained steady for most of the lifespan but slightly decreased in old age. In paper III, we developed and evaluated five antibody-based PET radioligands targeting αSyn aggregates. By conjugating anti-αSyn antibodies with the transferrin receptor (TfR) binder 8D3, we increased antibody brain entry significantly. These bispecific antibodies displayed high specificity and selectivity to αSyn aggregates. The most promising candidate successfully imaged brain-deposited αSyn but was unable to detect endogenously expressed αSyn in PD mouse models. In light of this, further investigation of antibody brain entry, distribution, and elimination is needed. Thus, in paper IV, we used microdialysis to compare the brain pharmacokinetics of a bispecific antibody targeting TfR and Aβ and its regular monospecific version that only binds to Aβ. The bispecific antibody showed distinct pharmacokinetics and entered the brain more efficiently than the regular antibody. Lastly, in paper V, we studied the impact of anti-Aβ antibody treatment on amyloid PET. AD mice were short-term treated with anti-Aβ antibody mAb158 and underwent [11C]PiB ex vivo autoradiography. We found a trend indicating that the treatment reduced the [11C]PiB signal despite no reduction in total Aβ levels. Our results contribute to an increased understanding of PET radioligands imaging neurodegeneration. Furthermore, it provides valuable information for designing and developing new PET radioligands

Visualising neurodegeneration in the living brain : Preclinical evaluation of PET radioligands

With an ageing population, the number of people suffering from Alzheimer’s disease (AD) and Parkinson’s disease (PD) escalates yearly. Pathological hallmarks of AD and PD include aggregated proteins and synaptic dysfunction. Developing imaging probes targeting specific pathological hallmarks is highly valuable in aiding early diagnosis and treatment assessment. The thesis focused on evaluating positron emission tomography (PET) imaging probes that can visualise different pathological changes in preclinical models of neurodegeneration. Ligands targeting synaptic vesicle protein 2A (SV2A), alpha-synuclein (αSyn), and amyloid-beta (Aβ) are investigated. In paper I, we compared synaptic density in transgenic AD and PD mouse models to their wild-type age-matched controls using SV2A PET. In the hippocampus, lower synaptic density was found in the PD mice compared to the control. In paper II, we continued using SV2A PET and studied synaptic density in ageing mice. Synaptic density remained steady for most of the lifespan but slightly decreased in old age. In paper III, we developed and evaluated five antibody-based PET radioligands targeting αSyn aggregates. By conjugating anti-αSyn antibodies with the transferrin receptor (TfR) binder 8D3, we increased antibody brain entry significantly. These bispecific antibodies displayed high specificity and selectivity to αSyn aggregates. The most promising candidate successfully imaged brain-deposited αSyn but was unable to detect endogenously expressed αSyn in PD mouse models. In light of this, further investigation of antibody brain entry, distribution, and elimination is needed. Thus, in paper IV, we used microdialysis to compare the brain pharmacokinetics of a bispecific antibody targeting TfR and Aβ and its regular monospecific version that only binds to Aβ. The bispecific antibody showed distinct pharmacokinetics and entered the brain more efficiently than the regular antibody. Lastly, in paper V, we studied the impact of anti-Aβ antibody treatment on amyloid PET. AD mice were short-term treated with anti-Aβ antibody mAb158 and underwent [11C]PiB ex vivo autoradiography. We found a trend indicating that the treatment reduced the [11C]PiB signal despite no reduction in total Aβ levels. Our results contribute to an increased understanding of PET radioligands imaging neurodegeneration. Furthermore, it provides valuable information for designing and developing new PET radioligands

A Band-Rejection Vivaldi Antenna with High Selectivity Using Hybrid HRW/CCLL

A simplified notched design method for the Vivaldi antenna is exhibiting high frequency-band-selectivity characteristics. By suitably introducing half-wavelength resonator (HWR) and complementary capacitively loaded loop (CCLL), the notched-band selectivity is promoted while maintaining the wide impedance bandwidth of the antenna applicable for wireless communications. HWR is bent in the middle to focus the first notch pole, and the second notch pole is obtained by CCLL on the radiating patch. Additionally, the resonant frequency of the notched pole can be determined by the position and size of two loaded resonators in theoretical analysis, thereby realizing a wideband antenna with the desired notched band. Finally, the Vivaldi antenna of loading resonator was fabricated to verify the feasibility of this new method. Measured and simulated experimental results reveal that the antenna exhibits directional pattern in the passband, low gain at the band-rejection, and excellent selectivity within a frequency range. The simulation and measurement results are in good agreement. The proposed antenna achieves S11<−10 dB in 2.6–13.7 GHz and a notch band from 4.49 to 6.64 GHz to reject IEEE 802.11a and HIPERLAN/2 frequency band. Moreover, the proposed antenna has good frequency selectivity, and its gain is good enough in the passband with peak gain up to 10.8 dBi. This antenna design presents frequency suitability, demonstrating that a UWB antenna with a controllable notched band has been realized

