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Since the discovery of small-world and scale-free networks the study of complex systems from a network perspective has taken an enormous flight. In recent years many important properties of complex networks have been delineated. In particular, significant progress has been made in understanding the relationship between the structural properties of networks and the nature of dynamics taking place on these networks. For instance, the 'synchronizability' of complex networks of coupled oscillators can be determined by graph spectral analysis. These developments in the theory of complex networks have inspired new applications in the field of neuroscience. Graph analysis has been used in the study of models of neural networks, anatomical connectivity, and functional connectivity based upon fMRI, EEG and MEG. These studies suggest that the human brain can be modelled as a complex network, and may have a small-world structure both at the level of anatomical as well as functional connectivity. This small-world structure is hypothesized to reflect an optimal situation associated with rapid synchronization and information transfer, minimal wiring costs, as well as a balance between local processing and global integration. The topological structure of functional networks is probably restrained by genetic and anatomical factors, but can be modified during tasks. There is also increasing evidence that various types of brain disease such as Alzheimer's disease, schizophrenia, brain tumours and epilepsy may be associated with deviations of the functional network topology from the optimal small-world pattern.

As caveolin-3 deficiencies may explain persistent hyper-CK-emia, we performed CAV3 gene mutation analysis and immunohistochemistry for caveolin-3 in 31 patients with idiopathic hyper-CK-emia. In 2 of 29 patients who donated blood, variants in the CAV3 gene were detected. Although immunohistochemical analysis strongly suggested that caveolin-3 was properly localized in the muscle tissue of the two affected patients, it may not function normally and could thus explain their persistent hyper-CK-emia. Our findings contribute to the clarification of unexplained persistent hyper-CK-emia, but further research is needed before CAV3 gene mutation analysis becomes part of the routine evaluation of these patients.

Objective: The diagnosis of leptomeningeal metastases (LM) is based on clinical symptoms, magnetic resonance imaging (MRI) of brain and spine and cytological analysis of cerebrospinal fluid (CSF). The clinical picture of LM is highly variable and both cytological CSF analysis and contrast-enhanced MRI are limited in sensitivity. More sensitive tools are needed to diagnose LM. We measured a profile of proteins involved in adhesion and inflammation in the CSF of LM and control patients and determined their potential diagnostic value for LM., Patients and Methods: Using Multiplex Immuno-Assay (MIA), the CSF concentrations of nine soluble adhesion molecules, cyto- and chemokines were measured in patients with cytologically proven LM (n = 57) and control patients with a systemic malignancy (n = 20), aseptic/viral meningitis (n = 11) or other (non-)neurological diseases (n = 19)., Results: We found high CSF levels of soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1), soluble Intercellular Adhesion Molecule-1 (sICAM-1), Interleukin-8 (IL-8), Pulmonary and Activation Regulated Chemokine (PARC), Interleukin-18 (IL-18) and Interferon-gamma inducible protein (IP-10) in patients with LM. The CSF protein profile in LM patients differed significantly from the profile found in control patients. Multivariate logistic regression and ROC analysis showed that the MIA-measured CSF protein profile has an additive discriminating value for LM above standard CSF parameters. A combination of total protein, glucose, IL-8, PARC and IP-10 CSF levels proved to be most discriminative between LM and non-LM patients., Conclusion: Our results warrant a prospective study to determine whether a CSF protein profile, including IL-8, PARC and IP-10 has diagnostic value compared with CSF cytology, the golden standard for LM.

Objective: Cerebral functions are based on the functional interactions between multiple distinct specialized regions of the brain. Functional interactions require anatomical connections as well as the synchronization of brain oscillations. The present work aims at evaluating the impact of brain tumours on spatial patterns of functional connectivity of the brain measured at rest by MEG., Methods: We analyzed the statistical dependency (by computing the synchronization likelihood (SL, a measure of generalized synchronization)) between MEG signals at rest, in 17 patients with a brain tumour and in 15 healthy controls. Following an approach that derives from graph theory, we also analyzed the architectural properties of the networks by computing two parameters from the SL matrix, the cluster coefficient C and the characteristic path length L., Results: Alterations in synchronization levels were found in the patients and were not focal but involved intra-hemispheric connectivity. Effects were different considering the frequencies sub-bands, predominating in a decrease in high frequencies bands for long-distance connections and an increase in slower bands for local connectivity. In addition, graph analysis reveals changes in the normal "small-world" network architecture in addition to changes in synchronization levels with some differences according to the studied frequency sub-bands., Conclusions: Brain tumours alter the functional connectivity and the "network" architecture of the brain. These alterations are not focal and effects are different considering the frequencies sub-bands., Significance: These neurophysiological changes may contribute to the cognitive alterations observed in patients with brain tumours.

