Amine pathways and sleep regulation

Delirium and epilepsy

Delirium (a state of usually reversible global brain disfunction due to toxic, metabolic, or infectious causes) and epilepsy (a condition of spontaneous, recurrent paroxysmal electrical excitation or dysfunction) are becoming increasingly better understood, and hence easier to diagnose and treat. The clinical features of delirium predominantly involve subacute changes in cognition, awareness, and activity levels, behavioral disturbance, clouding consciousness, and sleep-wake cycle changes. In contrast, epilepsy involves the acute interruption of brain function, often with convulsive activity, falls, and injury. States that may share the clinical features of both, such as nonconvulsive epileptic states, are also important: the cause of brain derangement is one of excessive and abnormal electrical brain activity. In such conditions, the clinical manifestations may resemble states of delirium and confusion, and the absence of convulsive clinical activity is significant. Electroencephalography remains the diagnostic test of choice: it is essential for differentiating these two conditions, enabling the distinctly different treatments and epilepsy. Ongoing research and investigation are essential to better understand the abnormal brat mechanisms underlying delirium, and to develop better tools for objective diagnosis.

Regulation of orexin neurons by the monoaminergic and cholinergic systems

Orexins are a pair of neuropeptides implicated in energy homeostasis and arousal. Here we characterize the electrophysiological properties of orexin neurons using slice preparations from transgenic mice in which orexin neurons specifically express green fluorescent protein. Orexin neurons showed high frequency firing with little adaptation by injecting a positive current. The hyperpolarization-activated current was observed in orexin neurons by a negative current injection. The neurotransmitters, which were implicated in sleep/wake regulation, affected the activity of orexin neurons; noradrenaline and serotonin hyperpolarized, while carbachol depolarized orexin neurons in either the presence or absence of tetrodotoxin. It has been reported that orexins directly or indirectly activate the nuclei that are the origin of the neurons containing these neurotransmitters. Our data suggest that orexin neurons have reciprocal neural circuitries between these nuclei for either a positive or negative feedback loop and orchestrate the activity of these neurons to regulate the vigilance states.

Orexins activate histaminergic neurons via the orexin 2 receptor

Orexins (orexin A and B) are recently identified neuropeptides implicated in the regulation of vigilance states and energy homeostasis. We have shown here the physiological significance of histaminergic neurons in the orexin-induced arousal responses. Immunohistochemical and electron microscopic techniques revealed direct synaptic interaction between orexin-immunoreactive nerve terminals and histidine decarboxylase-immunoreactive neurons in the TMN. Electrophysiological study revealed that orexins dose-dependently activate histaminergic neurons, which were freshly isolated from rats TMN region. To further evaluate, we examined the effect of pyrilamine, an H(1) receptor antagonist, on orexin-induced arousal response in rats. Simultaneously recordings of electroencephalograph and electromyograph showed that intracerebroventricular infusion of orexin A significantly increased the awake state in the light phase. Central application of pyrilamine significantly inhibited this response. These results strongly suggest that activation of histaminergic neurons by orexins might be important for modulation of the arousal.

Effects of parenterally administered triazolam on sleep in rats with lesions of the preoptic area

In previous work we have reported that microinjections of triazolam or pentobarbital into the medial preoptic area of the anterior hypothalamus produce a hypnotic effect. This finding raised the possibility that the sleep-enhancing actions after systemic administration of these compounds might be mediated by hypnogenic mechanisms in the preoptic area. The current study examined whether sleep enhancement by triazolam requires the anatomic integrity of the preoptic area. Nine rats with histologically confirmed lesions of the preoptic area induced by ibotenic acid (2.5 microg/microl in 0.4 microl), and 10 rats that had undergone a sham lesion procedure, had 2-h sleep studies that confirmed that by day 5 measures of total sleep time and sleep latency had returned to preintervention values. Rats were then given triazolam 0.8 mg/kg or vehicle intraperitoneally in counterbalanced order, on days 7 and 9 postlesion, in an environment with an ambient temperature of 25 degrees C. Following injections at 1000 h, in conditions in which lights were on from 0800-2000 h, 2-h sleep studies were performed. In the lesioned rats, triazolam significantly decreased sleep latency and increased total sleep time, primarily by increasing NREM sleep, whereas injections of vehicle did not. In summary, parenterally administered triazolam was found to have hypnotic effects in rats who were 1 week post-preoptic area lesion. These data are interpreted in light of previous evidence of redundancy of sleep-regulating mechanisms in the nervous system.

