Experimental Neurology

Functional recovery after spinal cord injury depends on whether reorganizing descending circuits form adaptive, task-specific relays rather than maladaptive ones. The corticospinal tract undergoes competitive, activity-dependent refinement during a defined juvenile window, so the timing and polarity of cortical activity may dictate whether injured circuits rewire usefully. Whether biasing cortical activity during this window can steer reorganization toward recovery, and whether naturalistic rehabilitation supplies the activity such steering requires, remain unknown. In juvenile rats we delivered excitatory or inhibitory chemogenetic receptors, or a control vector, to the forelimb motor cortex at postnatal day 5, induced a right cervical hemisection at postnatal day 14, and gave oral clozapine-N-oxide during nightly rough-and-tumble play from postnatal day 20 to 50. Play, the rehabilitation common to all groups, did not differ between them, isolating cortical-activity polarity as the manipulated variable. Outcomes spanned forelimb dexterity, reaching kinematics, cortical output by intracortical microstimulation, descending architecture by intersectional viral tracing, and frequency-dependent depression of the Hoffmann reflex. In untreated injured animals, cortical output re-lateralized maladaptively toward the intact forelimb, driving the ipsilateral (intact) limb in 11 of 15 evoked responses and 3 of 5 animals. Excitation preserved selective drive to the impaired forelimb (38 of 39 responses; concordant-site proportion Kruskal-Wallis H = 9.08, exact P = 0.0031), and pure ipsilateral re-lateralization was absent from all nine treated animals (3 of 5 control versus 0 of 9 treated; Fisher's exact P = 0.027). Across behavioural, kinematic, and anatomical measures a consistent excitatory > control > inhibitory gradient emerged. Excitation enhanced wrist elevation and forward extension during reaching, restored frequency-dependent depression of the Hoffmann reflex, and selectively recruited three parallel lesion-bypassing relays: interhemispheric cortico-cortical-spinal, cortico-reticulo-spinal, and cortico-propriospinal (ipsilesional cortical relay neurons F(2,14) = 56.96, P < 0.0001). Inhibition yielded the weakest behavioural recovery and least relay recruitment, and did not restore contralesional cortical drive. Cortical-activity polarity during a juvenile window thus acts as a developmental switch governing whether descending reorganization is adaptive or maladaptive. Guided excitation, paired with behaviourally meaningful activity, reshapes diffuse sprouting into structured, lesion-bypassing relays and corrects the spontaneous re-lateralization that otherwise misdirects recovery. These findings provide a translational rationale for activity-paired neuromodulation in paediatric spinal cord injury.

Spinal cord injury (SCI) is an incurable neurological condition in which post-traumatic edema contributes to secondary ischemic damage because the spinal cord is confined within the rigid vertebral canal. However, glymphatic transport in the healthy and injured spinal cord remains poorly characterized. We hypothesized that spinal cerebrospinal (CSF) and glymphatic transport is shaped by anatomy, administration route, and molecular size of the tracer; is disrupted after SCI; and is further impaired by loss of aquaporin-4 (AQP4). CSF tracers were administered by cisterna magna or lumbar intrathecal injection to anesthetized adult C57BL/6 mice. Dynamic contrast-enhanced MRI, ex vivo fluorescence imaging, and histology were used to characterize tracer distribution, influx, and clearance. Constrictions of the spinal subarachnoid space at C3-C7, T6-T12 and L5-S1 spinal segments accelerated contrast-agent dispersion, demonstrating that local anatomy regulates spinal CSF transport. Tracer influx into the cord itself occurred primarily along periarterial pathways.Tracer distribution depended on the administration route: cisterna magna injection preferentially labeled white matter in the upper spinal cord, whereas lumbar injection preferentially labeled grey matter in the lower spinal cord. Gadobutrol and ovalbumin penetrated and dispersed throughout the parenchyma, whereas fibrinogen remained confined to the meninges. Under physiological conditions, intraparenchymal tracers cleared within 24 h. SCI was modeled using a minimally invasive NMDA-induced lesion at T11 that produced focal necrosis while preserving the dura and vertebral structures. Glymphatic transport, lesion volume, and motor recovery were compared between wild-type and AQP4-knockout mice using imaging, the Basso Mouse Scale, and voluntary wheel running. After SCI, intrathecal contrast propagated more rapidly, especially at T7-T8 segments and at the S1 segment, but tissue clearance was profoundly impaired, with tracer retention persisting for up to seven days. AQP4-knockout mice showed greater clearance impairment, larger lesions, and poorer motor recovery than wild-type controls compared at 24 h. These findings define major determinants of spinal glymphatic transport and show that accelerated tracer propagation after SCI does not indicate effective clearance. Instead, SCI produces glymphatic dysfunction that is exacerbated by loss of AQP4 and associated with greater tissue damage and functional impairment. The results extend the glymphatic framework to the spinal cord and identify fluid-clearance pathways as potential therapeutic targets for limiting edema and secondary injury. Future studies should determine whether restoring glymphatic function improves neurological recovery after SCI.