Leptomeningeal metastases are a serious neurological complication in cancer patients and associated with a dismal prognosis. Tumor cells that enter the subarachnoid space adhere to the leptomeninges and form tumor deposits. It is largely unknown which adhesion molecules mediate tumor cell adhesion to leptomeninges. We studied the role of integrin expression and activation in the progression of leptomeningeal metastases. For this study, we used a mouse acute lymphocytic leukemic cell line that was grown in suspension (L1210-S cell line) to develop an adherent L1210 cell line (L1210-A) by selectively culturing the few adherent cells in the cell culture. beta1, beta2, and beta3 integrins were in a constitutively high active state on L1210-A cells and in a low, but inducible, active state on L1210-S cells. Expression levels of these integrins were comparable in the two cell lines. Static adhesion levels of L1210-A cells on a leptomeningeal cell layer were significantly higher than those of L1210-S cells. All mice that were injected intrathecally with L1210-A cells died rapidly of leptomeningeal leukemia. In contrast, 45% long-term survival was seen after intrathecal injection of mice with L1210-S cells. Our data indicate that constitutive integrin activation on leukemic cells promotes progression of leptomeningeal leukemia by increased tumor cell adhesion to the leptomeninges. We argue that an aberrantly regulated inside-out signaling pathway underlies constitutive integrin activation on the adherent leukemic cell population.

Objective: This study was undertaken to test the hypothesis that brain tumors interfere with normal brain function by disrupting functional connectivity of brain networks., Methods: Functional connectivity was assessed by computing the synchronization likelihood in a broad band (0.5-60Hz) or in the gamma band (30-60Hz) between all pairwise combinations of magnetoencephalography signals. Magnetoencephalography recordings were made at rest in 17 brain tumor patients and 15 healthy control subjects. For a given threshold of synchronization likelihood values, graphs of the suprathreshold connections between each magnetoencephalography channel and the others channels were built., Results: In some regions, a variable number of channels without connectivity (missing connective points) at this threshold was found. The number of missing connective points was higher in patients with brain tumors than in control subjects (p < 0.0001, broad and gamma band) and was higher for left-sided than right-sided tumors (p = 0.008, broad band; p < 0.0001, gamma band). Individual results analysis indicates that the majority of brain tumor patients display several regions with missing connective point alterations in the affected and in the contralateral hemisphere., Interpretation: Our findings suggest that brain tumors induce a loss of functional connectivity that affects multiple brain regions, and that left side brain tumors have the more severe consequences in this respect.

To develop new treatment strategies for patients with leptomeningeal metastases (LM), potential therapeutic agents have to be tested in murine models first. In vivo magnetic resonance imaging has an additive value in non-invasive monitoring of the effects of therapeutic agents on LM. Previously, we described a reproducible mouse model for B16F-10 melanoma LM. In this paper, we visualize leptomeningeal melanoma metastases in mice on both T2 weighted MR images and gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) enhanced T1 weighted MR images, using a 4.7T MR spectrometer. We conclude that both MR sequences can be used to detect and monitor LM of melanoma cells in mice. Our data further suggest that LM are more clearly visualized using T1 weighted Gd-DTPA enhanced subtraction imaging than T2 weighted imaging.

Leptomeningeal metastases occur in up to 8% of patients with systemic malignancies and have a poor prognosis. A better understanding of the pathophysiologic processes underlying leptomeningeal metastases is needed for more effective treatment strategies. We hypothesized that tumor cells will have to adhere to the well-vascularized leptomeninges, because the cerebrospinal fluid lacks nutrients and growth factors for efficient tumor cell proliferation. Specific receptor-ligand interactions, which are unknown until now, will mediate this adhesion process. We determined the growth characteristics of B16F-10 melanoma cells in cerebrospinal fluid. The expression levels of specific adhesion molecules on both mouse leptomeningeal cells (MLMC) and murine B16F-10 melanoma cells were measured by immunofluorescence flow cytometry. We used mAbs to determine the function of these specific adhesion molecules on B16F-10 melanoma cell adhesion to a leptomeningeal cell layer under static and (cerebrospinal fluid-like) flow conditions. B16F-10 melanoma cells did not proliferate in cerebrospinal fluid because of a lack of nutrients and growth factors. MLMC expressed low levels of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), beta1- and beta3-integrin subunits, and CD44. VCAM-1 expression on MLMC was shown to be up-regulated by TNF-alpha. Blocking VCAM-1 on the MLMC with a mAb resulted in a 60% inhibition of melanoma cell adhesion to a leptomeningeal cell layer under flow but not under static conditions. No additive inhibitory effect on melanoma cell adhesion was found by concomitant blocking of the beta1- and beta3-integrin subunits and CD44 with mAbs. Our experiments indicate that cerebrospinal fluid does not support B16F-10 melanoma cell proliferation, suggesting the need for melanoma cell adhesion to the well-vascularized leptomeninges. VCAM-1, expressed on MLMC, is an important mediator of in vitro melanoma cell adhesion under (cerebrospinal fluid-like) flow conditions.