Role of medial preoptic area beta adrenoceptors in the regulation of sleep-wakefulness

Adrenergic α2 receptors are implicated in seizure-induced respiratory arrest in DBA/1 mice

AIMS

Sudden unexpected death in epilepsy (SUDEP) is a serious and underestimated public health burden. Both clinical and animal studies show that seizure-induced respiratory arrest (S-IRA) is the primary cause of death in SUDEP. Our previous studies demonstrated that atomoxetine, a norepinephrine reuptake inhibitor (NRI), suppresses S-IRA in DBA/1 mice, suggesting that noradrenergic neurotransmission modulates S-IRA. However, it remains unclear which adrenoceptors are implicated in S-IRA in DBA/1 mice.

MATERIALS AND METHODS

Naïve DBA/1 mice exhibit a low incidence of S-IRA, but after primed by acoustic stimulation, they become consistently susceptible to S-IRA. Atomoxetine, adrenoceptor agonists, antagonists or vehicle was intraperitoneally (i.p.) administered alone or in combination, and the effects of drug treatments on S-IRA incidence and seizure behaviors were examined.

KEY FINDINGS

The incidence of S-IRA in primed DBA/1 mice was significantly reduced by clonidine, an α2 adrenoceptor agonist, as compared with that of the vehicle control. However, compared with the vehicle control, S-IRA was not altered by cirazoline, an α1 agonist. Consistent with previous reports, atomoxetine reduced S-IRA in primed DBA/1 mice. The suppressing effect of atomoxetine on S-IRA was prevented by injection of an α2 adrenoceptor antagonist, yohimbine or atipamezole, but not by prazosin, an α1 antagonist. Administration of α1 or α2 antagonists alone did not promote the incidence of S-IRA in nonprimed DBA/1 mice.

SIGNIFICANCE

These data demonstrate that noradrenergic neurotransmission modulates S-IRA predominantly via α2 adrenoceptors in DBA/1 mice, indicating that selective activation of α2 adrenoceptors can potentially prevent SUDEP.

Norepinephrine at the nexus of arousal, motivation and relapse

Arousal plays a critical role in cognitive, affective and motivational processes. Consistent with this, the dysregulation of arousal-related neural systems is implicated in a variety of psychiatric disorders, including addiction. Noradrenergic systems exert potent arousal-enhancing actions that involve signaling at α1- and β-noradrenergic receptors within a distributed network of subcortical regions. The majority of research into noradrenergic modulation of arousal has focused on the nucleus locus coeruleus. Nevertheless, anatomical studies demonstrate that multiple noradrenergic nuclei innervate subcortical arousal-related regions, providing a substrate for differential regulation of arousal across these distinct noradrenergic nuclei. The arousal-promoting actions of psychostimulants and other drugs of abuse contribute to their widespread abuse. Moreover, relapse can be triggered by a variety of arousal-promoting events, including stress and re-exposure to drugs of abuse. Evidence has long-indicated that norepinephrine plays an important role in relapse. Recent observations suggest that noradrenergic signaling elicits affectively-neutral arousal that is sufficient to reinstate drug seeking. Collectively, these observations indicate that norepinephrine plays a key role in the interaction between arousal, motivation, and relapse. This article is part of a Special Issue entitled SI: Noradrenergic System.

Neuropharmacology of Sleep and Wakefulness: 2012 Update

The development of sedative/hypnotic molecules has been empiric rather than rational. The empiric approach has produced clinically useful drugs but for no drug is the mechanism of action completely understood. All available sedative/hypnotic medications have unwanted side effects and none of these medications creates a sleep architecture that is identical to the architecture of naturally occurring sleep. This chapter reviews recent advances in research aiming to elucidate the neurochemical mechanisms regulating sleep and wakefulness. One promise of rational drug design is that understanding the mechanisms of sedative/hypnotic action will significantly enhance drug safety and efficacy.

