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Almeida-Corrêa S, Czisch M, Wotjak CT. In Vivo Visualization of Active Polysynaptic Circuits With Longitudinal Manganese-Enhanced MRI (MEMRI). Front Neural Circuits 2018; 12:42. [PMID: 29887796 PMCID: PMC5981681 DOI: 10.3389/fncir.2018.00042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/30/2018] [Indexed: 12/23/2022] Open
Abstract
Manganese-enhanced magnetic resonance imaging (MEMRI) is a powerful tool for in vivo non-invasive whole-brain mapping of neuronal activity. Mn2+ enters active neurons via voltage-gated calcium channels and increases local contrast in T1-weighted images. Given the property of Mn2+ of axonal transport, this technique can also be used for tract tracing after local administration of the contrast agent. However, MEMRI is still not widely employed in basic research due to the lack of a complete description of the Mn2+ dynamics in the brain. Here, we sought to investigate how the activity state of neurons modulates interneuronal Mn2+ transport. To this end, we injected mice with low dose MnCl2 2. (i.p., 20 mg/kg; repeatedly for 8 days) followed by two MEMRI scans at an interval of 1 week without further MnCl2 injections. We assessed changes in T1 contrast intensity before (scan 1) and after (scan 2) partial sensory deprivation (unilateral whisker trimming), while keeping the animals in a sensory enriched environment. After correcting for the general decay in Mn2+ content, whole brain analysis revealed a single cluster with higher signal in scan 1 compared to scan 2: the left barrel cortex corresponding to the right untrimmed whiskers. In the inverse contrast (scan 2 > scan 1), a number of brain structures, including many efferents of the left barrel cortex were observed. These results suggest that continuous neuronal activity elicited by ongoing sensory stimulation accelerates Mn2+ transport from the uptake site to its projection terminals, while the blockage of sensory-input and the resulting decrease in neuronal activity attenuates Mn2+ transport. The description of this critical property of Mn2+ dynamics in the brain allows a better understanding of MEMRI functional mechanisms, which will lead to more carefully designed experiments and clearer interpretation of the results.
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Affiliation(s)
- Suellen Almeida-Corrêa
- Department of Stress Neurobiology & Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany
| | - Michael Czisch
- Core Unit Neuroimaging, Max Planck Institute of Psychiatry, Munich, Germany
| | - Carsten T Wotjak
- Department of Stress Neurobiology & Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany
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Holahan MR. A Shift from a Pivotal to Supporting Role for the Growth-Associated Protein (GAP-43) in the Coordination of Axonal Structural and Functional Plasticity. Front Cell Neurosci 2017; 11:266. [PMID: 28912688 PMCID: PMC5583208 DOI: 10.3389/fncel.2017.00266] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/18/2017] [Indexed: 11/14/2022] Open
Abstract
In a number of animal species, the growth-associated protein (GAP), GAP-43 (aka: F1, neuromodulin, B-50, G50, pp46), has been implicated in the regulation of presynaptic vesicular function and axonal growth and plasticity via its own biochemical properties and interactions with a number of other presynaptic proteins. Changes in the expression of GAP-43 mRNA or distribution of the protein coincide with axonal outgrowth as a consequence of neuronal damage and presynaptic rearrangement that would occur following instances of elevated patterned neural activity including memory formation and development. While functional enhancement in GAP-43 mRNA and/or protein activity has historically been hypothesized as a central mediator of axonal neuroplastic and regenerative responses in the central nervous system, it does not appear to be the crucial substrate sufficient for driving these responses. This review explores the historical discovery of GAP-43 (and associated monikers), its transcriptional, post-transcriptional and post-translational regulation and current understanding of protein interactions and regulation with respect to its role in axonal function. While GAP-43 itself appears to have moved from a pivotal to a supporting factor, there is no doubt that investigations into its functions have provided a clearer understanding of the biochemical underpinnings of axonal plasticity.
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Shifts in developmental timing, and not increased levels of experience-dependent neuronal activity, promote barrel expansion in the primary somatosensory cortex of rats enucleated at birth. PLoS One 2013; 8:e54940. [PMID: 23372796 PMCID: PMC3556040 DOI: 10.1371/journal.pone.0054940] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
Birth-enucleated rodents display enlarged representations of whiskers (i.e., barrels of the posteromedial subfield) in the primary somatosensory cortex. Although the historical view maintains that barrel expansion is due to incremental increases in neuronal activity along the trigeminal pathway during postnatal development, recent evidence obtained in experimental models of intramodal plasticity challenges this view. Here, we re-evaluate the role of experience-dependent neuronal activity on barrel expansion in birth-enucleated rats by combining various anatomical methods and sensory deprivation paradigms. We show that barrels in birth-enucleated rats were already enlarged by the end of the first week of life and had levels of metabolic activity comparable to those in control rats at different ages. Dewhiskering after the postnatal period of barrel formation did not prevent barrel expansion in adult, birth-enucleated rats. Further, dark rearing and enucleation after barrel formation did not lead to expanded barrels in adult brains. Because incremental increases of somatosensory experience did not promote barrel expansion in birth-enucleated rats, we explored whether shifts of the developmental timing could better explain barrel expansion during the first week of life. Accordingly, birth-enucleated rats show earlier formation of barrels, accelerated growth of somatosensory thalamocortical afferents, and an earlier H4 deacetylation. Interestingly, when H4 deacetylation was prevented with a histone deacetylases inhibitor (valproic acid), barrel specification timing returned to normal and barrel expansion did not occur. Thus, we provide evidence supporting that shifts in developmental timing modulated through epigenetic mechanisms, and not increased levels of experience dependent neuronal activity, promote barrel expansion in the primary somatosensory cortex of rats enucleated at birth.
