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Article history:
Received 23 April 2015
Received in revised form 9 November 2015
Accepted 16 November 2015
Available online 19 November 2015
Keywords:
Amyotrophic lateral sclerosis
Fronto-temporal dementia
Cortex
N-methyl-d-aspartic acid
SOD1
a b s t r a c t
Amyotrophic lateral sclerosis (ALS) is now recognized as a multisystem disorder, in which the primary
pathology is the degeneration of motor neurons, with cognitive and/or behavioral dysfunctions that
constitutes the non-motor manifestations of ALS. The combination of clinical, neuroimaging, and neuropathological data, and detailed genetic studies suggest that ALS and frontotemporal dementia (FTD)
might form part of a disease continuum, with pure ALS and pure FTD at the two extremes.
Mutations in the superoxide dismutase 1 (SOD1) gene were the rst genetic mutations linked to the
insurgence of ALS. Since that discovery numerous animal models carrying SOD1 mutations have been
created. Despite their limitations these animal models, particularly the mice, have broaden our knowledge
on the system alterations occurring in the ALS spectrum of disorders.
The present review aims at providing an overview of the data obtained with the SOD1 animal models
rst and foremost on the cortical and subcortical regions, the cortico-striatal and hippocampal synaptic
plasticity, dendritic branching and glutamate receptors function.
2015 Elsevier Ltd. All rights reserved.
Contents
1.
2.
3.
4.
5.
6.
7.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Genetics of ALS and FTD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Cognitive impairment in the mutantSOD1 mouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Glutamatergic excitotoxicity and dying forward hypothesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Cortical NMDA receptors in ALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Cu2+ /Zn2+ dyshomeostasis: effects on toxicity and altered neuronal activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
1. Introduction
The classical neuropathological description of ALS focuses on
the degeneration of both the upper and lower population of motor
neurons (MNs) yielding a disorder largely recognized as selective to
the motor system, however this view is changing (Robberecht and
Philips, 2013). Fronto-temporal dementia (FTD), the most common
form of dementia after Alzheimers disease, is nowadays considered
Corresponding author at: Molecular Neurobiology Unit, Experimental Neurology, Fondazione Santa Lucia, via del Fosso di Fiorano 64, 00179 Rome, Italy.
E-mail address: p.longone@hsantalucia.it (P. Longone).
http://dx.doi.org/10.1016/j.neubiorev.2015.11.006
0149-7634/ 2015 Elsevier Ltd. All rights reserved.
cognitive impairment (Strong et al., 1999). The language characteristics of the ALS-dementia complex include word-nding difculty,
lexical disorganization (as manifested by problems on tests of word
uency), and reliance of stereotypic sentences (McKhann et al.,
2001; Abrahams et al., 2005). Anterior-based language functions
(e.g., uency, syntax, and grammar) are more compromised than
those associated with temporal-parietal lobe regions (e.g., auditory
and reading comprehension and naming) (Neary et al., 2005; Knibb
et al., 2009). Neuropsychological studies associated with imaging
techniques have repeatedly identied defects in executive functions (Frank et al., 1997; Gordon et al., 2010), most likely caused by
a marked frontal lobe atrophy (Kiernan and Hudson, 1994). In particular, executive function decits were represented by decits in
verbal/nonverbal uency, concept formation, working memory and
response inhibition (Schreiber et al., 2005). Interestingly, patients
with unclear speech showed considerable reduction in planning a
movement task suggesting an extended degeneration across wide
areas of the frontal lobe (Santhosh et al., 2004). Thus, cognitive
alterations might reect functional decits outside the primary
motor system and give clues to the aetiopathogenesis of the disease.