Brain pharmacokinetics of mono- and bispecific amyloid-beta antibodies in wild-type and Alzheimer's disease mice measured by high cut-off microdialysis

Background: Treatment with amyloid-beta (A beta) targeting antibodies is a promising approach to remove A beta brain pathology in Alzheimer's disease (AD) and possibly even slow down or stop progression of the disease. One of the main challenges of brain immunotherapy is the restricted delivery of antibodies to the brain. However, bispecific antibodies that utilize the transferrin receptor (TfR) as a shuttle for transport across the blood-brain barrier (BBB) can access the brain better than traditional monospecific antibodies. Previous studies have shown that bispecific A beta targeting antibodies have higher brain distribution, and can remove A beta pathology more efficiently than monospecific antibodies. Yet, there is only limited information available on brain pharmacokinetics, especially regarding differences between mono- and bispecific antibodies. Methods: The aim of the study was to compare brain pharmacokinetics of A beta-targeting monospecific mAb3D6 and its bispecific version mAb3D6-scFv8D3 that also targets TfR. High cut-off microdialysis was used to measure intravenously injected radiolabelled mAb3D6 and mAb3D6-scFv8D3 antibodies in the interstitial fluid (ISF) of hippocampus in wild-type mice and the App(NL-G-F) mouse model of AD. Distribution of the antibodies in the brain and the peripheral tissue was examined by ex vivo autoradiography and biodistribution studies. Results: Brain concentrations of the bispecific antibody were elevated compared to the monospecific antibody in the hippocampal ISF measured by microdialysis and in the brain tissue at 4-6 h after an intravenous injection. The concentration of the bispecific antibody was approximately twofold higher in the ISF dialysate compared to the concentration of monospecific antibody and eightfold higher in brain tissue 6 h post-injection. The ISF dialysate concentrations for both antibodies were similar in both wild-type and App(NL-G-F) mice 24 h post-injection, although the total brain tissue concentration of the bispecific antibody was higher than that of the monospecific antibody at this time point. Some accumulation of radioactivity around the probe area was observed especially for the monospecific antibody indicating that the probe compromised the BBB to some extent at the probe insertion site. Conclusion: The BBB-penetrating bispecific antibody displayed higher ISF concentrations than the monospecific antibody. The concentration difference between the two antibodies was even larger in the whole brain than in the ISF. Further, the bispecific antibody, but not the monospecific antibody, displayed higher total brain concentrations than ISF concentrations, indicating association to brain tissue

Evaluation of [11C]UCB-A positron emission tomography in human brains

Background: In preclinical studies, the positron emission tomography (PET) imaging with [C-11]UCB-A provided promising results for imaging synaptic vesicle protein 2A (SV2A) as a proxy for synaptic density. This paper reports the first-in-human [C-11]UCB-A PET study to characterise its kinetics in healthy subjects and further evaluate SV2A-specific binding. Results: Twelve healthy subjects underwent 90-min baseline [C-11]UCB-A scans with PET/MRI, with two subjects participating in an additional blocking scan with the same scanning procedure after a single dose of levetiracetam (1500 mg). Our results indicated abundant [C-11]UCB-A brain uptake across all cortical regions, with slow elimination. Kinetic modelling of [C-11]UCB-A PET using various compartment models suggested that the irreversible two-tissue compartment model best describes the kinetics of the radioactive tracer. Accordingly, the Patlak graphical analysis was used to simplify the analysis. The estimated SV2A occupancy determined by the Lassen plot was around 66%. Significant specific binding at baseline and comparable binding reduction as grey matter precludes the use of centrum semiovale as reference tissue. Conclusions: [C-11]UCB-A PET imaging enables quantifying SV2A in vivo. However, its slow kinetics require a long scan duration, which is impractical with the short half-life of carbon-11. Consequently, the slow kinetics and complicated quantification methods may restrict its use in humans