Tau is a microtubule-associated protein important for neuronal structure and function, with abnormal phosphorylation associated with neuronal dysfunction and degeneration. While tau pathology has been extensively studied in neurodegenerative diseases and traumatic brain injury, its role in spinal cord injury (SCI) remains unclear. This study investigates changes in the levels of tau isoforms and phosphorylation following a high lateral C2 hemisection (C2Hx) in adult female rats. Western blot analysis was performed on spinal cord tissue collected caudal to the lesion at 4 weeks post-injury. Low-molecular-weight (LMW) tau and high-molecular-weight, Big tau did not differ significantly between injured and control groups. In contrast, phosphorylated tau (p-tau), detected using the AT8 antibody, was significantly elevated after injury, suggesting a shift in tau functional state. Assessment of microtubule stability markers revealed increased acetylated tubulin and decreased tyrosinated tubulin after SCI, indicating a shift toward a more stable cytoskeletal state. Immunohistochemistry was performed on spinal cord sections at 6 weeks post-injury and dorsal root ganglia (DRG) at 8 weeks post-injury. These analyses demonstrated increased p-tau immunoreactivity within the ipsilateral dorsal horn of the injured spinal cord and a higher proportion of p-tau-positive neurons in DRGs from injured animals compared with controls. Together, these findings demonstrate that cervical SCI induces persistent tau phosphorylation without altering total tau levels, and that this modification extends beyond the lesion site into distal spinal regions and beyond the acute phase of injury. These alterations may influence neural plasticity and remodeling in the injured spinal cord.

Traumatic brain injury (TBI) is one of the world's leading causes of death and disability and a major risk factor for dementias. The primary dementia associated with TBI is chronic traumatic encephalopathy (CTE), a neurodegenerative disease classified as a tauopathy, in which toxic tau molecules lead to disease pathologies and degeneration. The processes that lead to tauopathy and subsequent dementia after TBI remain unclear. Here, we built upon the finding that seizures after TBI may be a mechanism leading to tauopathy, by dissecting the functions of the metabotropic glutamate receptor 5 - cellular prion protein (mGluR5-PrPC) pathway. We delivered TBI to larval in a blast paradigm, and quantified aggregation of Tau via a genetically-encoded Tau-GFP fusion reporter. Zebrafish larvae lacking prp2 (homolog of mammalian cellular Prion Protein, PrPC) displayed a 168% increase in post-traumatic seizures activity after TBI. An mGluR5 agonist (CHPG) reduced post-traumatic seizures, whereas an mGluR5 antagonist (MPEP) increased post-traumatic seizures. Moreover, agonizing mGluR5 reduced tau aggregation and antagonizing mGluR5 increased tau burden. Larvae seizing from convulsants, rather than TBI, were treated with CHPG/MPEP and provided a similar pattern of outcomes, suggesting seizures may be a factor needed for mGluR5 activity to influence tau aggregation. The PrPC-mGluR5 pathway is proposed as one candidate pathomechanism linking TBI to subsequent seizures and tauopathy, and thus it warrants investigation as a target for prophylactic interventions.

