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Glycine input induces the synaptic facilitation in salamander rod photoreceptors. J Biomed Sci 2008; 15:743-54. [PMID: 18553216 DOI: 10.1007/s11373-008-9263-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 05/23/2008] [Indexed: 10/21/2022] Open
Abstract
Glycinergic synapses in photoreceptors are made by centrifugal feedback neurons in the network, but the function of the synapses is largely unknown. Here we report that glycinergic input enhances photoreceptor synapses in amphibian retinas. Using specific antibodies against a glycine transporter (GlyT2) and glycine receptor beta subunit, we identified the morphology of glycinergic input in photoreceptor terminals. Electrophysiological recordings indicated that 10 muM glycine depolarized rods and activated voltage-gated Ca(2+) channels in the neurons. The effects facilitated glutamate vesicle release in photoreceptors, meanwhile increased the spontaneous excitatory postsynaptic currents in Off-bipolar cells. Endogenous glycine feedback also enhanced glutamate transmission in photoreceptors. Additionally, inhibition of a Cl(-) uptake transporter NKCC1 with bumetanid effectively eliminated glycine-evoked a weak depolarization in rods, suggesting that NKCC1 maintains a high Cl(-) level in rods, which causes to depolarize in responding to glycine input. This study reveals a new function of glycine in retinal synaptic transmission.
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2
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Zhang AJ, Zhang J, Wu SM. Electrical coupling, receptive fields, and relative rod/cone inputs of horizontal cells in the tiger salamander retina. J Comp Neurol 2006; 499:422-31. [PMID: 16998920 DOI: 10.1002/cne.21117] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Light responses, dendritic/axonal morphology, receptive field diameters, patterns of dye coupling, and relative rod/cone inputs of various types of horizontal cells (HCs) were studied using intracellular recording and Lucifer yellow/neurobiotin dye injection methods in the flatmount tiger salamander retina. Three physiologically and morphologically distinct types of HC entities were identified. 1) The A-type HCs are somas that do not bear axons, with average (+/-SE) soma diameters of 20.01 +/- 0.59 microm, relatively sparse and thick dendrites, and they resemble the A-type HC in mammals. The average receptive field diameter of these cells is 529.6 +/- 10.87 microm and they receive inputs predominantly from cones. 2) The B-type HCs are broad-field somas that bear thin and long axons, with average soma diameters of 17.67 +/- 0.38 microm, thinner dendrites of higher density, and they resemble the B-type HC in mammals. The average receptive field diameter of these cells is 1,633.55 +/- 37.34 microm and they receive mixed inputs from rods and cones. 3) The B-type HC axon terminals are broad-field, coarse axon terminal processes and they resemble the B-type HC axon terminal in rabbits. The average receptive field diameter of these axon terminals is 1,291.67 +/- 24.02 microm and they receive mixed inputs from rods and cones. All these types of HC are dye-coupled with adjacent HCs of the same type. Additionally, B-type HCs and axon terminals are dye-coupled with subpopulations of bipolar cells whose axon terminals ramify in the proximal half of the inner plexiform layer, raising the possibility that these HCs may send feedforward antagonistic surround responses to depolarizing bipolar cells through electrical synapses.
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Affiliation(s)
- Ai-Jun Zhang
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030, USA
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3
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Abstract
The molecular organization of ribbon synapses in photoreceptors and ON bipolar cells is reviewed in relation to the process of neurotransmitter release. The interactions between ribbon synapse-associated proteins, synaptic vesicle fusion machinery and the voltage-gated calcium channels that gate transmitter release at ribbon synapses are discussed in relation to the process of synaptic vesicle exocytosis. We describe structural and mechanistic specializations that permit the ON bipolar cell to release transmitter at a much higher rate than the photoreceptor does, under in vivo conditions. We also consider the modulation of exocytosis at photoreceptor synapses, with an emphasis on the regulation of calcium channels.
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Affiliation(s)
- Ruth Heidelberger
- Department of Neurobiology & Anatomy, University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - Wallace B. Thoreson
- Department of Ophthalmology & Visual Sciences and Department of Pharmacology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Paul Witkovsky
- Department of Ophthalmology and Department of Physiology & Neuroscience, New York University School of Medicine, New York, NY 10016, USA
- *Corresponding author. Tel: +1 212 263 6488; fax: +1 212 263 7602. E-mail address: (P. Witkovsky)
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4
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Thoreson WB, Rabl K, Townes-Anderson E, Heidelberger R. A highly Ca2+-sensitive pool of vesicles contributes to linearity at the rod photoreceptor ribbon synapse. Neuron 2004; 42:595-605. [PMID: 15157421 PMCID: PMC3108437 DOI: 10.1016/s0896-6273(04)00254-5] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2003] [Revised: 01/26/2004] [Accepted: 04/12/2004] [Indexed: 12/01/2022]
Abstract
Studies of the properties of synaptic transmission have been carried out at only a few synapses. We analyzed exocytosis from rod photoreceptors with a combination of physiological and ultrastructural techniques. As at other ribbon synapses, we found that rods exhibited rapid kinetics of release, and the number of vesicles in the releasable pool is comparable to the number of vesicles tethered at ribbon-style active zones. However, unlike other previously studied neurons, we identified a highly Ca(2+)-sensitive pool of releasable vesicles with a relatively shallow relationship between the rate of exocytosis and [Ca(2+)](i) that is nearly linear over a presumed physiological range of intraterminal [Ca(2+)]. The low-order [Ca(2+)] dependence of release promotes a linear relationship between Ca(2+) entry and exocytosis that permits rods to relay information about small changes in illumination with high fidelity at the first synapse in vision.
