Mutations in the netrin-1 gene cause congenital mirror movements.

Netrin-1 is a secreted protein that was first identified 20 years ago as an axon guidance molecule that regulates midline crossing in the CNS. It plays critical roles in various tissues throughout development and is implicated in tumorigenesis and inflammation in adulthood. Despite extensive studies, no inherited human disease has been directly associated with mutations in NTN1, the gene coding for netrin-1. Here, we have identified 3 mutations in exon 7 of NTN1 in 2 unrelated families and 1 sporadic case with isolated congenital mirror movements (CMM), a disorder characterized by involuntary movements of one hand that mirror intentional movements of the opposite hand. Given the diverse roles of netrin-1, the absence of manifestations other than CMM in NTN1 mutation carriers was unexpected. Using multimodal approaches, we discovered that the anatomy of the corticospinal tract (CST) is abnormal in patients with NTN1-mutant CMM. When expressed in HEK293 or stable HeLa cells, the 3 mutated netrin-1 proteins were almost exclusively detected in the intracellular compartment, contrary to WT netrin-1, which is detected in both intracellular and extracellular compartments. Since netrin-1 is a diffusible extracellular cue, the pathophysiology likely involves its loss of function and subsequent disruption of axon guidance, resulting in abnormal decussation of the CST.

Non cell-autonomous role of DCC in the guidance of the corticospinal tract at the midline.

DCC, a NETRIN-1 receptor, is considered as a cell-autonomous regulator for midline guidance of many commissural populations in the central nervous system. The corticospinal tract (CST), the principal motor pathway for voluntary movements, crosses the anatomic midline at the pyramidal decussation. CST fails to cross the midline in Kanga mice expressing a truncated DCC protein. Humans with heterozygous DCC mutations have congenital mirror movements (CMM). As CMM has been associated, in some cases, with malformations of the pyramidal decussation, DCC might also be involved in this process in human. Here, we investigated the role of DCC in CST midline crossing both in human and mice. First, we demonstrate by multimodal approaches, that patients with CMM due to DCC mutations have an increased proportion of ipsilateral CST projections. Second, we show that in contrast to Kanga mice, the anatomy of the CST is not altered in mice with a deletion of DCC in the CST. Altogether, these results indicate that DCC controls CST midline crossing in both humans and mice, and that this process is non cell-autonomous in mice. Our data unravel a new level of complexity in the role of DCC in CST guidance at the midline.

Specific inhibition of the JNK pathway promotes locomotor recovery and neuroprotection after mouse spinal cord injury.

Limiting the development of secondary damage represents one of the major goals of neuroprotective therapies after spinal cord injury. Here, we demonstrate that specific JNK inhibition via a single intraperitoneal injection of the cell permeable peptide D-JNKI1 6h after lesion improves locomotor recovery assessed by both the footprint and the BMS tests up to 4 months post-injury in mice. JNK inhibition prevents c-jun phosphorylation and caspase-3 cleavage, has neuroprotective effects and results in an increased sparing of white matter at the lesion site. Lastly, D-JNKI1 treated animals show a lower increase of erythrocyte extravasation and blood brain barrier permeability, thus indicating protection of the vascular system. In total, these results clearly point out JNK inhibition as a promising neuroprotective strategy for preventing the evolution of secondary damage after spinal cord injury.

Sprouting of adult Purkinje cell axons in lesioned mouse cerebellum: "non-permissive" versus "permissive" environment.

Adult rat Purkinje cells are extremely resistant to axotomy and, although they lack spontaneous regeneration, are able to sprout. Axon sprouting is a late process that occurs mainly 6 to 18 months after the lesion and results from an interplay between Purkinje cell intrinsic properties and chemical remodeling of the glial scar. To better appraise the role of the local environment in the late sprouting, we performed new axotomy experiments in mice. In this species, unlike the rat, there is no cavitation because the post-lesional necrotic tissue is invaded by astrocytes and incorporated into the glial scar. In this scarring tissue, chondroitin sulfate proteoglycans (CS-PGs) and PSA-NCAM are present one week after the lesion, but the time courses of their expression differ: the former are transiently expressed and rapidly disappears (by one month), thus preventing early sprouting and providing a negative spatiotemporal correlation with the late sprouting. PSA-NCAM expression, which is maintained up till 12 months, is by itself not sufficient to attract the sprouts, since the core of the glial scar--which exhibits high level of PSA-NCAM--is always devoid of them. Finally, by using a double experimental approach (lesion and graft) aimed at providing a permissive environment to the terminal bulbs of axotomized Purkinje cells, we show that the presence of grafted cerebellum at the lesion site neither changes the time course of the sprouting nor enhances the Purkinje cell axonal regeneration. Nevertheless, these experiments have revealed a new type of altered Purkinje cells, the "irritated" Purkinje cells with a high potentiality for axon sprouting.