Background and Purpose: Neonatal hypoxia-ischemia (NHI) is a leading cause of mortality and long-term neurodevelopmental disability. Therapeutic hypothermia (TH) is currently the only established treatment for NHI; however, its efficacy remains limited, underscoring the need for adjunctive neuroprotective strategies. Lactate is now regarded as a major metabolic substrate of the brain and has previously been shown to exert neuroprotective effects following experimental NHI. We investigated whether lactate enhances hypothermia-induced neuroprotection and evaluated the optimal timing of administration and potential underlying mechanisms. Methods: Postnatal day 7 Wistar rats were subjected to NHI using the Rice-Vannucci model and treated with TH alone (2h at 32{degrees}C), sodium L-lactate alone, or combined L-lactate-TH. Animals underwent longitudinal magnetic resonance imaging (MRI) and behavioral assessments, complemented by histological, immunohistochemical, and Western blot analyses, including assessment of protein lactylation. The effect of sodium L-lactate administration timing relative to TH was also evaluated. Results: Lactate significantly enhanced the neuroprotective effects of TH, particularly when administered before hypothermia, resulting in greater lesion recovery, reduced neuroinflammation and apoptotic cell death, preserved neuronal integrity, and improved long-term motor and cognitive outcomes. Combined treatment preserved neuronal lactate transporter, prevented NHI-induced astrocytic glutamate transporter upregulation, modulated lactylation markers, supporting coordinated metabolic and epigenetic adaptations following NHI. Conclusions: Early lactate administration enhances the neuroprotective efficacy of TH following NHI. These findings identify lactate as a promising adjunct to TH and support its translational potential as a metabolic strategy to improve outcomes following NHI brain injury.

Rehabilitation is the cornerstone of clinical care following spinal cord injury (SCI) and is frequently incorporated into preclinical studies to evaluate emerging therapies. However, the variables that influence the effectiveness of rehabilitation interventions in rodent models remain poorly characterized, limiting the translational value of preclinical research. Here, we performed a meta-analysis of 150 preclinical studies comprising more than 3000 rodents and 292 effect sizes to identify such factors associated with successful rehabilitation after SCI. Rehabilitation improved functional outcomes across multiple behavioral domains, with larger effects observed in thoracic than cervical injury models. Meta-regression identified environmental enrichment as the most effective strategy, particularly when combined with task-specific training. Longer rehabilitation duration was associated with improved recovery, whereas greater daily exposure to forced rehabilitation was associated with smaller gains. In contrast, prolonged access to voluntary rehabilitation did not show this relationship. Rehabilitation improved outcomes when initiated at all time points after injury, with greater benefits when initiated during the late subacute and intermediate phases. Rehabilitation approaches associated with higher stress burden produced reduced benefits, suggesting that stress may limit rehabilitation-induced recovery. Collectively, these findings identify rehabilitation type, duration, and delivery context as important determinants of recovery after SCI and support a broad therapeutic window for intervention. Our results favor low-stress, voluntary rehabilitation strategies that promote sustained engagement and provide principles for designing effective and biologically appropriate rehabilitation strategies, potentially improving translational success for emerging SCI therapies. One Sentence SummarySustained voluntary rehabilitation promotes functional recovery across stages of experimental spinal cord injury, whereas prolonged forced training may reduce its benefits.

Intrahippocampal kainate (IHK) is a well-established mouse model of temporal lobe epilepsy, in which focal hippocampal injection of kainic acid induces excitotoxic injury followed by the development of chronic spontaneous seizures. Commercial sources of kainic acid (KA) have increasingly transitioned from naturally derived to synthetic KA, which has introduced a potential source of variability to the implementation of the IHK model. Here, we evaluated injection parameters for synthetic KA, with the goal of identifying conditions that reliably produce spontaneous seizures while minimizing mortality. We found that intrahippocampal injection of 200nL of 5mM synthetic KA resulted in low mortality compared to 50-100nL of 20mM synthetic KA (a dosing range commonly used with naturally derived KA), while robustly inducing TLE-like hippocampal sclerosis and recurrent spontaneous electroclinical seizures. We further demonstrated high inter-animal variability in both seizure frequency and temporal clustering of seizures across animals receiving either injection protocol (200nL of 5mM or 50nL of 20mM). Together, these findings provide a framework for implementing the IHK model with synthetic KA and support its continued use to advance our understanding of the cellular and network mechanisms underlying temporal lobe epilepsy.