Noradrenergic modulation of wakefulness/arousal

The locus coeruleus-noradrenergic system supplies norepinephrine throughout the central nervous system. State-dependent neuronal discharge activity of locus coeruleus noradrenergic neurons has long-suggested a role of this system in the induction of an alert waking state. Work over the past two decades provides unambiguous evidence that the locus coeruleus, and likely other noradrenergic nuclei, exert potent wake-promoting actions via an activation of noradrenergic β- and α₁-receptors located within multiple subcortical structures, including the general regions of the medial septal area, the medial preoptic area and, most recently, the lateral hypothalamus. Conversely, global blockade of β- and α₁-receptors or suppression of norepinephrine release results in profound sedation. The wake-promoting action of central noradrenergic neurotransmission has clinical implications for treatment of sleep/arousal disorders, such as insomnia and narcolepsy, and clinical conditions associated with excessive arousal, such as post-traumatic stress disorder.

Neuropharmacology of Sleep and Wakefulness

The development of sedative/hypnotic molecules has been empiric rather than rational. The empiric approach has produced clinically useful drugs but for no drug is the mechanism of action completely understood. All available sedative/hypnotic medications have unwanted side effects and none of these medications creates a sleep architecture that is identical to the architecture of naturally occurring sleep. This chapter reviews recent advances in research aiming to elucidate the neurochemical mechanisms regulating sleep and wakefulness. One promise of rational drug design is that understanding the mechanisms of sedative/hypnotic action will significantly enhance drug safety and efficacy.

Dopaminergic projections to the medial preoptic area of postpartum rats

Dopamine receptor activity in the rodent medial preoptic area (mPOA) is crucial for the display of maternal behaviors, as well as numerous other physiological and behavioral functions. However, the origin of dopaminergic input to the mPOA has not been identified through neuroanatomical tracing. To accomplish this, the retrograde tracer Fluorogold was iontophoretically applied to the mPOA of postpartum laboratory rats, and dual-label immunocytochemistry for Fluorogold and tyrosine hydroxylase later performed to identify dopaminergic cells of the forebrain and midbrain projecting to the mPOA. Results indicate that the number of dopaminergic cells projecting to the mPOA is moderate ( approximately 90 cells to one hemisphere), and that these cells have an unexpectedly wide distribution. Even so, more than half of the dual-labeled cells were found in either what has been considered extensions of the A10 dopamine group (particularly the ventrocaudal posterior hypothalamus and adjacent medial supramammillary nucleus), or in the A10 group of the ventral tegmental area. The rostral hypothalamus and surrounding region also contained numerous dual-labeled cells, with the greatest number found within the mPOA itself (including in the anteroventral preoptic area and preoptic periventricular nucleus). Notably, dual-labeled cells were rare in the zona incerta (A13), a site previously suggested to provide dopaminergic input to the mPOA. This study is the first to use anatomical tracing to detail the dopaminergic projections to the mPOA in the laboratory rat, and indicates that much of this projection originates more caudally than previously suggested.

Noradrenergic modulation of arousal

Through a highly divergent efferent projection system, the locus coeruleus-noradrenergic system supplies norepinephrine throughout the central nervous system. State-dependent neuronal discharge activity of locus coeruleus neurons has long-suggested a role of this system in the induction of an alert waking state. More recent work supports this hypothesis, demonstrating robust wake-promoting actions of the locus coeruleus-noradrenergic system. Norepinephrine enhances arousal, in part, via actions of beta- and alpha1-receptors located within multiple subcortical structures, including the general regions of the medial septal area and the medial preoptic areas. Recent anatomical studies suggest that arousal-enhancing actions of norepinephrine are not limited to the locus coeruleus system and likely include the A1 and A2 noradrenergic cell groups. Thus, noradrenergic modulation of arousal state involves multiple noradrenergic systems acting within multiple subcortical regions. Pharmacological studies indicate that the combined actions of these systems are necessary for the sustained maintenance of arousal levels associated with spontaneous waking. Enhanced arousal state is a prominent aspect of both stress and psychostimulant drug action and evidence indicates that noradrenergic systems likely play an important role in both stress-related and psychostimulant-induced arousal. These and other observations suggest that the dysregulation of noradrenergic neurotransmission could well contribute to the dysregulation of arousal associated with a variety of behavioral disorders including insomnia and stress-related disorders.