Nicotinic activity in the interpeduncular nucleus of the midbrain prolongs recovery from halothane anesthesia

The influence of nicotinic transmission in the interpeduncular nucleus of the ventral midbrain on recovery from general anesthesia (3% halothane in oxygen) was assessed in rats. Immediately upon withdrawal of the anesthetic, nicotine (2 microliters, 10(-5) to 10(-1) M) was injected into the interpeduncular nucleus. Larger doses of nicotine (10(-2) and 10(-1) M) significantly (P < 0.05) prolonged the recovery of righting reflexes (to 371 +/- 55 and 362 +/- 67 sec, respectively, mean +/- SE), compared with injection of saline (187 +/- 19 sec). Prior intramuscular administration of the nicotinic antagonist, mecamylamine (2 mg/kg) significantly reduced the effect of 10(-2) M nicotine (to 211 +/- 43 sec). Injection of the nicotinic antagonist, hexamethonium (10(-1) M) led to a low mean recovery time (181 +/- 21 sec), not significantly different from control. Prolongation of recovery by 10(-2) M nicotine was not found to be significant when sites more dorsal to the interpeduncular nucleus were injected. An observed tendency for injection of nicotine to slow the post-anesthesia rate of breathing was not statistically significant and not correlated anatomically with the injection site in the midbrain. Increased release of acetylcholine has been shown previously to occur in the interpeduncular nucleus during anesthesia. The present results suggest that nicotinic activation of the interpeduncular nucleus facilitates or sums with the mechanisms in the brain that produce anesthesia under halothane.

Effect of ammonia on brain serotonin metabolism in relation to function in the portacaval shunted rat

Four weeks following portacaval anastomosis (PCA) in the rat, severe liver atrophy, sustained hyperammonemia, and increased plasma and brain tryptophan are observed. Administration of ammonium acetate (NH4Ac) to rats with PCA precipitates severe signs of hepatic encephalopathy (HE) (loss of righting reflex progressing to loss of consciousness and ultimately deep coma). To evaluate the relationship between the deterioration of neurological status in HE and serotonin (5-HT) metabolism, the levels of 5-HT, its precursor 5-hydroxytryptophan, and its major metabolite 5-hydroxy-indole-3-acetic acid (5-HIAA) were measured by HPLC with ion-pairing and electrochemical detection in three well-defined areas of the cerebral cortex: anterior cingulate, piriform and entorhinal, and frontoparietal; as well as in the caudate-putamen, the raphe nuclei, and the locus ceruleus in rats with PCA at different stages of HE, before and after injection of NH4Ac, as well as in sham-operated controls. The results demonstrate increased 5-HIAA/5-HT ratios after PCA and NH4Ac loading, suggesting increased 5-HT turnover in the brains of these animals. However, these changes do not appear to be related to the precipitation of coma as no significant difference in 5-HT turnover was observed between precoma and coma stages of HE. Increased 5-HT turnover in brain of shunted rats may be related to early symptoms of HE such as altered sleep patterns and disorders of motor coordination.

The search for the hypnogenic center

1. Electrophysiological and lesion studies have suggested that a number of specific sites in the brainstem and basal forebrain may be involved in the regulation of sleep and waking. In contrast, a study of glucose consumption as measured by the 2-deoxyglucose technique reported a generalized decrease in nonREM sleep compared to waking. The rate of protein synthesis was relatively unchanged in nonREM sleep. 2. Another approach to understanding sleep regulation is to study the mechanism by which hypnotic drugs affect the nervous system. This may be done at both a molecular and neuroanatomic level. Studies with B-carbolines, inverse agonists of benzodiazepines (BZs), indicate that sleep induction by BZs is mediated by binding at the BZ recognition site of the BZ receptor complex. Binding at this site by a long-acting B-carboline parallels the time course of its arousing effects. A study with an enantiomeric BZ indicates that the effects on sleep are stereospecific. It is conceivable that some inverse agonists or enantiomeric benzodiazepines might be developed for clinical use as analeptics. 3. Microinjection of a BZ into the dorsal raphe nucleus acutely increases wakefulness, while administration into the medial preoptic area of the hypothalamus enhances sleep maintenance.

Compound narcolepsy: development of biochemical imbalance

In a review of existing literature, compound narcolepsy is shown to involve not only problems of sleep regulation, but also autonomic, hormonal, emotional, and possibly motor and cognitive dysfunctions, strongly implicating the hypothalamus, limbic system, and possibly the striatum and cortex in the disorder. Neurochemical studies and the pattern of narcoleptic symptoms support the idea of a dynamic imbalance between dopamine and acetylcholine in the etiology of the disorder. What is known about the natural history of compound narcolepsy suggests a developmental course beginning with fluctuations in dopamine release, followed by supersensitivity of dopamine autoreceptors, and later followed by a pattern of intrinsic oscillations and reciprocal "overshoots" in release of dopamine and acetylcholine to account for the typical sequence of appearance of narcoleptic symptoms.

Differential effects of antidepressant drugs on [3H]dihydroalprenolol and [3H]imipramine ligand recognition sites in olfactory bulbectomized and sham-lesioned rats

In the olfactory bulbectomy rat model of major depression, the binding of [3H]imipramine is increased by 60% in the midbrain, reduced by 30% in the pons and by 20% in the hippocampus, and unchanged in the hypothalamus 6 weeks after the bulbectomy. Binding of [3H]dihydroalprenolol is unchanged in the midbrain but is increased by 30% in the pons and 15% in the hippocampus. The i.p. administration of the antidepressants amitriptyline, mianserin, tranylcypromine (all at a dose of 10 mg/kg) or iprindole (25 mg/kg) for 28 days followed by a 5-day drug washout period, alters brain part [3H]imipramine and [3H]dihydroalprenolol binding in a manner that is a function of the particular drug, brain part and lesion effect. Only in the hippocampus did the lesion increase beta-binding that was reduced by all four antidepressant drugs.