Experimental models of Parkinson's disease (PD) traditionally involve direct perturbations of the functioning of dopamine (DA) neurons. However, PD is increasingly recognized as multifactorial in origin and involving both cell-autonomous vulnerability factors and non-cell-autonomous triggers including inflammatory signals deriving from bacterial or viral infections. Notably, genes associated with early-onset familial PD as PRKN (Parkin) and PINK1, are ubiquitously expressed and have been implicated in immune regulation, further supporting a role for inflammation in disease etiology. In the present study, we tested the hypothesis that alternate Polyinosinic:polycytidylic acid (Poly(I:C)), mimicking viral infection, and lipopolysaccharides (LPS), mimicking bacterial infection, may induce sufficient brain inflammation to impair the DA system in Parkin-deficient mice and recapitulate some of the systemic features of PD. We developed a protocol with alternating Poly(I:C) and LPS, inducing acute peripheral inflammation in both genotypes, with consistent body weight loss and an increase of fecal lipocalin-2. Modest levels of neuroinflammation were present six months after the treatment, with higher levels of the microglial marker Iba1 in the dorsal striatum and reduced levels of the astrocyte marker GFAP in the mesencephalon, potentially indicating reduced neuronal support in the longer term. Finally, we find that this alternating Poly(I:C)/LPS treatment does not induce dopaminergic denervation or motor dysfunctions, even in Parkin KO mice. Taken together, our findings suggest that repeated short-term exposure to pathogen-derived signals is insufficient to induce DA system impairment in young adult Parkin deficient mice. Instead, induction of PD-like pathology may require a convergence of factors, including a prolonged or recurrent inflammatory burden, aging, genetic susceptibility, and potentially additional environmental or cellular stressors, that together create a pathogenic "perfect storm". Thus, in its current form, the paradigm developed in the present study should not be regarded as a fully representative model of PD. Rather, it provides proof of concept that temporally alternating inflammatory stimuli can shape non-motor symptom-like phenotypes and underscores the need for future animal model research to incorporate interacting risk factors, disease duration, and age-dependent vulnerability.

Deletion of the microtubule-associated protein, tau reduces seizure burden in rodent models of genetic epilepsies and suppresses evoked seizures. In the intrahippocampal kainate (IHK) model of acquired temporal lobe epilepsy (TLE), mice lacking tau expression develop spontaneous seizures, but at a lower rate than controls. Mechanisms by which tau deletion modifies the development of acquired TLE are not well understood, but a modification of the synaptic reorganization that accompanies epileptogenesis may contribute to modified seizure expression. Increased inhibitory synaptic input to dorsal dentate granule cells (DGCs) contralateral to the focal kainate injection results after development of TLE in tau-/- mice, but inhibitory synaptic reorganization distal to the kainate lesion is undefined in this model. We therefore investigated how development of TLE modifies excitability and synaptic transmission in DGCs of the ventral dentate gyrus, distant from the kainate lesion. Our results show that development of TLE increases evoked action potential firing of ventral DGCs (vDGCs) in mice that develop TLE, demonstrating an effect of TLE development on excitability of DGCs distant from the focal injury. After development of TLE, DGCs from tau-/- mice received increased inhibitory synaptic input bilaterally, suggesting that tau expression suppresses inhibitory synaptic reorganization in DGCs. Optogenetic stimulation of interneurons in tau-/- mice revealed increased inhibitory synaptic input to vDGCs and an increase in inhibitory convergence onto vDGCs once epileptogenesis occurred. Therefore, tau deletion modifies spontaneous seizure expression after epileptogenesis in mice, potentially involving increased synaptic inhibition of DGCs throughout the dentate gyrus.

