AbstractsBiology & Animal Science

Unverricht-Lundborg type progressive myoclonus epilepsy (EPM1, OMIM 254800) is an autosomal recessive disorder characterized by onset at the age of 6 to 16 years, incapacitating stimulus-sensitive myoclonus and tonic-clonic epileptic seizures. It is caused by mutations in the gene encoding cystatin B (CSTB). However, the disease processes leading to the observed symptoms are currently unclear. Clinical magnetic resonance imaging (MRI) of the brain has shown neurodegenerative changes and computed tomography data have suggested a bone phenotype. This thesis examined the disease processes and the background of the pathological changes in the brain and the bone, utilizing modern imaging methods and image analysis methodology complemented with experimental data in the mouse model (the Cstb -/- mouse) of the disease. In order to gain a comprehensive picture of the disease progression in the brain, we performed a longitudinal imaging study in the Cstb -/- mouse. Animals were studied from the pre-symptomatic to fully symptomatic disease stages (1-6 mo). For studying atrophic changes, in vivo MRI volumetry was preformed once a month from 1 to 6 months of age. For investigating white matter (WM) changes, ex vivo diffusion tensor imaging (DTI) was performed at 2, 4 and 6 months. The fractional anisotropy (FA) maps derived from DTI data were analysed using track based spatial statistics (TBSS) that provided us with a hypothesis-free analysis of white matter changes. In vivo volumetry showed progressive volume loss in Cstb-/- mice over time, the rate of which was neither spatially nor temporally uniform over the brain. TBSS revealed progressing FA decrease, suggesting severe and widespread WM damage, with most drastic changes in the cerebellum and the thalamus. Subsequently the congruence of the observed WM changes between the mouse model and EPM1 patients were evaluated. In vivo DTI data from fully symptomatic adult patients and ex vivo data from fully symptomatic (6 mo) Cstb-/- mice were analysed using TBSS with matching protocols. The results revealed extensive changes with a pattern of chronic WM degeneration in EPM1 patients, with similar alterations detected in Cstb-/- mice. Furthermore, previously unknown brain regions were shown to be affected both in patients and in mice. The imaging data were then used to guide tissue level analyses in mice. The microstructural counterpart of the areas with decreased FA in mice was characterized by immunohistochemistry and transmission electron microscopy. Based on the tissue level findings, the extensive changes identified by DTI in both EPM1 patients and in Cstb-/- mice are probably a consequence of widespread WM loss upon axonal degeneration, and likely contribute to the motor disturbances present in the disease. Finally, we characterized the bone changes underlying the observed skeletal phenotype in EPM1 patients by performing microtomography (µCT), histology, and in vitro cell culture experiments with the Cstb-/- mouse. Analysis of bone microstructure in Cstb-/- mice using…