Alpha-1 adrenergic receptors in the medial preoptic area are involved in the induction of sleep

This paper reviews the recent studies that led to the conclusion that the noradrenergic neurons projecting to the medial preoptic area (mPOA) are hypnogenic and that they mediate this action through alpha(1) adrenergic receptors. Microinjection of noradrenaline (NA) into the mPOA induced arousal. Studies using alpha(2) adrenergic drugs showed that the arousal induced by intrapreoptic injection of NA was due to its action on presynaptic alpha(2) adrenergic receptors. A combination of lesion and chemical stimulation techniques demonstrated that when NA acted on the postsynaptic alpha(1 )receptors in the mPOA, it induced sleep. Intrapreoptic injection of alpha(1) agonist, methoxamine could induce sleep, when the hypothermia, which was simultaneously produced, was behaviorally compensated for by the animal. Increased arousal produced by the destruction of noradrenergic fibers in the mPOA further confirmed the hypnogenic role of these fibers.

Sleep induction and temperature lowering by medial preoptic α1 adrenergic receptors

Changes in sleep-wakefulness (S-W) and body temperature (T(b)) on administration of alpha(1) agonist (methoxamine) and antagonist (prazosin) into the medial preoptic area (mPOA) were studied in rats. Presynaptic catecholaminergic terminals of the mPOA were destroyed by injecting 6-hydroxydopamine at the ventral noradrenergic bundle (VNA), before administration of the drugs. Microinjection of 0.05 microg methoxamine induced sleep, though 0.1 microg prazosin produced no change in S-W. On the other hand, in normal rats, the same dose of methoxamine produced no change, while prazosin produced arousal. Denervation hypersensitivity may be responsible for the appearance of hypnogenic response on methoxamine administration, in the VNA-lesioned rats. The VNA-lesioned animals (before administration of any drug) had higher pre-injection values of wake period than the normal rats. A reduction in the tonic activity of noradrenergic fibers to the mPOA, and resulting reduced activity of alpha(1) receptors, may be responsible for increased wake period in the VNA-lesioned rats. The action of prazosin was probably abolished in the absence of tonic activity of alpha(1) receptor in the VNA-lesioned rats. Reduction and increase in T(b) produced by methoxamine and prazosin, respectively, confirm the involvement of alpha(1) receptors in the thermal changes. Methoxamine was less effective, than in normal rats, in reducing T(b). So, the possibility of involvement of presynaptic receptors in the thermal response is suggested. The results suggest the involvement of separate sets of alpha(1) receptors (and neurons) in hypnogenesis and in lowering T(b). As sleep is associated with fall in T(b), the alpha(1) adrenergic receptors may be involved in interlinking sleep regulation and thermoregulation.

Low doses of delta-9 tetrahydrocannabinol (THC) have divergent effects on short-term spatial memory in young, healthy adults

Evidence suggests that manipulating spatial information within working memory depends upon a circuitry organized around the prefrontal cortex (PFC) and the activity of the catecholamine systems. Other evidence attests to the effects of Delta-9 tetrahydrocannabinol (THC) on short-term spatial memory function, most probably involving CB(1) receptor activity within hippocampal circuitries. At the current time, there have been no systematic studies of the effects of THC on spatial working memory in human subjects using tasks known to depend upon frontotemporal neural circuitries. We examined the effects of a single sublingual 5 mg dose of THC on a test of spatial working memory (requiring active manipulation of remembered spatial information for the management of future behavior) and a test of spatial span (requiring only the reproduction of sequences of previously presented spatial cues). In all, 19 healthy adults were administered 5 mg THC and placebo in a double-blind, placebo-controlled, within-subject, crossover design. Male participants performed more accurately than female participants. THC significantly enhanced spatial working memory performance of female participants. By contrast, male and female participants produced more intrusion errors during performance of the Spatial Span task. These results suggest that THC has relatively complex effects on spatial memory in human subjects, perhaps reflecting altered CB(1) receptor activity within frontotemporal circuits or altered activity of mesocortical dopaminergic pathways in PFC areas associated with spatial memory.