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Hildebrandt H, Hoffmann NA, Illing RB. Synaptic reorganization in the adult rat's ventral cochlear nucleus following its total sensory deafferentation. PLoS One 2011; 6:e23686. [PMID: 21887295 PMCID: PMC3161744 DOI: 10.1371/journal.pone.0023686] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 07/25/2011] [Indexed: 01/09/2023] Open
Abstract
Ablation of a cochlea causes total sensory deafferentation of the cochlear nucleus in the brainstem, providing a model to investigate nervous degeneration and formation of new synaptic contacts in the adult brain. In a quantitative electron microscopical study on the plasticity of the central auditory system of the Wistar rat, we first determined what fraction of the total number of synaptic contact zones (SCZs) in the anteroventral cochlear nucleus (AVCN) is attributable to primary sensory innervation and how many synapses remain after total unilateral cochlear ablation. Second, we attempted to identify the potential for a deafferentation-dependent synaptogenesis. SCZs were ultrastructurally identified before and after deafferentation in tissue treated for ethanolic phosphotungstic acid (EPTA) staining. This was combined with pre-embedding immunocytochemistry for gephyrin identifying inhibitory SCZs, the growth-associated protein GAP-43, glutamate, and choline acetyltransferase. A stereological analysis of EPTA stained sections revealed 1.11±0.09 (S.E.M.)×10(9) SCZs per mm(3) of AVCN tissue. Within 7 days of deafferentation, this number was down by 46%. Excitatory and inhibitory synapses were differentially affected on the side of deafferentation. Excitatory synapses were quickly reduced and then began to increase in number again, necessarily being complemented from sources other than cochlear neurons, while inhibitory synapses were reduced more slowly and continuously. The result was a transient rise of the relative fraction of inhibitory synapses with a decline below original levels thereafter. Synaptogenesis was inferred by the emergence of morphologically immature SCZs that were consistently associated with GAP-43 immunoreactivity. SCZs of this type were estimated to make up a fraction of close to 30% of the total synaptic population present by ten weeks after sensory deafferentation. In conclusion, there appears to be a substantial potential for network reorganization and synaptogenesis in the auditory brainstem after loss of hearing, even in the adult brain.
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Affiliation(s)
- Heika Hildebrandt
- Neurobiological Research Laboratory, Department of Otorhinolaryngology, University of Freiburg, Freiburg, Germany
| | - Nadine A. Hoffmann
- Neurobiological Research Laboratory, Department of Otorhinolaryngology, University of Freiburg, Freiburg, Germany
| | - Robert-Benjamin Illing
- Neurobiological Research Laboratory, Department of Otorhinolaryngology, University of Freiburg, Freiburg, Germany
- * E-mail:
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Hall KD, Lifshitz J. Diffuse traumatic brain injury initially attenuates and later expands activation of the rat somatosensory whisker circuit concomitant with neuroplastic responses. Brain Res 2010; 1323:161-73. [PMID: 20122903 DOI: 10.1016/j.brainres.2010.01.067] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 01/22/2010] [Accepted: 01/23/2010] [Indexed: 01/27/2023]
Abstract
Traumatic brain injury can initiate an array of chronic neurological deficits, effecting executive function, language and sensorimotor integration. Mechanical forces produce the diffuse pathology that disrupts neural circuit activation across vulnerable brain regions. The present manuscript explores the hypothesis that the extent of functional activation of brain-injured circuits is a consequence of initial disruption and consequent reorganization. In the rat, enduring sensory sensitivity to whisker stimulation directs regional analysis to the whisker barrel circuit. Adult, male rats were subjected to midline fluid percussion brain or sham injury and evaluated between 1day and 42days post-injury. Whisker somatosensory regions of the cortex and thalamus maintained cellular composition as visualized by Nissl stain. Within the first week post-injury, quantitatively less cFos activation was elicited by whisker stimulation, potentially due to axotomy within and surrounding the whisker circuit as visualized by amyloid precursor protein immunohistochemistry. Over six weeks post-injury, cFos activation after whisker stimulation showed a significant linear correlation with time in the cortex (r(2)=0.545; p=0.015), non-significant correlation in the thalamus (r(2)=0.326) and U-shaped correlation in the dentate gyrus (r(2)=0.831), all eventually exceeding sham levels. Ongoing neuroplastic responses in the cortex are evidenced by accumulating growth associated protein and synaptophysin gene expression. In the thalamus, the delayed restoration of plasticity markers may explain the broad distribution of neuronal activation extending into the striatum and hippocampus with whisker stimulation. The sprouting of diffuse-injured circuits into diffuse-injured tissue likely establishes maladaptive circuits responsible for behavioral morbidity. Therapeutic interventions to promote adaptive circuit restructuring may mitigate post-traumatic morbidity.