This view is supported by several clinical studies. Positron emission tomography (PET) investigations have revealed a signicant
reduction in cerebral glucose metabolism (Ludolph et al., 1992),
particularly in large frontal and parietal regions in the bulbar onset
patients (Cistaro et al., 2012). Kew et al. (1993) showed a decreased
activation of specic areas in the medial prefrontal cortex (Brodmann areas 9 and 10) the anterior cingulate region (Brodmann
areas 9 and 32), the parahippocampal gyrus and the anterior thalamic nuclear complex. Recent resonance magnetic spectroscopy
analyses have also demonstrated that a signicant and bilaterally
asymmetric alteration of metabolites occurs along the length of the
entire intracranial corticospinal tract in ALS patients (Govind et al.,
2012). A neuroimaging study (Bede et al., 2013) performed on a
cohort of 33 cognitively normal patients with ALS and 44 healthy
controls, to investigate focal gray matter loss in the motor cortex,
found a strikingly linear association between gray matter volumes
in the primary motor cortex and well-established clinical measures of ALS. The authors also measured a signicant difference in
the focal gray matter atrophy of the motor homunculus between
patients with bulbar or limb onset. Moreover, they observed that
the ALS pathology goes behind the motor cortex and affects the
frontal, occipital and temporal regions as well. Additionally, consistent evidence obtained with transcranial magnetic stimulation
(TMS) studies, performed on ALS patients, indicate cortical hyperexcitability as an early feature in sporadic and familial ALS. Thus,
while minorities of ALS patients meet criteria for the FTD and/or
primary progressive aphasia (Neary et al., 1990), approximately
one-third show cognitive impairments of a milder nature (Strong
et al., 2009). Indeed, executive dysfunction, a negative prognostic indicator of survival in ALS, has been the most commonly
investigated cognitive domain in non-demented patients with
ALS.
Mouse models of ALS and the studies performed with them have
greatly contributed to expand our knowledge on the disease progression and are a valuable tool to study ALS pathophysiology and
the resulting cognitive decits. In the present review we underline
the experimental evidence obtained with the mutant superoxide
dismutase 1 (mSOD1) mouse on the cortical and subcortical alterations related to the ALS/FTD syndrome. We have focused primarily
on the glutamatergic system, with a section dedicated to the Nmethyl-d-aspartic acid receptor (NMDAR), and to the mechanisms
of altered cortical functions associated with copper (Cu2+ ) and zinc
(Zn2+ ) dyshomeostasis. With the identication of new genes linked
to the ALS/FTD syndrome additional animal models have been
developed that will further expand our knowledge on this spectrum of diseases. The analyses of these models is beyond the scope
13
14
of abnormal proteins, specically in targeting endoplasmic reticulum proteins for degeneration (endoplasmic reticulum-associated
degeneration) (Weihl et al., 2009). In Johnson et al. (2010) linked a
number of families with typical ALS, to mutations in the VCP gene.
Some individuals in these families had FTD. The vesicle-associated
membrane protein-associated protein B (VAPB), involved in the ERGolgi-mediated vesicle transport (Nishimura et al., 1999), has also
been linked to ALS (Nishimura et al., 2004). Two missense mutations, the proline to serine substitution at residue 56 (P56S) and
the threonine to isoleucine substitution at residue 46 (T46I) in the
VAPB protein have been associated to ALS8, a slowly progressive
and late-onset dominant form of ALS (Marques et al., 2006; Tsuda
et al., 2008; Larroquette et al., 2015). In 2013, Aliaga et al. generated
transgenic mice expressing human wild-type and P56S VAPB under
the control of a pan-neuronal promoter Thy1.2. The mice carrying
the mutation while developing signs of distress in both CSMNs and
spinal MNs (i.e. increase of endoplasmic reticulum stress, unfolded
protein response activation), presented a progressive loss of CSMNs
but not spinal MNs.
Fused-in-sarcoma (FUS) gene mutations have also been
reported in familial and sporadic cases of ALS with FTD (Vance et al.,
2009; Blair et al., 2010; Broustal et al., 2010). FUS is a member of
the hnRNP family, located on chromosome 16p11.2, a chromosomal
region linked to multiple fALS cases (Sapp et al., 2003). Although
FUS represents an ALS gene, an accumulation of FUS protein in
inclusion bodies in neuronal cytoplasm and nucleus was associated
with clinicopathological subtypes of FTD (Mackenzie et al., 2010).
Mutations in other genes involved in the pathogenesis of ALS
also include senataxin (SETX) (Chen et al., 2004), angiogenin (ANG)
(Greenway et al., 2006), and Ataxin-2 (Elden et al., 2010; Van
Damme et al., 2011).
hypoglossal nuclei and the development of dysphagia and oral dysfunction in the SOD1G93A mouse. They found that oral dysfunction
(i.e. lick and mastication rates) could be detected as early as 60 days
of age. They infer that oral dysphagia could be one of the earliest
clinical symptoms in this fALS mouse model, as it is in about 30% of
patients (bulbar onset) (Khnlein et al., 2008).
