Single-dose randomized, open-label, 2-way crossover bioequivalence study of clopidogrel 75 mg tablet in healthy volunteers under fasting conditions.

AIM: This study aimed to assess the bioequivalence of 2 formulations of 75 mg clopidogrel hydrogen sulphate film-coated tablet, under fasting conditions. SUBJECTS AND METHODS: 64 healthy subjects, age ranging from 19 to 55 years, were enrolled in a single-centre, randomized, single-dose, open-label, 2-way crossover study, with a minimum washout period of 7 days. Plasma samples were collected up to 24 h post dosing. Clopidogrel and clopidogrel carboxylic acid levels were determined by reverse-phase high-performance chromatography coupled to tandem mass spectrometry detection, LC-MS-MS method. Pharmacokinetic parameters used for bioequivalence assessment were the AUClast (area under the concentration-time curve from time zero to time of last observed nonzero concentration) and the Cmax (maximum observed concentration). These parameters were determined from the clopidogrel concentration data using non-compartmental analysis as well for clopidogrel carboxylic acid concentration data. RESULTS: The 90% CI (90% confidence intervals), obtained by analysis of variance (ANOVA) were within the predefined ranges (80.00 - 125.00%) for both analytes. CONCLUSION: Bioequivalence between test and formulations, under fasting conditions, was concluded both in terms of rate and extent of absorption.

A genome-wide scan points to a susceptibility locus for bipolar disorder on chromosome 12.

Our previous results pointed to a putative gene for susceptibility to bipolar affective disorder located on the chromosomal region 12q23-q24 that segregated in the Saguenay-Lac-St-Jean population of Quebec. We report here results from a second genome-wide scan based on the analysis of 380 polymorphic microsatellite markers. For the purpose of this analysis, an additional 18 families were recruited from the Saguenay-Lac-St-Jean region and pooled to our previous sample to improve its statistical power, giving a total of 394 sampled individuals. This work confirms the presence of a susceptibility locus for affective disorder on chromosome 12q24 with parametric LOD score value of 3.35 at D12S378 when pedigrees were broken into nuclear families and analysed under a recessive segregation model. This result was supported by neighbouring markers and by a LOD score value of 5.05 at D12S378 under model-free analysis. Other regions of lower interest were indicated on chromosomes 2, 5, 7, 9, 10, 17 and 20.

Genetic heterogeneity in a very large bipolar affective disorder pedigree from Quebec.

We previously reported a genome-wide scan for bipolar affective disorder based on a multigenerational family sampled from a relatively homogeneous population derived from founding families that migrated to an isolated area of Quebec from the early 1830s onwards. For the genome scan, the pedigree was split into five branches to facilitate calculation and a second family was added to more specifically analyze chromosome 12 results. In the present study, we reanalyzed the undivided pedigree after genealogical links were reconstructed over ten generations to investigate a founder effect using an algorithm in the SIMWALK2 package. Our results do not lend support to the presence of a common haplotype shared among affected individuals.

Genome-wide search for linkage of bipolar affective disorders in a very large pedigree derived from a homogeneous population in quebec points to a locus of major effect on chromosome 12q23-q24.

We completed a genome-wide scan for susceptibility loci for bipolar affective disorders in families derived from a rather homogeneous population in the Province of Québec. The genetic homogeneity of this population stems from the migration of founding families into this relatively isolated area of Québec in the 1830s. A possible founder effect, combined with a prevalence of very large families, makes this population ideal for linkage studies. Genealogies for probands can be readily constructed from a population database of acts of baptism and marriage from the early 1830s up to the present time (the BALSAC register). We chose probands with a DSM III diagnosis of bipolar affective disorder and who may be grouped within large families having genealogical origins with the founding population of the Saguenay-Lac-St-Jean area. Living members (n approximately 120) of a very large pedigree were interviewed using the Structured Clinical Interview for DSM III (SCID I), SCID II, and with a family history questionnaire. A diagnostic panel evaluated multisource information (interview, medical records, family history) and pronounced best-estimate consensus diagnoses on all family members. Linkage, SimAPM, SimIBD, and sib-pair analyses have been performed with 332 microsatellite probes covering the entire genome at an average spacing of 11 cM. GENEHUNTER and haplotype analyses were performed on regions of interest. Analysis of a second large pedigree in the same regions of interest permitted confirmation of presumed linkages found in the region of chromosome 12q23-q24.

Impact of spontaneous synaptic activity on the resting properties of cat neocortical pyramidal neurons In vivo.