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Affiliation(s)
- Kelley D Hall
- Spinal Cord and Brain Injury Research Center, Chandler Medical Center, University of Kentucky, USA
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Peeva GP, Angelova SK, Guntinas-Lichius O, Streppel M, Irintchev A, Schütz U, Popratiloff A, Savaskan NE, Bräuer AU, Alvanou A, Nitsch R, Angelov DN. Improved outcome of facial nerve repair in rats is associated with enhanced regenerative response of motoneurons and augmented neocortical plasticity. Eur J Neurosci 2006; 24:2152-62. [PMID: 17074041 DOI: 10.1111/j.1460-9568.2006.05091.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Within a recent study on the vibrissae motor performance after facial nerve repair in strains of blind (SD/RCS) and sighted (SD) rats we found that, despite persisting myotopic disorganization in the facial nucleus, the blind animals fully restored vibrissal whisking. Here we searched for morphological substrates of better recovery in the regenerating motoneurons and in the cerebral motor cortex. Expression analyses of the neurite growth-related proteins f-actin, neuronal class III beta-tubulin and plasticity-related gene-1, and stereological estimates of growth cone densities revealed a more vigorous regenerative response in the proximal nerve stump of blind SD/RCS rats compared with SD animals at 5-7 days after buccal nerve transection. Using c-Fos immunoreactivity as a marker for neuronal activation, we found that the volume of the cortex acutely responding to nerve transection (facial muscles reactive volume, FMRV) in both hemispheres of intact sighted rats was twofold smaller than that measured in blind animals. One month after transection and suture of the right facial nerve (FFA) we found a twofold increase in the FMRV in both rat strains compared with intact animals. The FMRV in SD/RCS animals, but not in SD rats, returned to the values in intact rats 2 months after FFA. Our findings suggest that enhanced plasticity in the CNS and an augmented regenerative response of the injured motoneurons contribute to better functional recovery in blind rats.
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Illing RB, Kraus KS, Meidinger MA. Reconnecting neuronal networks in the auditory brainstem following unilateral deafening. Hear Res 2005; 206:185-99. [PMID: 16081008 DOI: 10.1016/j.heares.2005.01.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Accepted: 01/10/2005] [Indexed: 11/27/2022]
Abstract
When we disturbed the auditory input of the adult rat by cochleotomy or noise trauma on one side, several substantial anatomical, cellular, and molecular changes took place in the auditory brainstem. We found that: (1) cochleotomy or severe noise trauma both lead to a considerable increase of immunoreactivity of the growth-associated protein GAP-43 in the ventral cochlear nucleus (VCN) of the affected side; (2) the expression of GAP-43 in VCN is restricted to presynaptic endings and short fiber segments; (3) axon collaterals of the cholinergic medial olivocochlear (MOC) neurons are the path along which GAP-43 reaches VCN; (4) partial cochlear lesions induce the emergence of GAP-43 positive presynaptic endings only in regions tonotopically corresponding to the extent of the lesion; (5) judging from the presence of immature fibers and growth cones in VCN on the deafened side, at least part of the GAP-43 positive presynaptic endings appear to be newly formed neuronal contacts following axonal sprouting while others may be modified pre-existing contacts; and (6) GAP-43 positive synapses are formed only on specific postsynaptic profiles, i.e., glutamatergic, glycinergic and calretinin containing cell bodies, but not GABAergic cell bodies. We conclude that unilateral deafening, be it partial or total, induces complex patterns of reconnecting neurons in the adult auditory brainstem, and we evaluate the possibility that the deafness-induced chain of events is optimized to remedy the loss of a bilaterally balanced activity in the auditory brainstem.
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Affiliation(s)
- Robert-Benjamin Illing
- Neurobiological Research Laboratory, Department of Otorhinolaryngology, University of Freiburg, D-79106 Freiburg, Germany.
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8
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Tailby C, Wright LL, Metha AB, Calford MB. Activity-dependent maintenance and growth of dendrites in adult cortex. Proc Natl Acad Sci U S A 2005; 102:4631-6. [PMID: 15767584 PMCID: PMC555467 DOI: 10.1073/pnas.0402747102] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2004] [Indexed: 11/18/2022] Open
Abstract
Whereas it is widely accepted that the adult cortex is capable of a remarkable degree of functional plasticity, demonstrations of accompanying structural changes have been limited. We examined the basal dendritic field morphology of dye-filled neurons in layers III and IV of the mature barrel cortex after vibrissal-deafferentation in adult rats. Eight weeks later, the tendency for these neurons to orient their dendritic arbors toward the center of their home barrel was found to be disrupted by the resultant reduced activity of thalamocortical innervation. Measures of spine density and total dendritic length were normal, indicating that the loss of dendritic bias was accompanied by growth of dendrites directed away from the barrel center. This finding suggests that in the mature cortex, the apparently static structural attributes of the normal adult cortex depend on maintenance of patterns of afferent activity; with the corollary that changes in these patterns can induce structural plasticity.
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Affiliation(s)
- Chris Tailby
- School of Biomedical Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle NSW 2308, Australia
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9
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Guntinas-Lichius O, Irintchev A, Streppel M, Lenzen M, Grosheva M, Wewetzer K, Neiss WF, Angelov DN. Factors limiting motor recovery after facial nerve transection in the rat: combined structural and functional analyses. Eur J Neurosci 2005; 21:391-402. [PMID: 15673438 DOI: 10.1111/j.1460-9568.2005.03877.x] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It is believed that a major reason for the poor functional recovery after peripheral nerve lesion is collateral branching and regrowth of axons to incorrect muscles. Using a facial nerve injury protocol in rats, we previously identified a novel and clinically feasible approach to combat axonal misguidance--the application of neutralizing antibodies against neurotrophic factors to the injured nerve. Here, we investigated whether reduced collateral branching at the lesion site leads to better functional recovery. Treatment of rats with antibodies against nerve growth factor, brain-derived neurotrophic factor, fibroblast growth factor, insulin-like neurotrophic factor I, ciliary neurotrophic factor or glial cell line-derived neurotrophic factor increased the precision of reinnervation, as evaluated by multiple retrograde labelling of motoneurons, more than two-fold as compared with control animals. However, biometric analysis of vibrissae movements did not show positive effects on functional recovery, suggesting that polyneuronal reinnervation--rather than collateral branching --may be the critical limiting factor. In support of this hypothesis, we found that motor end-plates with morphological signs of multiple innervation were much more frequent in reinnervated muscles of rats that did not recover after injury (51% of all end-plates) than in animals with good functional performance (10%). Because polyneuronal innervation of muscle fibres is activity-dependent and can be manipulated, the present findings raise hopes that clinically feasible and effective therapies could be soon designed and tested.