Axons of substantia nigra dopaminergic neurons "die back" in Parkinson's disease (PD), exhibiting early degeneration relative to cell bodies, a key feature also observed in PD models. A critical step towards understanding the process of axonal neurodegeneration is to determine the physiological properties of dopaminergic axons that are altered during the early stages of cellular dysfunction. Here, we compared the electrophysiology and calcium dynamics of dopaminergic axons in the MitoPark model of PD with age-matched controls. Our experiments show a pronounced reduction in action potential (AP)-evoked calcium signals in MitoPark axons that emerges well before the onset of dopaminergic fiber loss and motor deficits. In addition, calcium imaging and direct axon recording revealed deficits in AP propagation accompanied by alterations in the axonal AP waveform. Therefore, our experimental findings identify the progression of axon-specific physiological deficits that occur long before neurodegeneration, more precisely defining the period that precedes axonal loss.

Epilepsy is increasingly recognized as a disorder involving both neuronal and vascular dysfunction. While connexin signaling has been implicated in epileptogenesis, the contribution of vascular connexins to seizure associated cerebrovascular pathology remains poorly understood. Connexin40 (Cx40) is an endothelial gap junction protein that plays a crucial role in vascular communication and blood-flow regulation. Seizures induce dynamic changes in cerebral perfusion and oxygenation, including prolonged postictal hypoperfusion/hypoxia. To determine whether Cx40 influences postictal hypoxia following focal seizures, we examined seizure characteristics and postictal oxygen dynamics in Cx40 knockout (Cx40-/-) mice using an established focal hippocampal seizure model. Electrically kindled seizures were elicited in wild-type and Cx40-/- mice, and local hippocampal tissue oxygenation was continuously monitored before and after seizure induction. Seizure duration did not differ between genotypes, indicating comparable seizure severity. Interestingly, Cx40 deletion altered the temporal pattern of postictal oxygen recovery, producing greater early hypoxia and a delayed secondary rebound in pO2 despite similar peak oxygen levels and overall hypoxic burden. These findings demonstrate that loss of Cx40 selectively alters the temporal profile of postictal oxygen dynamics without affecting seizure duration. Taken together, the results suggest that endothelial gap junctional communication contributes to postictal vascular recovery and identify Cx40 as a potential modulator of seizure associated neurovascular dysfunction.

Peripheral neurons exhibit robust regeneration after nerve injury in adulthood; a process linked to the activation of regeneration-associated genes (RAGs). However, the mechanisms underlying nerve regeneration during early postnatal development remain poorly understood. In a previous work, we observed that motoneurons axotomized at early postnatal stages regenerate without overexpressing RAGs, contrasting with the expected RAG activation observed in postnatal day 30 (P30) mice. To determine whether this phenomenon extends to sensory neurones, we investigated two paradigmatic dorsal root ganglia populations: proprioceptive (PV) and nociceptive (TrpV1) neurones, which exhibit distinct regenerative capacities in adult mice. Following sciatic nerve crush injury at P4, P10, and P30, both neuronal subtypes demonstrated robust axonal regeneration across all postnatal stages, with nociceptors exhibiting significantly superior regeneration compared to proprioceptors. Remarkably, no substantial neuronal death was observed at any developmental timepoint. However, RNA sequencing revealed that P4 and P10 sensory neurones failed to upregulate RAGs following injury, whereas P30 neurones exhibited the expected pro-regenerative transcriptional programme. Pathway enrichment analysis confirmed that classical regeneration-associated signalling pathways were activated exclusively in young adults, whilst developmental and inflammatory pathways predominated in early postnatal stages. Using the conditioning lesion paradigm in primary dorsal root ganglia cultures, we demonstrated that only P30 neurones exhibited enhanced neurite outgrowth following conditioning lesion, whilst P4 and P10 neurones showed no conditioning effect or reduced outgrowth, respectively. These findings indicate that early postnatal sensory neurones possess intrinsic growth capacity independent of RAG activation, suggesting fundamentally distinct regenerative mechanisms across developmental stages.