Similarly to the neurodegenerative traits, cognitive changes
occur in the mSOD1 mice before clinical symptoms become evident.
These changes are associated with anatomically specic neural
modications in brain regions beyond the classical motor areas.
Indeed, ALS is not anymore regarded as a neurodegenerative disorder primarily involving the pyramidal motor system and the
spinal cord MNs, but there are growing indications that degenerative changes can occur in nonmotor neocortical areas (Toyoshima
et al., 2003), or areas such as the substantia nigra and the basal
ganglia generally neglected in ALS (Borasio et al., 1998; Sudo et al.,
2002; Mackenzie and Feldman, 2004; Sharma et al., 2011). Interestingly, Przedborski and co-workers described a degeneration of
the dopaminergic system in the early years of the SOD1G93A studies (Kostic et al., 1997). In Geracitano et al. (2003) the authors
described for the rst time functional striatal alterations specically associated with a dopaminergic dysfunction. The study shows
that repetitive stimulation of the corticostriatal pathway generates
an N-methyl-d-aspartic acid (NMDAR) receptor-dependent longterm potentiation (LTP) in the SOD1G93A mouse, while the same
stimulation generates a long-term depression (LTD) response in
the control mice. The LTD in the fALS mouse was restored by bath
perfusion of dopamine or quinpirole, a dopamine D(2) receptor
agonist. Consistent with these observations, habituation of locomotor activity and striatal-dependent active avoidance learning were
impaired. These data support the observation that a degeneration of
the dopaminergic neurons occurs in the SOD1G93A mouse affecting the striatal-related synaptic plasticity and behavior, and give a
cellular substrate to the extrapyramidal motor and cognitive disorders observed in familial and sporadic ALS. We went on to explore
a cognitive behavioral phenotype of the fALS models in view of the
frontal lobe dysfunction described in patients. Thus we extended
the description of the cognitive characteristics of this mutant
by investigating various indexes of their hippocampal and prefrontal cortex functions. In the hippocampus, of pre-symptomatic
SOD1G93A mice we observed, an enhanced reactivity to spatial
novelty associated with a higher expression of the hippocampal
-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)
GluR1 subunit (mRNA and protein), and with an increased induction and maintenance of CA3-CA1 LTP (Spalloni et al., 2006). These
ndings are further supported by molecular evidence showing
increased levels of phosphorylated Erk, an extracellular signalregulated kinase involved in neural plasticity and memory in
symptomatic SOD1G93A mice (Chung et al., 2005). In a paper just
published Quarta et al. (2015) described hippocampal alterations
in the SOD1G93A mouse, prior to the onset of motor symptoms,
affecting GABAergic interneurons (parvalbumine-positive). They
linked these damages to the GABAergic system to an increased
anxiety-like behavior in the open-eld test and a delay in learning and impaired long-term memory in the Barnes maze test.
The loss of parvalbumin-positive inhibitory interneurons has been
also described in the motor cortex of ALS patients and linked to
the development of cortical hyperexcitability (Nihei et al., 1993).