Role of noradrenergic fibers of the preoptic area in regulating sleep

The preoptic area (POA) has noradrenergic (NE) terminals, and this area controls sleep apart from body temperature and reproduction. The destruction of catecholaminergic (CA) terminals in the POA produced a decrease in sleep in rats. This effect was shown to be due to the destruction of NE and not dopaminergic terminals. The rats, which were hyperthermic after the destruction of CA fibers in the POA, preferred a lower ambient temperature. Though they were unable to have normal amount of sleep after lesion, it did not affect their behavioral thermoregulation. Acute total sleep deprivation for 48 h led to a significant decrease in noradrenaline, increase in the level of metabolites of monoamines, and an enhancement in the number of dendritic spines at the medial preoptic area (mPOA). Enhanced sleep pressure during sleep deprivation could have led to a higher release of noradrenaline, and an increase in dendritic spines in the mPOA. Arousal was produced by application of noradrenaline at the mPOA, whereas the alpha antagonists produced sleep in free-moving rats. This was in contrast to the increased wakefulness produced by the destruction of NE terminals. As wakefulness and sleep, respectively, were induced on local application of alpha-2 antagonist and agonists, it was suspected that the noradrenaline and alpha antagonists might have acted on the alpha-2 receptors, which are predominantly present on the pre-synaptic terminals. Sleep produced by noradrenaline, which was locally applied at the mPOA, after destroying the NE terminals, further confirmed this possibility. Hypothermia and sexual arousal produced by application of alpha- and beta-adrenergic agonists at the mPOA would have contributed towards the wakefulness induced by these drugs in normal rats. Thus, the available evidence shows that the NE fibers in the POA are involved in the induction of sleep.

Orexin A (hypocretin-1) application at the medial preoptic area potentiates male sexual behavior in rats

The medial preoptic area plays an important role in the regulation of male sexual behavior in rats, and this area receives orexinergic inputs. The role of orexinergic inputs in the medial preoptic area in sexual behavior has not been studied, though they have been shown to play a role in some other physiological functions. In this study, the changes in male sexual behavior in rats were studied after local injection of orexin A (Hypocretin-1) at the medial preoptic area. The results of the study showed that orexin A application at the medial preoptic area increased sexual arousal as well as the copulatory performance. Sexual arousal is one of the physiological stimuli, which influences wakefulness. It is possible that the earlier reports showing increased wakefulness, on application of orexin A at the medial preoptic area/basal forebrain, has a contribution from sexual arousal.

The locus coeruleus-noradrenergic system: modulation of behavioral state and state-dependent cognitive processes

Through a widespread efferent projection system, the locus coeruleus-noradrenergic system supplies norepinephrine throughout the central nervous system. Initial studies provided critical insight into the basic organization and properties of this system. More recent work identifies a complicated array of behavioral and electrophysiological actions that have in common the facilitation of processing of relevant, or salient, information. This involves two basic levels of action. First, the system contributes to the initiation and maintenance of behavioral and forebrain neuronal activity states appropriate for the collection of sensory information (e.g. waking). Second, within the waking state, this system modulates the collection and processing of salient sensory information through a diversity of concentration-dependent actions within cortical and subcortical sensory, attention, and memory circuits. Norepinephrine-dependent modulation of long-term alterations in synaptic strength, gene transcription and other processes suggest a potentially critical role of this neurotransmitter system in experience-dependent alterations in neural function and behavior. The ability of a given stimulus to increase locus coeruleus discharge activity appears independent of affective valence (appetitive vs. aversive). Combined, these observations suggest that the locus coeruleus-noradrenergic system is a critical component of the neural architecture supporting interaction with, and navigation through, a complex world. These observations further suggest that dysregulation of locus coeruleus-noradrenergic neurotransmission may contribute to cognitive and/or arousal dysfunction associated with a variety of psychiatric disorders, including attention-deficit hyperactivity disorder, sleep and arousal disorders, as well as certain affective disorders, including post-traumatic stress disorder. Independent of an etiological role in these disorders, the locus coeruleus-noradrenergic system represents an appropriate target for pharmacological treatment of specific attention, memory and/or arousal dysfunction associated with a variety of behavioral/cognitive disorders.

