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164 Current Literature in Basic Science
ATHALAMIC SLEEP TONIC
GABA
A
Receptor-Mediated Tonic Inhibition in Thalamic Neurons
Cope DW, Hughes SW, Crunelli V
J Neurosci 2005;25:11553–11563
Tonic GABA
A
receptor-mediated inhibition is typically gen-
erated by δ subunit-containing extrasynaptic receptors.
Because the δ subunit is highly expressed in the tha-
lamus, we tested whether thalamocortical (TC) neurons
of the dorsal lateral geniculate nucleus (dLGN) and ven-
trobasal complex exhibit tonic inhibition. Focal applica-
tion of gabazine (GBZ) (50 µM) revealed the presence
of a 20 pA tonic current in 75 and 63% of TC neu-
rons from both nuclei, respectively. No tonic current was
observed in GABAergic neurons of the nucleus reticu-
laris thalami (NRT). Bath application of 1 µM GABA in-
creased tonic current amplitude to 70 pA in 100% of
TC neurons, but it was still not observed in NRT neu-
rons. In dLGN TC neurons, the tonic current was sensitive
to low concentrations of the δ subunit-specific receptor
agonists allotetrahydrodeoxycorticosterone (100 nM) and
4,5,6,7-tetrahydroisoxazolo[5,4-c]-pyridin-3-ol (THIP) (100
nM) but insensitive to the benzodiazepine flurazepam (5
µM). Bath application of low concentrations of GBZ (25–
200 nM) preferentially blocked the tonic current, whereas
phasic synaptic inhibition was primarily maintained. Un-
der intracellular current-clamp conditions, the preferential
block of the tonic current with GBZ led to a small depolar-
ization and increase in input resistance. Using extracellular
single-unit recordings, block of the tonic current caused
the cessation of low-threshold burst firing and promoted
tonic firing. Enhancement of the tonic current by THIP hy-
perpolarized TC neurons and promoted burst firing. Thus,
tonic current in TC neurons generates an inhibitory tone. Its
modulation contributes to the shift between different firing
modes, promotes the transition between different behav-
ioral states, and predisposes to absence seizures.
COMMENTARY
T
onic inhibition is a remarkable form of signaling in the
CNS, which contrasts in both form and function from
classic phasic inhibitory signaling. The latter, as described in any
neurobiology text, is the result of neural activity of inhibitory
interneurons, fusion of GABA filled vesicles at synapses, tran-
sient (millisecond) increases in synaptic GABA concentration
to millimolar levels, gating (opening) of GABA
A
receptors, and
chloride ion flux into postsynaptic neurons. These phasic re-
sponses, which have effects whose durations are on the order
of milliseconds to tens of milliseconds, influence the timing,
synchrony, and number of spikes produced in the neuron(s)
receiving the inhibition. Phasic inhibition has surgical-like pre-
cision in terms of timing and focality of inhibitory signaling—it
is localized to the synapse at which GABA is released. If phasic
inhibition is a scalpel, designed to sculpt inputs by selectively
eliminating brief periods of input from specific dendrites, then
tonic inhibition is, pardon the expression, somewhat of a sledge-
hammer.
Tonic inhibition is the steady activation of extrasynap-
tic GABA
A
receptors, which produces a corresponding steady
GABA
A
conductance. Tonic inhibition, thus, increases the elec-
trical conductivity of the neuronal membrane and serves as
a short circuit, such that electrical signals traveling down the
membrane are shunted to the extracellular fluid “ground” and
lose their efficacy. Tonic inhibition can be considered a time-
invariant “veto” of synaptic and intrinsic signals. The veto ex-
erted by tonic inhibition is not absolute; that is, the degree
of tonic inhibition and the efficacy of the shunt will vary de-
pending on the resting level of GABA in the extracellular fluid.
Changes in the efficacy of tonic inhibition have been reported
as a consequence of modulation of the extrasynaptic GABA
A
re-
ceptors by neuromodulators, such as alcohol and neurosteroids
(1), which alter the sensitivity of extrasynaptic GABA receptors
and thus, increase their openings in response to ambient GABA
concentrations.
As far as is known, tonic inhibition does not distinguish
between one dendrite and another and certainly does not change
much over time. However, to date, tonic inhibition has only
been studied in recordings from the soma; it might be that
in different dendrites, tonic inhibition increases or decreases as
GABA released from localized synapses spreads to extrasynaptic
receptors on that particular dendrite. GABA might even be
Epilepsy Currents, Vol. 6, No. 5 (September/October) 2006 pp. 164–166
Blackwell Publishing, Inc.
C
American Epilepsy Society
Current Literature in Basic Science 165
released to specific locations in the extracellular space by the
reversed action of GABA transporters on neuronal and axonal
membranes (2). Recordings from the soma would reveal only
the average GABA conductance from all the dendrites, and so
at this time, there is no specific evidence that tonic inhibition
has any time or location specificity.
What is the point of this sledgehammer approach to inhi-
bition? Certainly, anesthesiologists and epileptologists can pro-
vide a ready answer: tonic inhibition, by reducing or blocking
excitatory synaptic input, is a great way to put neurons to sleep.
Recently, Belelli and colleagues (3) as well as Cope et al., re-
viewed here, have examined thalamic neurons in vitro to deter-
mine whether tonic GABA inhibition might play a role in the
sleep/wake cycle and in the generation of absence seizures (3).