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Calford MB. Mechanisms for acute changes in sensory maps. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2003; 508:451-60. [PMID: 12171142 DOI: 10.1007/978-1-4615-0713-0_51] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Many studies have examined changes in the topographic representations of the special senses in cerebral cortex following partial peripheral deafferentations. This approach has demonstrated the short- medium- and long-term aspects of plasticity. However, the extensive capacity for immediate plasticity, while first demonstrated more than 15 years ago, still challenges explanation. What such studies indicate is that each locus in sensory cortex receives viable input from a far wider area of the sensory epithelium than is represented in the normal receptive field, with the implication that much of this input is normally inhibited. Consideration of the geometric and temporal aspects of receptive field plasticity suggests that this inhibition must be tonic and must derive its driving input from a tonically active periphery.
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Affiliation(s)
- Mike B Calford
- Discipline of Human Physiology, School of Biomedical Science & Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
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11
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Czupryn A, Skangiel-Kramska J. Deprivation and denervation differentially affect zinc-containing circuitries in the barrel cortex of mice. Brain Res Bull 2001; 55:287-95. [PMID: 11470329 DOI: 10.1016/s0361-9230(01)00457-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the neocortex, a population of glutamatergic synapses contains chelatable zinc that is released upon depolarization. The present study compares the effect of chronic tactile deprivation and vibrissectomy performed at different postnatal ages on the synaptic zinc distribution in the mouse barrel cortex. We found that a chronic unilateral tactile deprivation resulted in an increase of synaptic zinc in deprived barrels. Distribution and intensity of zinc staining in non-deprived barrels resembled the control situation. The increase of zinc staining was observed if chronic deprivation started in early postnatal life or in adolescent mice but not in 70-day-old animals. This suggests that a critical period exists for plasticity of zinc containing terminals in the barrel cortex. The alteration of zinc staining was localized to not only the thalamorecipient layers IV but also layer II/III, and upper layer V. Neonatal denervation of selected vibrissal rows resulted in rearrangement of synaptic zinc distribution following cytoarchitectonic alterations in the barrel field. However, no changes in the intensity of zinc staining were observed. Vibrissectomy performed after the critical period for barrel formation did not affect either the distribution or intensity of zinc staining. It appears that the integrity of vibrissa-barrel pathway is necessary to induce activity-dependent alterations in synaptic zinc.
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Affiliation(s)
- A Czupryn
- Department of Neurophysiology, The Nencki Institute of Experimental Biology, Warsaw, Poland
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Abstract
There is an obesity epidemic in the industrialized world that is not simply explained by excess energy intake and decreased energy expenditure. Persistent obesity develops when genetically predisposed individuals are in a chronic state of positive energy balance. Once established, the obese body weight is avidly defended against both over- and underfeeding. Animal studies have shown that lean individuals who are genetically predisposed toward obesity have abnormalities of neural function that prime them to become obese when caloric density of the diet is raised. These neural abnormalities are gradually "corrected" as obesity becomes fully developed, suggesting that obesity is the normal state for such individuals. Thus, defense of the obese body weight may be perpetuated by the formation of new neural circuits involved in energy-homeostasis pathways that are not then easily abolished. Such neural plasticity can occur in both adult life and during nervous-system development. Early pre- and postnatal metabolic conditions (maternal diabetes, obesity, undernutrition) can lead genetically predisposed offspring to become even more obese as adults. This enhanced obesity is associated with altered brain neural circuitry, and these changes can then be passed on to subsequent generations in a feed-forward cycle of ever-increasing body weight. Thus, the metabolic perturbations associated with obesity during both brain development and adult life can produce "metabolic imprinting" on genetically predisposed neural circuits involved in energy homeostasis. Drugs that reduce body weight decrease the defended body weight and alter neural pathways involved in energy homeostasis but have no permanent effect on body weight or neural function in most individuals. Thus, early intervention in mothers, infants, children, and adults may be the only way to prevent the formation of permanent neural connections that promote and perpetuate obesity in genetically predisposed individuals.
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Affiliation(s)
- B E Levin
- Department of Neurosciences, New Jersey Medical School, Newark, New Jersey, USA.
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Levin BE. The obesity epidemic: metabolic imprinting on genetically susceptible neural circuits. OBESITY RESEARCH 2000; 8:342-7. [PMID: 10933311 DOI: 10.1038/oby.2000.41] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The apparent obesity epidemic in the industrialized world is not explained completely by increased food intake or decreased energy expenditure. Once obesity develops in genetically predisposed individuals, their obese body weight is avidly defended against chronic caloric restriction. In animals genetically predisposed toward obesity, there are multiple abnormalities of neural function that prime them to become obese when dietary caloric density and quantity are raised. Once obesity is fully developed, these abnormalities largely disappear. This suggests that obesity might be the normal state for such individuals. Formation of new neural circuits involved in energy homeostasis might underlie the near permanence of the obese body weight. Such neural plasticity can occur during both nervous system development and in adult life. Maternal diabetes, obesity, and undernutrition have all been associated with obesity in the offspring of such mothers, especially in genetically predisposed individuals. Altered brain neural circuitry and function often accompanies such obesity. This enhanced obesity may then be passed on to subsequent generations in a feed-forward, upward spiral of increasing body weight across generations. Such findings suggest a form of "metabolic imprinting" upon genetically predisposed neural circuits involved in energy homeostasis. Centrally acting drugs used for obesity treatment lower the defended body weight and alter the function of neural pathways involved in energy homeostasis. But they generally have no permanent effect on body weight or neural function. Thus, early identification of obesity-prone mothers, infants, and adults and treatment of early obesity may be the only way to prevent the formation of permanent neural connections that promote and perpetuate obesity in genetically predisposed individuals.
