Functional topography of cortical thumb movement representations in human primary motor cortex.

Intracortical microstimulation and single cell recordings in non-human primates showed that both, muscles and movements are represented in primary motor cortex (M1). This was also suggested in humans using electrophysiological and neuroimaging techniques. Transcranial magnetic stimulation (TMS) thus far was used to study motor cortical muscle representations, but data on movement representations in man are scarce. Therefore, we used TMS of M1 to evoke directional (flexion, extension) thumb movements and generated topographic movement maps (TMS-mov-map) in fourteen healthy individuals. TMS-mov-maps were related to the individual voluntary motor output (Vol-mov, directional thumb acceleration). Conventional TMS-motor evoked potentials (TMS-MEP) were simultaneously recorded from the prime movers (flexor and extensor pollicis brevis) and also compared to the voluntary motor output. Remarkably stable topographic maps were generated with both, thumb flexion and extension being multiply represented, overlapped and interspersed. Thumb Flexion was usually more robust than extension. TMS-mov-maps rather than TMS-MEP-maps seemed to better reflect the individual voluntary motor output. The findings emphasize existing models of multiple, overlapping finger movement representations in human M1, and indicate that this model also adapts to antagonistic thumb movements. The results suggest that investigating topographic movement maps may be an interesting adjunct in studying human motor cortical topography and its relevance for motor control.

Patterns of TH1/TH2 cytokines predict clinical response in multiple sclerosis patients treated with glatiramer acetate.

The patterns of Th1/Th2 cytokines in relapsing-remitting multiple sclerosis were analyzed to evaluate their relevance as biomarkers of therapy response to glatiramer acetate (GA). Serum interferon-γ (IFN-γ), osteopontin and interleukin (IL)-2, IL-4, and IL-10 were measured in 19 relapsing-remitting multiple sclerosis patients treated with GA in a prospective study over 3 years. The quotient (IL-2 + IFN-γ)/(IL-4 + IL-10) was elevated in patients with relapses as compared to relapse-free patients after 12 (p = 0.04), 24 (p = 0.02) and 36 months (p = 0.04). Our study indicates that specific patterns of Th1/Th2 cytokines predict the response to GA therapy.

The chemokine CXCL13 is a prognostic marker in clinically isolated syndrome (CIS).

BACKGROUND: There is increasing recognition of the importance of B lymphocytes in the immunopathogenesis of multiple sclerosis (MS), encouraging the evaluation of B cell-associated biomarkers in the cerebrospinal fluid (CSF). We aimed to evaluate the relevance of the B cell chemoattractant CXCL13 as a prognostic marker in patients with clinically isolated syndrome (CIS) regarding conversion to MS, and to compare it to Barkhof criteria in magnetic resonance imaging (MRI), oligoclonal bands (OCB) and the polyspecific intrathecal B cell response against measles, rubella and varicella zoster virus (MRZR). METHODOLOGY/PRINCIPAL FINDINGS: CXCL13 was determined in a prospective study over 2 years including 46 patients that remained CIS over follow-up (CIS-CIS), 45 patients that developed MS (CIS-RRMS), and 30 controls using ELISA. CSF CXCL13 was significantly elevated in CIS-RRMS as compared to CIS-CIS and controls (p<0.001). It was significantly elevated in CIS with OCB (p<0.001), positive MRZR (p=0.04), and gadolinium enhancement in MRI (p=0.02) and showed a significant correlation with CSF leukocyte count (p<0.001) and QIgG (p<0.001). CXCL13 showed the best positive predictive value (PPV) of all parameters investigated (70%, 95%-CI: 53-84%), which could be further increased by combination with Barkhof criteria in MRI (80%). CONCLUSIONS/SIGNIFICANCE: Our data indicate the relevance of CXCL13 in CIS to predict conversion to MS. It furthermore shows CXCL13 to be an important mediator in the inflammatory cascade associated with the polyspecific intrathecal B cell response that manifests itself in OCB and MRZR.

MMP-2 and MMP-9 are elevated in spinal cord and skin in a mouse model of ALS.

We aimed to clarify the role of matrix metalloproteinases (MMP) as a possible link between neurodegeneration and skin pathology in ALS by determination of gelatinase MMP-2 and MMP-9 in spinal cord and skin of transgenic SOD1((G93A)) mice. To elucidate mechanisms influencing MMPs, markers of oxidative damage (malondialdehyde (MDA), 3-nitrotyrosine (3-NT) and 8-hydroxy-2'-deoxyguanosine (8OH2'dG)) as well as cytokines (tumor necrosis factor alpha (TNF-alpha) and interleukin 1ss (IL-1ss)) were determined. We measured MMP-9, MMP-2, 3-NT, TNF-alpha, and IL-1ss using ELISA, MDA using High Performance Liquid Chromatography (HPLC) and 8OH2'dG using HPLC with electrochemical detection (HPLC-ECD) in SOD1 and WT. MMP-9 was elevated in spinal cord and skin of SOD1 at 90 days (p=0.009, p<0.001) and 120 days (p<0.01, p=0.04). MMP-2 was elevated in the spinal cord at 90 days (p=0.01) and in the skin at 120 days (p=0.039). We observed a correlation of MMP-9 in spinal cord and skin of SOD1 (p=0.04). MDA was elevated in the spinal cord of SOD1 at 90 and 120 days (p=0.00006, p=0.01) and 8OH2'dG at 90 days (p=0.048). IL-1ss was elevated in the spinal cord of SOD1 at 120 days (p=0.02). Our data confirms that gelatinase MMPs are a common factor linking neurodegeneration and skin changes in ALS. It suggests that oxidative stress and microglial-derived cytokines contribute to the elevation of gelatinase MMPs especially in later stages of disease. Our data raises the question whether the skin may function as a biomarker for specific aspects of disease pathology in ALS.