Resistance to anti-seizure medications (ASMs) remains a major clinical challenge in the management of epilepsy. Neuroinflammation has been implicated as a contributing mechanism and, consistent with this, antagonists of the ATP-gated P2X7 receptor (P2X7R) have been shown to enhance ASM efficacy in animal models. It remains unclear, however, if P2X7R antagonism is effective in human models of drug-resistant epilepsy. Here, we assessed the seizure-suppressive potential of the P2X7R antagonists AFC-5128 and JNJ-47965567 using electrophysiological recordings in acute resected brain slices from patients with epilepsy using artificial cerebrospinal fluid containing low Mg2+ and high K+ to evoked seizure-like events. P2X7R antagonists alone did not suppress seizure-like activity. When co-administered, however, P2X7R antagonists significantly enhanced the anti-seizure efficacy of carbamazepine and lorazepam. Notably, P2X7R antagonist treatment lowered Interleukin-1{beta} levels, and betaine, a drug targeting Interleukin-1{beta} release, mimicked the effects of P2X7R antagonists when combined with carbamazepine. Finally, mice with microglia-specific P2X7R depletion showed improved responsiveness to carbamazepine, suggesting P2X7R-mediated effects are partially mediated via their functions in microglia. These findings suggest that P2X7R-based therapies may represent an effective add-on approach for treating drug-resistant seizures associated with neuroinflammation.

The majority of Parkinson's disease patients suffer from decreased tactile acuity or neuropathic pain, both of which contribute to low quality of life and likely exacerbate motor dysfunction. How Parkinson's disease pathology relates to altered somatosensation remains unclear. One potential contributor is the progressive degeneration of dopamine neurons. To assess the extent to which gradual dopamine neuron loss contributes to altered somatosensation, we recorded spontaneous and stimulus-evoked activity in the primary somatosensory cortex of the MitoPark mouse model of Parkinson's disease. MitoPark mice experience progressive dopamine neuron degeneration that is independent of -synuclein. We found that MitoPark layer V regular-spiking (largely pyramidal) neurons, but not fast-spiking (largely parvalbumin-expressing inhibitory) neurons, had elevated spontaneous firing rates relative to littermate controls at late stages of symptom progression. Regular-spiking neurons also became hyperresponsive to tactile stimuli -- more neurons were recruited by stimuli across a wide range of intensities, and these neurons responded with higher firing rates. Fast-spiking neurons, but not regular-spiking neurons, became desynchronized at late stages of symptom progression. These physiological changes coincided with pronounced degeneration of dopamine neurons and axons, which we measured with tyrosine hydroxylase immunostaining in the midbrain, striatum, and primary somatosensory cortex. Altogether, this characterization revealed cell-type-specific changes in the primary somatosensory cortex that are consistent with both decreased tactile acuity and hyperalgesia in Parkinson's disease patients. This suggests that the loss of dopamine neurons, potentially including those that innervate primary somatosensory cortex, contributes to somatosensory impairments associated with Parkinson's disease.

Deep brain stimulation (DBS) of the mesencephalic locomotor region (MLR) has been explored to treat gait disturbances. However, clinical outcomes of MLR-DBS have been disappointing overall, with only modest benefits in some individuals and unwanted effects, including anxiety, reported in others. Preclinical studies in several species, by contrast, show that MLR-DBS can improve locomotor and gait deficits, although defensive behaviours in response to stimulation have also been reported in some species. To investigate this discrepancy, we examined frequency- and amplitude-dependent effects of MLR-DBS in healthy rats, combining semi-supervised and unsupervised behavioural analyses. High-frequency, high-amplitude DBS (80-130 Hz), but not low-frequency stimulation (20-60 Hz), elicited hyperlocomotion intermixed with acute defensive-like behaviours. Low-frequency stimulation instead promoted phases of immobility. Consistently, only high-frequency DBS induced region-specific c-Fos expression in the MLR. Complex behaviours, including hyperlocomotion, rearing, tail rattling, and periods of immobility, were most pronounced in animals with the DBS electrode tip localized to the cuneiform nucleus (CnF) of the MLR. Using AAV tracer constructs for bright labelling of CaMKII-positive neurons and their axons, we identified prominent ascending projections from the CnF to the thalamus, substantia nigra pars compacta, zona incerta, hypothalamus, subthalamic nucleus, and central amygdala (CeA). Retrograde tracing confirmed the CnF-to-CeA projection independently. These findings show that the MLR is anatomically connected to higher-order centres linking motor and defensive networks, with DBS frequency and amplitude critically shaping behavioural outcomes that extend beyond locomotion.