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Affiliation(s)
- B E Levin
- Department of Neurosciences, NJ Medical School, Newark 07103, USA.
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Yamamoto T, Nguyen TT, Stevens RT, Meiri KF, Hodge CJ. Increase of GAP-43 expression following kainic acid injection into whisker barrel cortex. Neuroreport 2000; 11:1603-5. [PMID: 10852209 DOI: 10.1097/00001756-200006050-00002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Plasticity after microinjection of kainic acid (KA) into the adult rat whisker barrel cortex was investigated with immunohistochemical staining of phosphorylated growth-associated protein (GAP)-43. After mapping the barrel cortex with the technique of intrinsic signal optical imaging, a small volume of KA was injected into one barrel. Rats were sacrificed at 2 days, 3 days, 1 week, and 6 weeks after lesioning. GAP-43 staining demonstrated intense immunoreactivity (IR) at the injected barrel which spread to the inter-barrel septa and the surrounding barrels. Elevated IR of GAP-43 was visible 2 days after KA injection, and increased gradually at least 6 weeks following the lesion. This model has the possibility of offering a simple and reliable tool for studying cortical plasticity.
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Affiliation(s)
- T Yamamoto
- Department of Neurosurgery, State University of New York, Upstate Medical University, Syracuse 13210, USA
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15
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Mooney SM, Miller MW. Effects of prenatal exposure to ethanol on systems matching: the number of neurons in the ventrobasal thalamic nucleus of the mature rat. BRAIN RESEARCH. DEVELOPMENTAL BRAIN RESEARCH 1999; 117:121-5. [PMID: 10536240 DOI: 10.1016/s0165-3806(99)00111-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Following prenatal exposure to ethanol, rats have a 1/3 fewer neurons in the second order (principal sensory nucleus of the trigeminal nerve) and fourth order neurons (somatosensory cortex) of the trigeminal-somatosensory pathway than do controls. Based on the numerical matching hypothesis, we predict that the number of third-order neurons (in the ventrobasal nucleus of the thalamus; VB) also will show a similar effect of prenatal ethanol exposure. Stereological methods were used to determine the total number of neurons in the VB on postnatal day 30. Surprisingly, prenatal exposure to ethanol had no effect on the VB volume or on the number of VB neurons. Thus, prenatal exposure to ethanol induces numerical imbalances within the trigeminal-somatosensory system.
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Affiliation(s)
- S M Mooney
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52242-1000, USA
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16
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Gutiérrez-Ospina G, Díaz-Cintra S, Aguirre-Portilla A, Aguilar-Vázquez A, López SR, Barrios FA. Comparable activity levels in developmentally deprived and non-deprived layer IV cortical columns of the adult rat primary somatosensory cortex. Neurosci Lett 1998; 247:5-8. [PMID: 9637396 DOI: 10.1016/s0304-3940(98)00218-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
It has been suggested that evoked neural activity levels promote the selective construction of the primary somatosensory cortex (S1) neuropil. Sensory deprivation after S1 formation has, however, no effects on its postnatal growth. This indicates that S1 neuropil elaboration is independent from the ongoing levels of evoked cortical activity, and/or that sensory deprivation does not reduce overall levels of S1 evoked activity. We thus indirectly evaluated chronic and acute levels of neural activity in the developmentally, sensory deprived adult S1. Relative succinic dehydrogenase activity and 3H2-deoxyglucose uptake were comparable in control and deprived barrels. Our observations support the idea that normal levels of evoked neural activity prevent atrophic changes in the developmentally deprived adult S1. They can not rule out, however, that early selective S1 neuropil construction occurs independent from evoked neural activity levels.
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Affiliation(s)
- G Gutiérrez-Ospina
- Department of Developmental Neurobiology, Center of Neurobiology, National University of México, Juriquilla Querétaro.
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Oestreicher AB, De Graan PN, Gispen WH, Verhaagen J, Schrama LH. B-50, the growth associated protein-43: modulation of cell morphology and communication in the nervous system. Prog Neurobiol 1997; 53:627-86. [PMID: 9447616 DOI: 10.1016/s0301-0082(97)00043-9] [Citation(s) in RCA: 237] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The growth-associated protein B-50 (GAP-43) is a presynaptic protein. Its expression is largely restricted to the nervous system. B-50 is frequently used as a marker for sprouting, because it is located in growth cones, maximally expressed during nervous system development and re-induced in injured and regenerating neural tissues. The B-50 gene is highly conserved during evolution. The B-50 gene contains two promoters and three exons which specify functional domains of the protein. The first exon encoding the 1-10 sequence, harbors the palmitoylation site for attachment to the axolemma and the minimal domain for interaction with G0 protein. The second exon contains the "GAP module", including the calmodulin binding and the protein kinase C phosphorylation domain which is shared by the family of IQ proteins. Downstream sequences of the second and non-coding sequences in the third exon encode species variability. The third exon also contains a conserved domain for phosphorylation by casein kinase II. Functional interference experiments using antisense oligonucleotides or antibodies, have shown inhibition of neurite outgrowth and neurotransmitter release. Overexpression of B-50 in cells or transgenic mice results in excessive sprouting. The various interactions, specified by the structural domains, are thought to underlie the role of B-50 in synaptic plasticity, participating in membrane extension during neuritogenesis, in neurotransmitter release and long-term potentiation. Apparently, B-50 null-mutant mice do not display gross phenotypic changes of the nervous system, although the B-50 deletion affects neuronal pathfinding and reduces postnatal survival. The experimental evidence suggests that neuronal morphology and communication are critically modulated by, but not absolutely dependent on, (enhanced) B-50 presence.
