Alzheimer's Disease (AD) is the most prevalent form of dementia in the elderly population and a debilitating neurodegenerative disease. Histopathologically, AD presents itself as amyloid plaques, neurofibrillary tangles and neuronal loss. Amyloid plaques consist primarily of beta-amyloid peptide (Aβ) that has been produced through an altered proteolytic cleavage of amyloid precursor protein (APP) by β-secretase and γ-secretase enzymes1,2,3. The cleavage product, Aβ, deposits in the brain creating pathological amyloid plaques and has toxic effects on the brain that can lead to the characteristic learning impairments and memory loss. All of these steps together are referred to as the "amyloid cascade hypothesis"3,4. While this hypothesis is important when investigating AD, other cellular changes have been found to precede these plaque formations that strays from the original amyloid cascade pathway. These other cellular changes are thought to contribute to early memory loss, learning impairments and other cognitive dysfunctions involved in AD prior to plaque formation3,5,6.
With AD becoming increasingly prevalent, risk factors for developing AD are becoming an extremely important focus of research. Although age is the principal risk factor for sporadic forms of AD, other risk factors have been identified, including stroke7,8. Stroke is not only a risk factor, but it can also exacerbate already present dementias. For example, clinically, the progression of AD has been shown to be worse in patients who had previously experienced stroke9. Moreover, increased APP expression and Aβ accumulation has been found in experimental animal models of Aβ toxicity combined with induced stroke10,11. Since there is this important interaction between stroke and AD, it is essential that these two pathologies be further researched together in co-morbid models to better understand pathophysiology and behaviors implicated in both conditions.
To investigate co-morbid conditions, an appropriate model had to be developed in which a stroke could interact with Aβ to produce AD-like pathology. For the first time, an APP21 transgenic rat that has a mutated human APP gene incorporated into its DNA was used to achieve an appropriate model of AD. The mutations are the Swedish double missense and Indiana single missense mutations, which have both been implicated in familial forms of AD4,8,12. In the absence of an additional insult, this rat model ages without developing the characteristic Aβ plaques or neurofibrillary tangles12. Therefore, in an effort to induce AD-like behavioral pathology, a small stroke is introduced into the right striatum to mimic the small subcortical strokes often present in dementia patients9. The stroke in the APP21 transgenic rat embodies the co-morbid condition and allows investigation of various types of behavioral changes implicated in both disease conditions. In particular, this induction of AD-like pathology and cognitive deficits in the adult rat allows us investigate the earliest molecular and cognitive changes preceding AD.
Since the goal is to determine the first signs of behavioral changes and since both stroke and AD have very distinct behavioral pathologies, when studying the co-morbid model, behavior tasks need to assess a variety of behavioral phenotypes. There are a battery of relatively sensitive tests that can be done to analyze motor and cognitive behavior in rodent models that involve a variety of paradigms and equipment. To specifically analyze forelimb and hindlimb motor function, the cylinder task and beam-walk task have been implemented to detect motor deficits and monitor locomotion in this model. Other sensitive tasks designed to specifically assess fine forelimb motor skill (i.e. the staircase task and single pellet reaching task) require food deprivation11,13,14. To avoid any of the known effects of food deprivation on disease pathologies15,16,17, these tests have been deemed unsuitable for this study. The cylinder task assesses the spontaneous use of the rat's forelimbs during rearing in a novel environment and can detect asymmetry between forelimbs in rats with unilateral stroke10,18. A major benefit to this task is that the apparatus can be utilized for other behavior tasks, such as the Porsolt forced swim task19. Contrary to the cylinder task, the beam-walk task also allows analysis of hindlimb and forelimb motor control, in addition to locmotion10,14. Beam walking includes a locomotor component, a balance component and skilled foot placement. Both of these tests are cost-efficient, straightforward, and time-efficient and elucidate the effects of stroke and AD on differences in limb functioning.
Aside from changes in motor function, AD involves memory deficits that can present in early stages of the disease progression. When addressing AD-like pathologies in a rodent model, it is crucial that hippocampal dependent learning and memory is assessed because the hippocampus is an important brain structure largely affected in AD2. The hippocampus is an essential brain region for spatial learning and memory and its function can be tested using various maze paradigms in rodents. One of the mostly widely used maze tasks for rodent models of different diseases is the Morris water maze20. The Morris water maze utilizes spatial cues to assist the rat in locating a stationary hidden platform and tests spatial reference memory when the platform is removed. A valuable advantage of the water maze setup is that it is highly adaptable depending on the proposed research question20.
For the first time, the techniques described have been used to assess motor and cognitive function in a novel co-morbid rat model of stroke and AD. involving small strokes in an APP21 transgenic rat model. Co-morbidity was achieved by inducing vasoconstriction of the blood vessels in the striatum to produce a small stroke in APP21 transgenic rats. This stroke model has been well established as a co-morbid condition in an alternative rat model of AD11. Advancement into this novel APP21 transgenic rat model was intended to produce a more translationally valuable model. While the behavioural tasks are described using a co-morbid stroke and AD rat model, these tasks can be further applied to other models of stroke or models of other neurological diseases (i.e. Parkinson’s disease). The general methodology described will be widely applicable to these other disease states, but behavior timelines and paradigms may require alteration based on the proposed research question and model. In addition to being adaptable, the tasks described are effective in demonstrating minor deficits, while also being cost and time-efficient.