Eye behavior disruption is reported in Parkinson's disease (PD), but its correlation with disease severity has not been well examined. Here, in a nonhuman primate model of PD, we show that spontaneous eye behavior is impaired in parkinsonism and correlates with clinical rating scores and subthalamic beta oscillatory activity. These findings suggest that spontaneous eye behavior could serve as an objective, non-invasive biomarker of parkinsonian severity.

Huntington&'s disease (HD) is characterized by progressive accumulation of mutant huntingtin (mHTT), neurodegeneration and motor dysfunction. Increasing evidence implicates impaired glymphatic function and loss of perivascular aquaporin 4 (AQP4) polarization in HD, suggesting that defective brain waste clearance may contribute to disease pathogenesis. Whether restoration of AQP4&-mediated glymphatic transport can ameliorate HD pathology remains unknown. We tested whether genetic restoration of AQP4 improves glymphatic function and HD&-associated phenotypes in heterozygous zQ175 knock-in mice. At 2 months of age, premanifest zQ175 mice received a single retro-orbital injection of BBB-penetrant AAV9&-PHP.eB encoding the AQP4 (M1 isoform). Glymphatic transport was assessed by intracisternal injection of fluorescent BSA 647 and quantification of parenchymal influx and drainage to the deep cervical lymph nodes. Perivascular AQP4 localization, mHTT aggregation, gliosis, DARPP32 immunoreactivity, CSF neurofilament light chain (NfL) and total Tau, structural brain volumes by 11.7T MRI, and motor behavior were assessed longitudinally through 12 months of age. AAV9&-PHP.eB&-AQP4 produced widespread brain expression and restored perivascular AQP4 localization in the striatum and cortex of zQ175 mice. AQP4 overexpression significantly increased glymphatic tracer influx into brain parenchyma and BSA-647 drainage to the deep cervical lymph nodes. At 12 months, AQP4 restoration reduced CSF NfL and total Tau concentrations, mHTT aggregate number and mean aggregate size, and striatal Iba1 positive microglia and GFAP-positive astrocytes (P < 0.05). AQP4 overexpression also preserved striatal DARPP32 immunoreactivity and significantly attenuated striatal atrophy measured by MRI. Female zQ175 mice showed improved balance-beam performance and locomotor activity, while effects on motor performance in males did not reach statistical significance. AQP4 overexpression attenuated body-weight loss in both sexes. No detectable structural, behavioral or body-weight abnormalities were observed following sustained AQP4 overexpression in wild-type mice. In summary, restoration of AQP4 enhances glymphatic transport and is associated with reduced proteopathic, neuroinflammatory and neurodegenerative phenotypes in zQ175 HD mice. These findings provide proof-of-concept that impaired glymphatic function is a modifiable component of HD pathology and support AQP4&-mediated restoration of brain waste clearance pathways as a potential disease-modifying therapeutic strategy.

BackgroundSerotonergic signaling plays an important role in the modulation of absence seizures (ASs), and activation of serotonin 2A receptors (5-HT2ARs) with TCB-2 suppresses spontaneous absence seizures (ASs) in Genetic Absence Epilepsy Rats from Strasbourg (GAERS). Lisuride is a pharmacologically complex serotonergic and dopaminergic ligand with low 5-HT2AR signaling efficacy and a receptor profile distinct from that of TCB-2. We therefore investigated its effects on spontaneous ASs and the contribution of 5-HT2ARs to its actions. MethodsThe effects of systemic lisuride (0.1 and 0.5 mg/kg) on spontaneous ASs were examined in freely moving GAERS over 120 min by quantifying time spent in seizure, mean seizure duration and seizure number. The contribution of 5-HT2ARs was investigated by administering lisuride (0.5 mg/kg) following pretreatment with the selective 5-HT2AR antagonist MDL11,939 (0.5 mg/kg). ResultsLisuride produced marked dose- and time-dependent effects on ASs. At 0.1 mg/kg, lisuride elicited modest pro-absence effect. In contrast, 0.5 mg/kg produced a pronounced biphasic response, with a marked reduction in seizure activity during the first 40 min, followed by rebound increase during the second hour. The early suppression involved reductions in both seizure number and duration, whereas the delayed pro-absence effect was predominantly associated with prolonged ASs. MDL11,939 did not prevent the early seizure suppression but blocked the increase in seizure duration while producing a transient increase in seizure number. ConclusionsLisuride is a dose- and time-dependent bidirectional modulator of ASs in GAERS. The persistence of the profound early anti-absence effect during 5-HT2AR blockade indicates that this response does not require 5-HT2AR activation, whereas the modification of the delayed response by MDL11,939 supports a 5-HT2AR-dependent component in the later phase. These findings distinguish lisuride pharmacologically from TCB-2 and suggest that its biphasic effects arise from the dynamic engagement of multiple receptor mechanisms, potentially including dopaminergic signaling.