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Affiliation(s)
- A B Oestreicher
- Department of Medical Pharmacology, Rudolf Magnus Institute for Neurosciences, University of Utrecht, The Netherlands
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Baekelandt V, Eysel UT, Orban GA, Vandesande F. Long-term effects of retinal lesions on growth-associated protein 43 (GAP-43) expression in the visual system of adult cats. Neurosci Lett 1996; 208:113-6. [PMID: 8859903 DOI: 10.1016/0304-3940(96)12558-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have investigated the role of growth-associated protein 43 (GAP-43) in synaptic reorganization in the visual system of adult cats that received binocular central retinal lesions. Different survival times between 3 and 8 months after induction of the lesion were chosen. In the deafferented part of the dorsal lateral geniculate nucleus (dLGN) we found a long-lasting increase in GAP-43 protein, while glial fibrillary acidic protein (GFAP) immunoreactivity, which initially increased due to the degeneration of retinal ganglion cells, slowly subsided over this period. In area 17, the pattern of GAP-43 expression did not provide indications for morphological changes in the cortical architecture following retinal lesions.
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Affiliation(s)
- V Baekelandt
- Laboratory of Neuroendocrinology and Immunological Biotechnology, Zoological Institute, Katholieke Universiteit Leuven, Belgium
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Cantallops I, Routtenberg A. Rapid induction by kainic acid of both axonal growth and F1/GAP-43 protein in the adult rat hippocampal granule cells. J Comp Neurol 1996; 366:303-19. [PMID: 8698889 DOI: 10.1002/(sici)1096-9861(19960304)366:2<303::aid-cne9>3.0.co;2-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Hippocampal granule cells do not normally express the axonal growth- and plasticity-associated protein F1/GAP-43 in the adult rat. Using three different methods that lead to hypersynchronous activity in limbic circuits, expression of F1/GAP-43 mRNA can be induced in granule cells which is followed by sprouting in mossy fibers, the axons of granule cells. F1/GAP-43 mRNA expression in granule cells was induced in the temporal, but not septal, hippocampus beginning at 12 hours after kainic acid (KA) subcutaneous injection (10 mg/kg). Beginning 2 days after KA treatment, mossy fiber sprouts restricted to the temporal hippocampus were observed in the supragranular layer. In the same animal we also observed that levels of protein F1/GAP-43 immunoreactivity in this layer apparently increased at this same 2 day time point and same ventral hippocampal location. F1/GAP-43 protein levels and mossy fiber sprouting showed an increase up to 10 days after KA treatment. Sprouting was at a maximum at 40 days, the longest time point studied. These events parallel axonal regeneration with one critical difference: granule cell axons are not damaged by kainate. The rapid onset of axonal growth in the adult is striking and occurs earlier than reported previously (2 days vs. 12 days). Such growth closely associated with elevated levels of protein F1/GAP-43 may occur as a result of a) reactive synaptogenesis caused by the availability of post-synaptic surface on granule cell dendrites at the supragranular layer, b) Hebbian co-activation of the post-synaptic granule cells and their presynaptic afferents, and c) loss of target-derived inhibitory growth factor.