The frequency of spontaneous synaptic events in vitro is probably lower than in vivo because of the reduced synaptic connectivity present in cortical slices and the lower temperature used during in vitro experiments. Because this reduction in background synaptic activity could modify the integrative properties of cortical neurons, we compared the impact of spontaneous synaptic events on the resting properties of intracellularly recorded pyramidal neurons in vivo and in vitro by blocking synaptic transmission with tetrodotoxin (TTX). The amount of synaptic activity was much lower in brain slices (at 34 degrees C), as the standard deviation of the intracellular signal was 10-17 times lower in vitro than in vivo. Input resistances (Rins) measured in vivo during relatively quiescent epochs ("control Rins") could be reduced by up to 70% during periods of intense spontaneous activity. Further, the control Rins were increased by approximately 30-70% after TTX application in vivo, approaching in vitro values. In contrast, TTX produced negligible Rin changes in vitro (approximately 4%). These results indicate that, compared with the in vitro situation, the background synaptic activity present in intact networks dramatically reduces the electrical compactness of cortical neurons and modifies their integrative properties. The impact of the spontaneous synaptic bombardment should be taken into account when extrapolating in vitro findings to the intact brain.

Neuronal circuitry and synaptic connectivity of the basal ganglia.

The concept of organization of the basal ganglia has changed markedly over the last 10 years. These developments have led to the introduction of a schematic model of the functional circuitry of the basal ganglia that accounts for normal and abnormal basal ganglia functions. The recent introduction of powerful techniques for the analysis of neuronal networks has led to many new developments in our understanding of the anatomic and synaptic organization of the basal ganglia. The objective of this article is to go from the established model of the basal ganglia connectivity to new anatomic findings that lead to reconsideration and refinement of some aspects of the models.

Microcircuitry of the direct and indirect pathways of the basal ganglia.

Our understanding of the organization of the basal ganglia has advanced markedly over the last 10 years, mainly due to increased knowledge of their anatomical, neurochemical and physiological organization. These developments have led to a unifying model of the functional organization of the basal ganglia in both health and disease. The hypothesis is based on the so-called "direct" and "indirect" pathways of the flow of cortical information through the basal ganglia and has profoundly influenced the field of basal ganglia research, providing a framework for anatomical, physiological and clinical studies. The recent introduction of powerful techniques for the analysis of neuronal networks has led to further developments in our understanding of the basal ganglia. The objective of this commentary is to build upon the established model of the basal ganglia connectivity and review new anatomical findings that lead to the refinement of some aspects of the model. Four issues will be discussed. (1) The existence of several routes for the flow of cortical information along "indirect" pathways. (2) The synaptic convergence of information flowing through the "direct" and "indirect" pathways at the single-cell level in the basal ganglia output structures. (3) The convergence of functionally diverse information from the globus pallidus and the ventral pallidum at different levels of the basal ganglia. (4) The interconnections between the two divisions of the pallidal complex and the subthalamic nucleus and the characterization of the neuronal network underlying the indirect pathways. The findings summarized in this commentary confirm and elaborate the models of the direct and indirect pathways of information flow through the basal ganglia and provide a morphological framework for future studies.

Efferent connections of the internal globus pallidus in the squirrel monkey: II. Topography and synaptic organization of pallidal efferents to the pedunculopontine nucleus.

The first objective of the present study was to verify whether projections from regions of the internal pallidum (GPi) that receive inputs from different functional areas of the striatum remain segregated at the level of the pedunculopontine nucleus (PPN) in squirrel monkeys. Second, we analyzed the ultrastructural features and synaptic organization of pallidal terminals in contact with PPN neurons. This was achieved by performing iontophoretic injections of biotinylated dextran amine (BDA) in different regions of the GPi. The animals were pooled into three groups on the basis of the location of the injection sites and the resulting distribution of retrogradely labelled striatal neurons. The experimental groups were divided as follows: group 1: injections in the dorsal one-third of the GPi, retrograde labelling in the head and body of the caudate nucleus ("associative striatum"); group 2: injections in the ventrolateral two-thirds of the GPi, retrograde labelling in the postcommissural region of the putamen ("sensorimotor striatum"); and group 3: injections in the rostromedial pole of the GPi, retrograde labelling in the ventral striatum ("limbic striatum"). These injections led to the anterograde labelling of varicose fibers that arborized profusely in common regions of the PPN dorsal to the brachium conjunctivum. The fields of fibers that arose from the dorsal one-third and the rostromedial pole of the GPi were more widely spread than the afferents from the ventrolateral two-thirds of the GPi. Small numbers of retrogradely labelled cells were encountered in the PPN after each injection in the GPi. Some of them were tightly surrounded by large, BDA-containing varicosities, which implies that the connections between the GPi and the PPN are partly reciprocal. In sections processed for the simultaneous localization of beta-nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase (a marker of cholinergic cells in the PPN) and BDA, the anterogradely labelled fibers largely avoided the dense aggregate of NADPH-diaphorase-containing neurons in the PPN pars compacta (PPNc) but, rather, established contacts with unlabelled neurons in the pars dissipata (PPNd). In the electron microscope, the GPi terminals were large (1.0-5.0 microns in diameter), contained many mitochondria and pleomorphic vesicles, and formed symmetric synapses predominantly with proximal dendrites of PPN cells. In conclusion, our data suggest that the noncholinergic neurons of the PPNd are potential targets for the integration of information arising from different functional territories of the GPi in primates. The PPNd is thus in a position to act as an interface between motivational, cognitive, and motor information transmitted along the pallidotegmental projection in primates.