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Affiliation(s)
- Wallace B Thoreson
- Department of Ophthalmology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Thoreson WB, Tranchina D, Witkovsky P. Kinetics of synaptic transfer from rods and cones to horizontal cells in the salamander retina. Neuroscience 2004; 122:785-98. [PMID: 14622921 DOI: 10.1016/j.neuroscience.2003.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We examined synaptic transmission between rods or cones and horizontal cells, using perforated patch recording techniques in salamander retinal slices. Experimental conditions were established under which horizontal cells received nearly pure rod or pure cone input. The response-intensity relation for both photoreceptors and horizontal cells was described by a Michaelis-Menten function with an exponent close to 1. A dynamic model was developed for the transduction from photoreceptor voltage to postsynaptic current. The basic model assumes that: (i) photoreceptor light-evoked voltage controls Ca2+ entry according to a Boltzmann relation; (ii) the rate of glutamate release depends linearly on the voltage-gated Ca2+ current (ICa) in the synaptic terminal; (iii) glutamate concentration in the synaptic cleft reflects the balance of release and reuptake in which reuptake obeys first order kinetics; (iv) the binding of glutamate to its receptor and channel gating are fast compared with glutamate kinetics in the synaptic cleft. The good fit to the model confirms that these are the key features of synaptic transmission from rods and cones. The model accommodated changes in kinetics induced by the glutamate uptake blocker, dihydrokainate. The match between model and response was not improved by including an estimate of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor desensitization or by making glutamate uptake voltage dependent.
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Affiliation(s)
- W B Thoreson
- Department of Ophthalmology, 985540 University of Nebraska Medical Center, Omaha, NE 68198-5540, USA.
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Witkovsky P, Thoreson W, Tranchina D. Transmission at the photoreceptor synapse. PROGRESS IN BRAIN RESEARCH 2001; 131:145-59. [PMID: 11420937 DOI: 10.1016/s0079-6123(01)31013-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- P Witkovsky
- Departments of Ophthalmology and Physiology, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
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7
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Marc RE, Liu W. Fundamental GABAergic amacrine cell circuitries in the retina: nested feedback, concatenated inhibition, and axosomatic synapses. J Comp Neurol 2000; 425:560-82. [PMID: 10975880 DOI: 10.1002/1096-9861(20001002)425:4<560::aid-cne7>3.0.co;2-d] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Presynaptic gamma-aminobutyrate-immunoreactive (GABA+) profiles were mapped in the cyprinid retina with overlay microscopy: a fusion of electron and optical imaging affording high-contrast ultrastructural and immunocytochemical visualization. GABA+ synapses, deriving primarily from amacrine cells (ACs), compose 92% of conventional synapses and 98% of the input to bipolar cells (BCs) in the inner plexiform layer. GABA+ AC synapses, the sign-inverting elements of signal processing, are deployed in micronetworks and distinctive synaptic source/target topologies. Nested feedback micronetworks are formed by three types of links (BC --> AC, reciprocal BC <-- AC, and AC --> AC synapses) arranged as nested BC<--> [AC --> AC] loops. Circuits using nested feedback can possess better temporal performance than those using simple reciprocal feedback loops. Concatenated GABA+ micronetworks of AC --> AC and AC --> AC --> AC chains are common and must be key elements for lateral spatial, temporal, and spectral signal processing. Concatenated inhibitions may represent exceptionally stable, low-gain, sign-conserving devices for receptive field construction. Some chain elements are GABA immunonegative (GABA-) and are, thus, likely glycinergic synapses. GABA+ synaptic baskets target the somas of certain GABA+ and GABA- cells, resembling cortical axosomatic synapses. Finally, all myelinated intraretinal profiles are GABA+, suggesting that some efferent systems are sources of GABAergic inhibition in the cyprinid retina and may comprise all axosomatic synapses. These micronetworks are likely the fundamental elements for receptive field shaping in the inner plexiform layer, although few receptive field models incorporate them as functional components. Conversely, simple feedback and feedforward synapses may often be chimeras: the result of an incomplete view of synaptic topology.