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Affiliation(s)
- I Cantallops
- Cresap Neuroscience Laboratory, Northwestern Institute for Neuroscience, Northwestern University, Evanston, Illinois 60208, USA
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Figueiredo BC, Skup M, Bedard AM, Tetzlaff W, Cuello AC. Differential expression of p140trk, p75NGFR and growth-associated phosphoprotein-43 genes in nucleus basalis magnocellularis, thalamus and adjacent cortex following neocortical infarction and nerve growth factor treatment. Neuroscience 1995; 68:29-45. [PMID: 7477932 DOI: 10.1016/0306-4522(95)91510-j] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A loss of target-derived neurotrophic factors is hypothesized to be one of the major determinants of central nervous system neuronal degeneration. In order to obtain further insight into early neuronal responses to injury, lesion-induced alterations in the expression of high- and low-affinity nerve growth factor receptors, as well as growth-associated phosphoprotein-43 genes in nucleus basalis magnocellularis, thalamic and neocortical neurons were studied. For this purpose, unilateral cortical devascularization operations were conducted on adult rats. Animals received i.c.v. infusions of vehicle or nerve growth factor (12 micrograms/day) and were killed at one, three, seven and 15 days post-lesion. In situ hybridization studies using 35S-labelled oligonucleotide probes for p75NGFR, p140trk and growth-associated phosphoprotein-43 messenger RNAs reveals that these genes were differentially regulated following the lesion. In the nucleus basalis magnocellularis ipsilateral to the lesion, p140trk gene expression significantly decreased on days 3 and 7, while p75NGFR messenger RNA initially increased on day 3 and decreased on days 7 and 15 after lesion. GAP-43 messenger RNA levels were significantly increased in the nucleus basalis magnocellularis on post-lesion days 3 and 7. Moreover, in contrast to p75NGFR or 140trk, growth-associated phosphoprotein-43 messenger RNA levels were significantly increased in pyramidal neurons located in the remaining cortex adjacent to the cortical lesion at all time points. In the lateral and ventroposterior nuclei of the thalamus, growth-associated phosphoprotein-43 messenger RNA level was slightly increased on days 1 and 3 and was dramatically decreased, significantly below the levels in sham-operated controls, on post-lesion days 7 and 15. During nerve growth factor application, the level of p140trk messenger RNA in the lesioned nucleus basalis magnocellularis returned to values observed in the contralateral nucleus basalis magnocellularis while p75NGFR messenger RNA was increased above values noted in all animals not treated with nerve growth factor. Nerve growth factor treatment did not affect the expression of growth-associated phosphoprotein-43 messenger RNA in any of the areas studied. p140trk messenger RNA was not up-regulated during the time that nerve growth factor was applied, as observed for p75NGFR, but only eight days after interrupting nerve growth factor treatment. Three cell types, nucleus basalis magnocellularis, cortical pyramidal and thalamic neurons, were probably affected in different ways by the devascularization with respect to lesion extent. Consequently, the remaining number of synaptic contacts in each of these brain areas is most likely different which may lead to a differential regulation of growth-associated phosphoprotein-43 messenger RNA.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- B C Figueiredo
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
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Steiner H, Gerfen CR. Tactile sensory input regulates basal and apomorphine-induced immediate-early gene expression in rat barrel cortex. J Comp Neurol 1994; 344:297-304. [PMID: 8077463 DOI: 10.1002/cne.903440210] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Clipping of mystacial vibrissae on one side of the rat's snout results in sensorimotor asymmetries in normal behavior and in behavior induced by the dopamine receptor agonist, apomorphine. Immediate-early gene expression, a marker for short-term changes in neuron function, was used to examine whether this sensory deprivation leads to functional changes in the somatosensory barrel cortex under experimental conditions which reveal behavioral asymmetries. The expression of c-fos and zif268 immediate-early genes was assessed with in situ hybridization histochemistry. Four hours after unilateral clipping of the mystacial vibrissae, the level of zif268 mRNA was reduced in the corresponding part of the contralateral barrel field. Injection of apomorphine (5 mg/kg) resulted in increased expression of both c-fos and zif268 immediate-early genes in cortex and striatum. This apomorphine-induced increase was blocked in the sensory-deprived somatosensory cortex. Laminar analysis of gene regulation showed that vibrissae removal affected immediate-early gene expression in all layers of the barrel cortex. These results demonstrate that: (1) basal zif268 gene expression in neurons of the somatosensory cortex is dependent on sensory input, (2) cortical immediate-early gene expression is increased after dopamine receptor activation, and (3) in the barrel cortex, this increase is also dependent on sensory input. We suggest that the observed reduction in gene expression after vibrissae removal reflects decreased activation of neurons in the barrel column by removal of sensory input.
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Affiliation(s)
- H Steiner
- Laboratory of Cell Biology, National Institute of Mental Health, Bethesda, Maryland 20892
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23
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Baekelandt V, Arckens L, Annaert W, Eysel UT, Orban GA, Vandesande F. Alterations in GAP-43 and synapsin immunoreactivity provide evidence for synaptic reorganization in adult cat dorsal lateral geniculate nucleus following retinal lesions. Eur J Neurosci 1994; 6:754-65. [PMID: 8075819 DOI: 10.1111/j.1460-9568.1994.tb00987.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Growth-associated protein-43 (GAP-43) and synapsin were used as molecular markers for synaptic reorganization in the adult cat visual system following sensory deprivation. Small binocular retinal lesions (central 10 degrees) were made with a xenon light photocoagulator in adult cats. One, 3, 5 and 7 weeks after induction of the lesion, the neuropil levels of synapsin and GAP-43 in the dorsal lateral geniculate nucleus (dLGN) and area 17 were determined by immunocytochemistry. GAP-43 displayed a moderately low basal level in the dLGN of normal adult cats. The parvocellular C layers and the interlaminar plexi were characterized by higher immunoreactivity for GAP-43. Lesion-induced alterations were observed in all layers: GAP-43 immunoreactivity increased in the part of the dLGN representing central vision. This increase was maximal 3 weeks after the lesion. Under our experimental conditions, sensory deprivation did not significantly alter GAP-43 levels in the visual cortex. The changes in synapsin immunoreactivity were also restricted to the dLGN. In this nucleus, synapsin immunoreactivity decreased in all layers in the part subserving central vision 1 week after lesion. By 3 weeks after lesion, the level of synapsin had already returned to normal. This study provides evidence for a capacity for structural remodelling in primary sensory brain areas such as the dLGN throughout adult life. The observed changes in GAP-43 and synapsin in the dLGN suggest that synaptic reorganization is induced by retinal lesions. Normalization of synaptic density and activity could be important for the survival of the partially deafferented geniculate neurons.