Objective: Genes within the lysosomal glycosphingolipid pathway, including GBA1 and GALC, are important genetic risk factors in Parkinson's disease (PD). We hypothesized that PD risk relates not only to individual enzyme effects but also to coordination between glucocerebrosidase (GCase) and galactosylceramidase (GalCase) activities, and examined how genetic variants influence their activity ratio. Methods: We studied 1,290 individuals from the Parkinson's Precision Medicine Initiative and Columbia University cohorts with genetic and dried-blood-spot enzymatic data. Genome-wide association analyses of the glucocerebrosidase/galactosylceramidase activity ratio were performed in the combined cohort, by sex, and per cohort, followed by meta-analysis. For lead variants, Pearson correlations between enzyme activities were compared across genotypes, and genotype-by-GCase interactions were tested. Results: The GALC locus was associated with glucocerebrosidase/galactosylceramidase activity ratio in the combined cohort (rs365448; beta=-1.90; P=5.91e-115), replicated across cohorts and meta-analysis (beta = -1.66, P=6.33e-191), and in linkage disequilibrium with the PD GWAS index variant rs979812. This association remained significant in both sexes. Correlation between glucocerebrosidase and galactosylceramidase activities differed by rs979812 genotype (TT r=0.33 versus GG r=0.13; P=0.01), with a significant genotype-by-GCase interaction (P=3.05e-5). Among 134 PD loci examined, ten showed nominal association with the ratio-GWAS, including GBA1, where risk-variant carriers showed a similar pattern, yet not statistically significant. Interpretation: GALC variants influence the balance between glucocerebrosidase and galactosylceramidase activity, and this relationship may differ by genotype at PD-associated variants. These findings suggest PD risk at lysosomal glycosphingolipid genes may partly reflect altered coordination between pathway enzymes rather than isolated single-enzyme effects, warranting functional validation.

Traumatic brain injury (TBI) is a risk factor for Alzheimer's disease (AD), and both conditions are associated with impaired glucose metabolism and mitochondrial dysfunction. We previously reported time-dependent mitochondrial dysfunction following closed-head injury (CHI) in amyloid precursor protein/presenilin 1 (APP/PS1) knock-in (KI) mice, but whether glucose-derived carbon labeling showed a corresponding temporal pattern remained unknown. We hypothesized that early deficits would involve tricarboxylic acid (TCA)-cycle metabolites, whereas chronic changes persisted upstream at the pyruvate-lactate branchpoint. Here, oral uniformly 13C-labeled glucose ([U-13C]-glucose) tracing and gas chromatography-mass spectrometry (GC-MS)-based isotopologue analysis were used to quantify first-turn glucose-derived carbon fate in cortex and hippocampus. To distinguish the effects of age at injury from those of post-injury interval, mice were analyzed 1 month after injury either at 7 or 12 months of age or 8 months after injury at 12 months of age. The most pronounced alterations occurred 8 months after CHI, when KI mice exhibited increased pyruvate and lactate labeling in the cortex and broader increases in glycolytic labeling in the hippocampus. These findings suggest that in APP/PS1 KI mice, chronic closed-head injury produced a delayed shift in glucose-derived carbon labeling centered on glycolytic and pyruvate/lactate nodes, with loss of hippocampal precursor-product coupling but without broad reduction of first-turn TCA-linked labeling.