The investigators used a standard method to evaluate tonic
inhibition, which is to evaluate the overall conductance of a
neuron before and after GABA
A
receptors are blocked. Unfor-
tunately, there are no drugs that perfectly select between phasic
and tonic inhibition, so blocking tonic inhibition usually re-
duces phasic inhibition as well. However, because tonic inhibi-
tion is generated by a low concentration of GABA reaching the
extrasynaptic receptors, whereas phasic inhibition is generated
by a very high concentration of GABA in the synaptic cleft, low
concentrations of competitive GABA antagonists are relatively
selective for tonic versus phasic inhibition.
When tonic inhibition was compared with phasic inhibi-
tion, Cope et al. confirmed a finding that is perhaps surprising
but previously had been observed in the cerebellar slices: more
than 90% of the total GABA conductance recorded in vitro
arises from tonic inhibition, leaving less than 10% that arises
from phasic inhibition. While the conductance change underly-
ing tonic inhibition is not large compared with the peak conduc-
tance changes that occur during synaptic GABA release, tonic
inhibition is always present. Thus, the 90% fraction reflects the
steady presence of a small conductance change compared with
the intermittent presence of a much larger conductance change.
The relative contributions of these two types of inhibition to
physiological activity in vivo, where both the intensity of synap-
tic activity as well as the resting levels of extracellular GABA are
likely to be different than in isolated brain slices, remains to be
seen.
Tonic inhibition is not observed in all types of neurons
(4), and both Cope et al. and Belelli et al. established that
this finding also is true in the thalamus. Thus, GABA-releasing
neurons in the nucleus reticularis thalami (nRT) do not ex-
hibit tonic inhibition, whereas thalamocortical relay neurons
in both the dorsal lateral geniculate nucleus and ventrobasal
complex, exhibit tonic inhibition. nRT neurons inhibit the tha-
lamocortical neurons, so agents that increase tonic inhibition
will selectively affect the thalamocortical principal neurons. For
example, benzodiazepines modulate synaptic receptors contain-
ing a γ 2 subunit but do not affect nonsynaptic receptors that
contain a δ subunit. These δ-subunit–containing GABA
A
re-
ceptors are ideal for subserving tonic inhibition, because they
are sensitive to low concentrations of GABA and are resistant
to desensitization (5). Another study showed that membrane
noise, presumably an index of tonic-receptor activation, was
decreased in mice relay neurons of deficient in the GABA
A
re-
ceptor δ subunit (6). Both Cope et al. and Belelli et al. studies
demonstrated that while benzodiazepines do not alter tonic in-
hibition (consistent with the presence of a δ subunit in the
GABA
A
receptors that subserve tonic inhibition), they do en-
hance phasic inhibition. Furthermore, the direct GABA ag-
onist 4,5,6,7-tetrahydroisoxazolo[5,4-c]-pyridin-3-ol (THIP),
to which such δ-subunit–containing receptors appear to be se-
lectively sensitive, preferentially increased tonic inhibition in
the thalamocortical neurons.
Because thalamocortical neurons express high levels of T-
type calcium channels, membrane hyperpolarization enables
subsequent calcium-dependent burst firing. Thus, enhance-
ment of tonic inhibition by THIP causes the thalamocortical
neurons to begin bursting. As burst firing in thalamocortical
cells underlies sleep (7), the finding that GABA agonists induce
sleep-related behavior in the thalamic slices is interesting and
plausible. This finding by Cope and colleagues was augmented
by the finding of Belelli et al. that THIP administration in
vivo enhances slow-wave sleep activity. In absence epilepsy, tha-
lamocortical neuron burst firing also is prominent; therefore,
the efficacy of benzodiazepines in treatment of absence seizures
makes sense, as the tonic inhibition that promotes bursting
is not sensitive to benzodiazepines. Benzodiazepine efficacy in
absence seizures likely is related to selective enhancement of in-
hibitory signaling in the nRT, which decreases inhibitory output
of this nucleus and suppresses bursting of thalamocortical relay
neurons (8,9).
These new results from Cope et al. suggest one possible
function of tonic inhibition: rapid switching of neurons from
one state (tonic firing that subserves wakefulness) to another
state (burst firing that subserves sleep...and absence seizures).
Changes in ambient GABA concentration would then trigger
the switch. Why this effect might occur via GABA, rather than
a neuromodulator (e.g., acting on potassium conductances), re-
mains unknown. Perhaps, the ability to quickly exit sleep states
by rapidly altering GABA release or uptake provides a more
robust mechanism to become “instantly awake” than would be
possible using neuromodulators acting through second messen-
ger systems.
What do these findings mean for epilepsy treatment? If
benzodiazepines are effective therapy for absence seizures by
virtue of their lack of effect on tonic inhibition in thalamo-
cortical neurons, in addition to the specificity of their effect
on intrathalamic phasic signaling, one would predict that less
166 Current Literature in Basic Science
selective GABA agents should be similarly less effective ther-
apies for absence. This hypothesis seems to hold up well; for
example, barbiturates are effective but nonselective modula-
tors of GABA
A
receptors, and are not effective in the treat-
ment of absence. Tiagabine is a GABA reuptake inhibitor that
increases the concentration of extracellular GABA. Tiagabine
would be expected to enhance tonic inhibition in the thalam-
ocortical neurons and, thus, would not be expected to be an
effective treatment for absence. Accordingly, tiagabine has been
reported to induce absence status in children (10) and enhance
spike wave activity experimentally (11). Thus, the differential
action of selected allosteric GABA modulators on phasic versus
tonic inhibition may have important consequences not only
for the physiology and pharmacology of sleep, but also for the
treatment of epilepsy.
by Kevin J. Staley, MD
and John R. Huguenard, PhD
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