Partial restoration of physiological UP-state activity by GABA pathway modulation in an acute brain slice model of epilepsy

An integrated approach for early in vitro seizure prediction utilizing hiPSC neurons and human ion channel assays

Seizure liability remains a significant cause of attrition throughout drug development. Advances in stem cell biology coupled with an increased understanding of the role of ion channels in seizure offer an opportunity for a new paradigm in screening. We assessed the activity of 15 pro-seizurogenic compounds (7 CNS active therapies, 4 GABA receptor antagonists, and 4 other reported seizurogenic compounds) using automated electrophysiology against a panel of 14 ion channels (Nav1.1, Nav1.2, Nav1.6, Kv7.2/7.3, Kv7.3/7.5, Kv1.1, Kv4.2, KCa4.1, Kv2.1, Kv3.1, KCa1.1, GABA α1β2γ2, nicotinic α4β2, NMDA 1/2A). These were selected based on linkage to seizure in genetic/pharmacological studies. Fourteen compounds demonstrated at least one "hit" against the seizure panel and 11 compounds inhibited 2 or more ion channels. Next, we assessed the impact of the 15 compounds on electrical signaling using human-induced pluripotent stem cell neurons in microelectrode array (MEA). The CNS active therapies (amoxapine, bupropion, chlorpromazine, clozapine, diphenhydramine, paroxetine, quetiapine) all caused characteristic changes to electrical activity in key parameters indicative of seizure such as network burst frequency and duration. The GABA antagonist picrotoxin increased all parameters, but the antibiotics amoxicillin and enoxacin only showed minimal changes. Acetaminophen, included as a negative control, caused no changes in any of the parameters assessed. Overall, pro-seizurogenic compounds showed a distinct fingerprint in the ion channel/MEA panel. These studies highlight the potential utility of an integrated in vitro approach for early seizure prediction to provide mechanistic information and to support optimal drug design in early development, saving time and resources.

GABAb- and GABAa- mediated regulation of Up and Down states across development

KEY POINTS

Slow oscillations (SOs), the EEG hallmark of non-REM sleep, and their cellular counterpart, Up-and-Down states (UDSs), are considered the default activity of the cerebral cortex and reflect the underlying neural connectivity. GABAb- and GABAa- receptor-mediated inhibition play a major role in regulating UDS activity. Although SOs and UDSs exhibit significant alterations as a function of age, it is unknown how developmental changes in inhibition contribute to the developmental profile of this activity. In this study, we reveal for the first time, age-dependent effects of GABAb and GABAa signalling on UDSs. We also document the differential subunit composition of postsynaptic GABAa receptors in young and adult animals, highlighting the α1-subunit as a major component of the age-differentiated regulation of UDSs. These findings help clarify the mechanisms that underlie the maturation of cortical network activity, and enhance our understanding regarding the emergence of neurodevelopmental disorders.

ABSTRACT

Slow oscillations, the hallmark of non-REM sleep, and their cellular counterpart, Up-and-Down states (UDSs), are considered a signature of cortical dynamics that reflect the intrinsic network organization. Although previous studies have explored the role of inhibition in regulating UDSs, little is known about whether this role changes with maturation. This is surprising since both slow oscillations and UDSs exhibit significant age-dependent alterations. To elucidate the developmental impact of GABAb and GABAa receptors on UDS activity, we conducted simultaneous LFP and intracellular recordings ex vivo, in brain slices of young and adult male mice, using selective blockers, CGP and non-saturating concentration of gabazine, respectively. Blockade of both GABAb- and GABAa- signalling showed age-differentiated functions. CGP caused an increase in Down state duration in young animals, but a decrease in adults. Gabazine evoked Spike-and-Wave-Discharges in both ages; however, while young networks became completely epileptic, adults maintained the ability to generate UDSs. Furthermore, voltage clamp recordings of mIPSCs revealed that gabazine selectively blocks phasic currents, particularly involving postsynaptic mechanisms. The latter exhibit clear maturational changes, suggesting a different subunit composition of GABAa receptors in young vs. adult animals. Indeed, subsequent LFP recordings under diazepam (nanomolar or micromolar concentrations) revealed that mechanisms engaging the drug's classical-binding-site, mediated by α1-subunit containing GABAa receptors, have a bigger contribution in Up state initiation in young networks compared to adults. Taken together, these findings help clarify the mechanisms that underlie the maturation of cortical network activity and enhance our understanding regarding the emergence of neurodevelopmental disorders. Abstract figure legend GABAb receptors' participation in Up state termination mechanisms is well-conserved across development. However, regulation of Down-to-Up transitions is age-dependent; GABAb receptors promote them in young while preventing them in adults. Up state maintenance is determined by age-dependent synaptic GABAa receptors' subunit composition and kinetics; α1-GABAa receptors dominate in young while non-α1-GABAa receptors dominate in adults. This article is protected by copyright. All rights reserved.

Can We Panelize Seizure?

Seizure liability remains a significant cause of attrition in drug discovery and development, leading to loss of competitiveness, delays, and increased costs. Current detection methods rely on observations made in in vivo studies intended to support clinical trials, such as tremors or other abnormal movements. These signs could be missed or misinterpreted; thus, definitive confirmation of drug-induced seizure requires a follow-up electroencephalogram study. There has been progress in in vivo detection of seizure using automated video systems that record and analyze animal movements. Nonetheless, it would be preferable to have earlier prediction of seizurogenic risk that could be used to eliminate liabilities early in discovery while there are options for medicinal chemists making potential new drugs. Attrition due to cardiac adverse events has benefited from routine early screening; could we reduce attrition due to seizure using a similar approach? Specifically, microelectrode arrays could be used to detect potential seizurogenic signals in stem-cell-derived neurons. In addition, there is clear evidence implicating neuronal voltage-gated and ligand-gated ion channels, GPCRs and transporters in seizure. Interactions with surrounding glial cells during states of stress or inflammation can also modulate ion channel function in neurons, adding to the challenge of seizure prediction. It is timely to evaluate the opportunity to develop an in vitro assessment of seizure linked to a panel of ion channel assays that predict seizure, with the aim of influencing structure-activity relationship at the design stage and eliminating compounds predicted to be associated with pro-seizurogenic state.

Kainate receptors have different modulatory effect in seizure-like events and slow rhythmic activity in entorhinal cortex ex vivo

In the neocortex, neurons form functional networks, the members of which exhibit a variable degree of synchronization. Slow rhythmic activity may be regarded as a balanced interplay of excitatory and inhibitory neuronal network activity, which is essential in learning and memory consolidation. On the other hand, seizures may be considered as hypersynchronized network states occurring in epileptic diseases. The brain slice method and multi-electrode array (MEA) systems offer a good opportunity for the modelling of cortical spontaneous activities by examining their initiation and propagation. Our main goals were to characterise and compare spontaneous activities developing in different conditions and cortical network states. The role of kainate receptors in these processes was also tested. According to our results, there are demonstrable dissimilarities between slow rhythmic activities vs. seizure-like events developing in the rat entorhinal cortex ex vivo in normal vs. epileptic conditions. Propagation velocity, time scale, activity pattern and pharmacological sensitivity are all different. Kainate receptors play a role in network activity in entorhinal cortex, they are capable to prolong the duration of the events of epileptiform activity. Their regulatory effect is more prominent under epileptic than under normal conditions.