Hyperexcitability, probably arising from a combination of glutamate excitotoxicity processes and degeneration of inhibitory
cortical neurons circuitry has also been associated to a characteristic feature of ALS, the split-hand phenomenon (Menon et al.,
2014)
In the prefrontal cortex we described a dramatic reduction
of the dendritic arbor accompanied by a mild decrease in spine
density of basal dendrites on pyramidal neurons lying in the
15
16
Fig. 1. Schematic and simplied representation of the alterations, linked to hyperexcitability and the glutamatergic system, affecting the motor cortex and the spinal cord
in ALS. Motor cortex: At early (2130 days) and later at pre-symptomatic stages (8085 days) the M1 region of the fALS mouse cerebral cortex show an increased vGlut2
expression in the area surrounding the layer V CMN, and a decreased expression of the NMDA receptor subunit GluN2B in the synaptic compartment, respectively. The rst
observation reveals how, already at early stages, the glutamatergic releasing machinery is over-functioning leading to an increased release of glutamate that, associated
with the decrease/malfunction of the glial glutamate transporter EAAT2/GLT1, affects cortical glutamatergic homeostasis. The latter indicate that not only the releasing
machinery but the glutamatergic receptor system (specically the NMDA receptor) is altered leading to a malfunctioning glutamatergic excitatory system. These alterations
together with a decrease of the inhibitory drive lead to a widespread cortical hyperexcitability affecting not just the cortical areas but the descending motor pathways up
until the spinal cord. Spinal cord: Spinal cord hyperexcitability is a well-established characteristic of mutant-SOD1 MNs in cultures and slice preparations. They indicate that
electrophysiological abnormalities in MNs are a very early event in ALS, probably determined by disturbances of the voltage-gated Na+ channels expression and activity
causing an increment in the persistent Na+ currents. This sodium current increased activity may thus lead to excessive inuxes of sodium and calcium ions in the MNs, cells
known to have a limited cytosolic calcium-buffering capacity. The increased cytosolic calcium could lead to an excessive uptake of calcium by mitochondria setting off of
a series of events that ultimately might favor MN degeneration and death. A reduction in the slow K+ channels currents has also been considered as a contributor to the
hyperexcitable MN. Additionally, glutamatergic excitotoxicity promotes MN hyperactivity, intracellular Ca2+ increase, nurturing in the end MN death. The gure summarizes
the ndings presented within this review paper and is not intended to be comprehensive. In the gure is also represented the functional cross-talk between the lower and
upper MNs through the descending and ascending motor pathways.
17
18
cognitive tasks and could contribute to the occurrence of cognitive impairment/dementia in ALS. NMDAR subunit expression is
downregulated in response to its excessive activation in in vitro
and in vivo models of excitotoxicity (Gascn et al., 2005). Thus,
we may infer that the enhancement of extracellular glutamate levels present in presymptomatic SOD1G93A mice (Guo et al., 2000)
could modify the pattern of glutamate receptors subunit expression at upper MNs synapses affecting, in turn, the synaptic plasticity
and neuronal morphology of the motor cortex. In this context two
recent studies (Saba et al., 2015; Fogarty et al., 2015) illustrate how,
as early as postnatal day 21, morphological and electrophysiological changes occur in the cortical area of the SOD1G93A strongly
supporting an early onset of motor cortical dysfunction in this fALS
SOD1 mouse model.
19
7. Conclusion
Cognitive impairment is becoming increasingly important in the
ALS pathogenesis. The presence of frontal decits has a negative
inuence on survival. In one study language-dominant impairment
had a larger impact than behavioral impairment (Coon et al., 2011).
To intervene promptly, with an appropriate drug treatment, it is
important to develop practical relevant screening instruments for
behavioral and aphasic decits in ALS patients, independently from
the decline of motor function. Similarly, when testing therapeutic
strategies in experimental models of the ALS/FTD-type of pathologies we should also evaluate the degeneration of the CSMN as to
have a complete picture of any potential compound tested as elegantly highlighted by Hand zdinler in a recent review (Genc and
zdinler, 2014). Although, it is important to keep in mind that these
models are incomplete analogs of human cognition. A key limitation is that many cognitive functions are unique to humans or
cannot be adequately measured in experimental models (i.e. language). Indeed, these differences might explain, at least in part, the
recent high-prole clinical trial failures with drugs that showed
promising efcacy in preclinical behavioral tasks. However, in the
absence of practical alternatives, mouse models will continue to be
essential.
Interest and knowledge regarding the involvement of the cortical and subcortical areas in the ALS spectrum of disorders has grown
rapidly over the past years. In this review we have discussed the
evidences collected with the SOD1 fALS mouse models, particularly
the involvement of the glutamatergic system in the ALS-related cortical decit and the alterations that may occur prior to or coexist
with the lower MN degeneration.
Acknowledgements
We gratefully acknowledge the support of the EU Joint ProgramNeurodegenerative Disease (JPND) project RimoD-FTD to PL. We
also acknowledge the long lasting and fruitful collaboration with
Dr. Martine Ammassari-Teule, with whom a great deal of our work,
discussed in the review, was conducted.
20
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