The subthalamic nucleus and the external pallidum: two tightly interconnected structures that control the output of the basal ganglia in the monkey.

The aim of the present study was to elucidate the organization of the interconnections between the subthalamic nucleus and the two segments of the globus pallidus in squirrel monkeys. By making small deposits of tracers in the two segments of the globus pallidus, we demonstrate that interconnected neurons of the subthalamic nucleus and the external pallidum innervate, via axon collaterals, the same population of neurons in the internal pallidum. Furthermore, this organizational principle holds true for different functional regions of the pallidum and the subthalamic nucleus. Injections of biotinylated dextran amine were made in the dorsal (associative), ventrolateral (sensorimotor) and rostromedial (limbic) regions of the internal pallidum. Following these injections, there were rich clusters of labelled terminals in register with retrogradely labelled perikarya in related functional regions of the subthalamic nucleus and the external pallidum. At the electron microscopic level, the majority of labelled terminals in the external pallidum displayed the ultrastructural features of boutons from the subthalamic nucleus and were non-immunoreactive for GABA, whereas those in the subthalamic nucleus resembled terminals from the external pallidum and displayed GABA immunoreactivity. In both cases, the synaptic targets of the labelled terminals included labelled neurons. These observations suggest that the biotinylated dextran amine injected in the internal globus pallidus was transported retrogradely to perikarya in the external pallidum and the subthalamic nucleus and then anterogradely, via axon collaterals, to the subthalamic nucleus and the external pallidum respectively. This suggestion was supported by injections of biotinylated dextran amine or Phaseolus vulgaris-leucoagglutinin in regions of the external pallidum that corresponded to those containing retrogradely labelled cells following injections in the internal pallidum. The clusters of labelled cells and varicosities that resulted from these injections were found in regions of the subthalamic nucleus similar to those labelled following injections in the internal globus pallidus. Furthermore, terminals from the external pallidum and the subthalamic nucleus converged on the same regions in the internal globus pallidus. The results of the present tracing study define the basic network underlying the interconnections between the external segment of the globus pallidus and the subthalamic nucleus, and their connections with the output neurons of the basal ganglia in primates.

Differential synaptic innervation of neurons in the internal and external segments of the globus pallidus by the GABA- and glutamate-containing terminals in the squirrel monkey.

The present study aimed at comparing the pattern of synaptic innervation of neurons in the external (GPe) and internal (GPi) pallidum by gamma-aminobutyric acid (GABA)- and glutamate-immunoreactive terminals in the squirrel monkey. Four major populations of terminals were encountered in GPe and GPi. Our findings combined with those obtained in previous tract-tracing studies reveal that the synaptic innervation of perikarya in GPe is strikingly different from that in GPi. Although the GABA-positive type I boutons (from the striatum) represent 85% of the terminals in contact with somata in GPe, only 32% of the axosomatic synapses involve this type of terminal in GPi. However, the type II terminals (from GPe), which display a moderate level of GABA and glutamate immunoreactivities, account for 48% of the boutons in contact with perikarya in GPi but only 10% in GPe. In both pallidal segments, less than 10% of the axosomatic synapses involve the glutamate-immunoreactive type III terminals (from the subthalamic nucleus). Finally, the type IIa boutons (unknown source), which show levels of immunoreactivities similar to the type II terminals, account for 12% of the boutons in contact with perikarya in GPi but only 4% in GPe. In contrast to perikarya, the innervation of dendritic shafts is similar in both GPe and GPi; more than 80% of the axodendritic synapses involve the type I terminals, 10-15% involve the type III terminals, less than 5% are formed by the type II boutons, and less than 1% involve the type IIa terminals. Three other categories of boutons (types IV, V, VI) account for less than 1% of the total population of terminals in GPe and GPi. In conclusion, our findings demonstrate a differential synaptic innervation of neuronal perikarya in GPe and GPi in primates. These data suggest that the two pallidal segments are separate functional entities of which the neuronal activity is largely controlled by extrinsic inputs that are differentially distributed at the level of single cells.