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Affiliation(s)
- V Baekelandt
- Laboratory for Neuroendocrinology and Immunological Biotechnology, Katholieke Universiteit Leuven, Belgium
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Schwarting RK, Pei G, Söderström S, Ebendal T, Huston JP. Unilateral stimulation or removal of rat vibrissae: analysis of nerve growth factor and tyrosine hydroxylase mRNA in the brain. Behav Brain Res 1994; 60:63-71. [PMID: 7910464 DOI: 10.1016/0166-4328(94)90064-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Previous work has shown that unilateral manipulation of vibrissae in the rat can lead to behavioral asymmetries and to neuronal changes in the basal ganglia: in brief, vibrissae stimulation led to increases in neostriatal dopamine release, whereas unilateral removal of vibrissae led to asymmetries in striatal afferents and to bilateral changes in mesencephalic dopamine mechanisms which were related to the occurrence of behavioral asymmetries and the later recovery therefrom. In the present study, the analysis of neuronal mechanisms possibly affected by vibrissae manipulation was extended to the nerve growth factor and the expression of tyrosine hydroxylase mRNA. Unilateral stimulation or removal of the vibrissae did not lead to significant changes in tissue levels of nerve growth factor in the neostriatum, parietal cortex (including the barrel cortex) or the hippocampus. In contrast, tyrosine hydroxylase mRNA in the substantia nigra and ventral tegmental area was affected by vibrissae removal but not by stimulation, as a bilateral increase in labeling was observed on the level of individual neurons. This effect was only observed in animals tested 4 h after vibrissae removal but not after 10 days. The results are discussed with respect to the interaction of vibrissae function with the basal ganglia, the neurotransmitter dopamine and mechanism of functional recovery.
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Affiliation(s)
- R K Schwarting
- Institute of Physiological Psychology I, University of Düsseldorf, Germany
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Dunn-Meynell AA, Levin BE. Alpha 1-adrenoceptors in the adult rat barrel field: effects of deafferentation and norepinephrine removal. Brain Res 1993; 623:25-32. [PMID: 8221090 DOI: 10.1016/0006-8993(93)90005-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Norepinephrine (NE), acting on brain adrenoceptors, plays an important role in barrel field neuronal activity and plasticity. For this reason, the distribution of alpha 1- and alpha 2-adrenoceptors in the somatosensory cortex barrel field was studied by autoradiographic techniques in rats undergoing plastic change or NE depletion. In layers IV and V of the cortex, the pattern of alpha 1-adrenoceptors (assessed by [3H]prazosin binding) varied across the barrel field. There was relatively low binding within the barrels themselves, with 21% higher binding in the surrounding septa. alpha 2-Adrenoceptor binding (assessed with [3H]paraminoclonidine) was almost homogeneous across the entire barrel field. Two weeks after noradrenergic deafferentation by unilateral lesioning of the locus coeruleus, there was a 16% upregulation of [3H]prazosin binding. This then returned to control levels of by 8 weeks. Peripheral deafferentation of sensory input to the barrel field produced the opposite effect on alpha 1-adrenoceptors. Unilateral removal of all but the central (C3) vibrissa (which induces plastic changes in the cortical representation of the spared virbrissa) caused a 12% decrease in [3H]prazosin binding in the whole barrel field at 2 weeks after surgery which returned to normal by 8 weeks. Therefore, alpha 1-adrenoceptors in the barrel field of the rat are affected in opposite ways by changes in NE content and afferent sensory input. We hypothesize that alpha 1-adrenoceptor levels are modulated after vibrissectomy through either an indirect reaction to reduced cortical gamma-aminobutyric acid levels, or by a reordering of metabolic priorities during plastic change of the cortical neuronal network.
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Affiliation(s)
- A A Dunn-Meynell
- Department of Veterans Affairs Medical Center, East Orange, NJ 07018
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Levin BE, Dunn-Meynell A. Regulation of growth-associated protein 43 (GAP-43) messenger RNA associated with plastic change in the adult rat barrel receptor complex. BRAIN RESEARCH. MOLECULAR BRAIN RESEARCH 1993; 18:59-70. [PMID: 8479290 DOI: 10.1016/0169-328x(93)90173-m] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Plastic change occurs in the adult rat barrel receptor complex following peripheral deafferentation by removal of facial vibrissae (vibrissectomy) and can be prevented by prior depletion of brain norepinephrine. Growth-associated protein (GAP-43, B50, F1, pp46), a marker for synaptic reorganization, increases in the barrel cortex of adult rats following both peripheral and central deafferentation. Here we followed changes in GAP-43 mRNA expression in the barrel receptor system following vibrissectomy. Adult rats had unilateral total vibrissectomy with sparing of the central (C3) vibrissa. By in situ hybridization, GAP-43 mRNA first increased at 24h (9%, P < 0.05) in the ipsilateral trigeminal complex. Levels remained elevated (up to 25% of the unlesioned side) over the next 6 days, decreased to 88% at 7 days and returned to control levels at 14 days. Contralateral barrel cortex levels of GAP-43 mRNA increased by 14% at 4-5 days remained elevated through 7 days and returned to control levels by 14 days. Increased GAP-43 mRNA levels 6 days after vibrissectomy were reproduced by complete transection of the infraorbital nerve and were blocked by depletion of brain norepinephrine. No change occurred in ventrobasal thalamus GAP-43 mRNA at any time. Dot blot and Northern blot hybridizations of GAP-43 mRNA after vibrissectomy showed a 43% increase in the ipsilateral trigeminal complex and a 16% increase in the contralateral barrel cortex at 3 days and an 84% increase in ipsilateral trigeminal and 50% increase in contralateral barrel cortex GAP-43 mRNA at 6 days, respectively. Thus, deafferentation-induced plasticity in the barrel pathway depends upon norepinephrine and is associated with increase in both GAP-43 mRNA and protein suggesting that this may involve a structural change.
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Affiliation(s)
- B E Levin
- Neurology Service, Department of Veterans Affairs Medical Center, E. Orange, NJ 07018
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