Relationship between low-dose amphetamine-induced arousal and extracellular norepinephrine and dopamine levels within prefrontal cortex

Despite the well-known and potent arousal-enhancing effects of amphetamine (AMPH)-like stimulants, the neurobiological substrates of AMPH-induced arousal have rarely been examined explicitly. Available evidence suggests the possible participation of noradrenergic and/or dopaminergic systems in the arousal-enhancing actions of AMPH-like stimulants. The current studies examined the extent to which low-dose AMPH-induced increases in waking are related to AMPH-induced increases in extracellular norepinephrine (NE) and dopamine (DA) levels within the prefrontal cortex (PFC), as measured by in vivo microdialysis. Vehicle injections elicited brief epochs of waking. Vehicle-induced waking was closely associated with a brief and moderate (50% above baseline) increase in NE levels. DA levels were less sensitive to the arousing actions of vehicle injections, with maximal increases of approximately 25% above baseline observed. 0.15 mg/kg and 0.25 mg/kg AMPH increased time spent awake, which resulted primarily from increases in quiet waking. Although the magnitude of the waking response did not differ substantially between the two doses across time, a trend for a more rapid recovery to baseline waking levels was observed at the higher dose, possibly suggesting the development of a relatively rapid-onset tolerance to the wake-promoting actions of AMPH at this dose. At the 0.15 mg/kg dose, AMPH elicited maximum increases of approximately 175% and 125% above baseline levels for NE and DA, respectively. The time course of AMPH-induced increases in waking closely paralleled the time course of AMPH-induced increases in both NE and DA efflux. These observations are consistent with the hypothesis that both increased DA and NE efflux contribute to the low-dose behavioral effects of AMPH-like stimulants, including the arousal-enhancing actions of these drugs. Additionally, these observations also suggest a possibly greater sensitivity of NE efflux, relative to DA, to moderately arousing conditions including low-dose AMPH-like stimulant administration.

Differential sensitivity to the wake-promoting actions of norepinephrine within the medial preoptic area and the substantia innominata

Mapping studies were conducted to delineate the site(s) of action for the arousal-enhancing actions of norepinephrine (NE) within the basal forebrain region encompassing the medial preoptic area (MPOA) and the substantia innominata (SI). Varying doses of NE, the beta-agonist, isoproterenol, or the alpha1-agonist, phenylephrine, were infused into the MPOA or SI in the resting rat. Infusions of NE (4 nmol, 16 nmo/150 nl), isoproterenol (15 nmol/150 nl), and phenylephrine (40 nmol/250 nl) into the MPOA elicited robust increases in waking. In contrast, neither isoproterenol or phenylephrine infusions into the SI altered behavioral state. NE infusions into the SI increased waking only at the highest dose, and at this dose there was an anatomical gradient for NE-induced waking, with infusions placed farther from the MPOA, producing smaller increases in waking. Thus, in contrast to the MPOA, the SI is relatively insensitive to the wake-promoting actions of NE.

Contrasting effects of noradrenergic beta-receptor blockade within the medial septal area on forebrain electroencephalographic and behavioral activity state in anesthetized and unanesthetized rat

The locus coeruleus-noradrenergic system participates in the modulation of behavioral state. Previous studies demonstrated that beta-receptors located within the general region encompassing the medial septum/vertical limb of the diagonal band of Broca (medial septal area) exert arousal-enhancing actions in both anesthetized and unanesthetized animals. These studies also demonstrated that, under conditions of limited locus coeruleus discharge rates, blockade of beta-receptors within this region decreased forebrain electroencephalographic indices of arousal. The current studies assess the extent to which medial septal area beta-receptors contribute to the maintenance of electroencephalographic and/or behavioral indices of arousal, under conditions associated with elevated locus coeruleus discharge rates. In the halothane-anesthetized rat, bilateral, but not unilateral, blockade of beta-receptors within this area prevented forebrain (cortical and hippocampal) electroencephalographic activation elicited by activation of locus coeruleus neurons. Placement of beta-antagonist immediately adjacent to the medial septal area had no effect on locus coeruleus-dependent cortical and hippocampal electroencephalographic activation. In contrast, in unanesthetized rat, bilateral pretreatment of the medial septal area did not alter either electroencephalographic or behavioral measures in animals tested in an arousal-enhancing, brightly-lit novel environment, which has been demonstrated to elicit an activation of the locus coeruleus-noradrenergic system. The results obtained in anesthetized animals are consistent with previous studies demonstrating potent modulatory actions of noradrenergic systems on actions of general anesthetics, and suggest that beta-receptors may be an appropriate target for pharmacological adjuncts to general anesthetics. In contrast to that observed in anesthetized animals, medial septal beta-receptors alone do not contribute significantly to the maintenance of an activated forebrain in unanesthetized animals. It is presumed that actions of other noradrenergic receptors and/or other neurotransmitter systems located within or outside the medial septal area make the arousal-modulating actions of medial septal area beta-receptors redundant, in the unanesthetized, alert animal.

Amphetamine acts within the medial basal forebrain to initiate and maintain alert waking

Amphetamine-like stimulants exert well-known arousal-enhancing actions. Surprisingly, little is known concerning the neuroanatomical substrates through which these drugs enhance arousal. Previous work implicates a number of basal forebrain structures in the regulation of behavioral state. The current studies examined the effects of amphetamine infusions made directly within basal forebrain sites on behavioral, electroencephalographic, and electromyographic indices of arousal in anesthetized and unanesthetized rat. In the anesthetized rat, amphetamine elicited prolonged epochs of bilateral electroencephalographic activation when infused unilaterally (3.75 microg/150 nl) into an extended region of the medial basal forebrain, demarcated anteriorally by the anterior portion of the medial septal area (which includes posterior accumbens shell) and posteriorally by the posterior aspect of the preoptic area of the hypothalamus. In the unanesthetized (undisturbed, resting) rat, amphetamine infusions into this region elicited prolonged epochs of alert waking, which at the lowest dose (3.75 microg), qualitatively resembled normal waking. Infusions placed lateral (including within the substantia innominata), anterior (including within the core subregion of the nucleus accumbens), posterior, or dorsal to these structures, as well as directly within the lateral ventricles did not alter electroencephalographic or behavioral measures. These results indicate that a region of the medial basal forebrain, extending from the anterior medial septum/accumbens shell to the posterior preoptic area, is a site within which amphetamine-like stimulants act to enhance behavioral and electroencephalographic measures of arousal.

Changes in magnetic resonance imaging and sex behavior after 6-OHDA injection in the medial preoptic area

Magnetic resonance imaging (MRI) of the brains of male rats was done before and after destroying the catecholamine (CA) fibers by local application of 6-hydroxydopamine (6-OHDA) in the medial preoptic area (mPOA). The male sexual behavior was also assessed before and after injection of this toxic drug. The administration of 6-OHDA (8 microg) resulted in highly variable lesions, as shown by MRI and confirmed by histological examination. A hyperintense area was visible either on one or on both sides, about 1-3 h after the administration of the drug. Postmortem histofluorescence showed destruction of CA fibers in the mPOA on those sides that showed hyperintense areas in the MRI. No CA fiber destruction was seen in those rats that had shown no change in MRI after 6-OHDA injection. There was a transient reduction in sex drive score in all the 6-OHDA-treated rats. The present findings point out a correlation between the MRI changes and CA fiber destruction, whereas the transient reduction in the sexual behavior was not related to these changes. It is suggested that some biochemical events related to 6-OHDA destruction of CA fibers may have been responsible for the hyperintensity seen in the MRI.