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Affiliation(s)
- R E Marc
- John Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
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Dong CJ, Hare WA. Contribution to the kinetics and amplitude of the electroretinogram b-wave by third-order retinal neurons in the rabbit retina. Vision Res 2000; 40:579-89. [PMID: 10824262 DOI: 10.1016/s0042-6989(99)00203-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The ERG b-wave is widely believed to reflect mainly light-induced activity of on-center bipolar cells and Müller cells. Third-order retinal neurons are thought to contribute negligibly to generation of the b-wave. Here we show that pharmacological agents which affect predominantly third-order neurons alter significantly both the kinetics and amplitude of the b-wave. Our results support the notion that changes in the amplitude and kinetics of light-induced membrane depolarization in third-order neurons produce similar changes in the amplitude and kinetics of the b-wave. We conclude that activity in third-order neurons makes a significant contribution to b-wave generation. Our results also provide evidence that spiking activity of third-order neurons truncates the a-wave by accelerating the onset of the b-wave.
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Affiliation(s)
- C J Dong
- Department of Biological Sciences, RD-2C Allergan Inc., Irvine, CA 92612, USA.
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9
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Molday R, Kaupp U. Chapter 4 Ion channels of vertebrate photoreceptors. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s1383-8121(00)80007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Yang JH, Maple B, Gao F, Maguire G, Wu SM. Postsynaptic responses of horizontal cells in the tiger salamander retina are mediated by AMPA-preferring receptors. Brain Res 1998; 797:125-34. [PMID: 9630565 DOI: 10.1016/s0006-8993(98)00373-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The postsynaptic responses of sign-preserving second-order retinal neurons (horizontal cells (HCs) and off-bipolar cells) are mediated by CNQX-sensitive AMPA/KA glutamate receptors. In this study we used receptor-specific allosteric regulators of desensitization and selected antagonists to determine the glutamate receptor subtypes in tiger salamander horizontal cells. Two approaches were employed in this study. The first was to measure postsynaptic currents induced by exogenously applied glutamate under voltage clamp conditions in living retinal slices; and the second was to record voltage responses controlled by endogenous glutamate released from photoreceptors in whole retinas. Application of 100 microM cyclothiazide (a specific AMPA receptor desensitization blocker) enhanced the glutamate-induced current by about 5 fold. In contrast, 300 microgram ml-1 Co nA (a specific kainate receptor desensitization blocker), had no effect. GYKI 52466 (a specific AMPA receptor antagonist) at 30 microM almost completely suppressed the glutamate-induced inward current in HCs. Cyclothiazide at 100 microM depolarized the HC dark membrane potential by about 5 mV and reduced the amplitudes of the voltage responses to dim lights, but enhanced the voltage responses to bright lights. Cyclothiazide had no effect on either the dark potential or the light responses of rods and cones. Con A at 300 microgram ml-1 had no effect on either the dark potential or the light responses of the HC. GYKI 52466 (30 microM) hyperpolarized the HC dark membrane potential by about 55 mV and almost completely suppressed the light responses. We conclude from these results that the postsynaptic glutamate- and light-induced responses in the tiger salamander retinal horizontal cells are mediated by AMPA-preferring, and not kainate-preferring glutamate receptors. The functional roles of AMPA receptors and their desensitization kinetics in visual information processing are discussed.
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Affiliation(s)
- J H Yang
- Cullen Eye Institute, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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11
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Abstract
Glutamate transporters in the tiger salamander retina were studied by autoradiographic and intracellular recording techniques. When the retina was incubated with 15 microM L-[3H]glutamate, photoreceptors and Muller cells were labeled, indicating that these cells had high-affinity glutamate uptake transporters. A much higher dose of glutamate than kainate was required in the bath to produce the same membrane depolarization in horizontal cells (HCs), and the time course of glutamate-induced depolarization was much slower than that of the kainate-induced depolarization. Since glutamate is a substrate of glutamate transporters whereas kainate is not, we attribute these differences to the buffering of extracellular glutamate by glutamate transporters in the retina. D-aspartate (D-asp) increased the efficacy of bath-applied glutamate. Dihydrokainate (DHKA) exerted little effect on glutamate efficacy when applied alone, but it increased glutamate efficacy in the presence of D-asp. These results are consistent with the notion that glutamate transporters in Muller cells are D-asp sensitive and those in photoreceptors are DHKA and D-asp sensitive. Application of DHKA (1-2 mM) did not affect the dark membrane potential or the light responses in rods and cones, but it depolarized the HC dark membrane potential and reduced the HC peak and tail light responses. Our results suggest that DHKA-sensitive glutamate transporters in photoreceptors regulate glutamate levels in rod and cone synaptic clefts. They modulate dark membrane potential and the relative rod cone inputs in retinal HCs.
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Affiliation(s)
- J H Yang
- Cullen Eye Institute, Houston, TX, USA
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12
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van de Grind WA, Lankheet MJ, van Wezel RJ, Rowe MH, Hulleman J. Gain control and hyperpolarization level in cat horizontal cells as a function of light and dark adaptation. Vision Res 1996; 36:3969-85. [PMID: 9068850 DOI: 10.1016/s0042-6989(96)00150-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
First a model is presented that accurately summarizes the dynamic properties of cat horizontal (H-) cells under photopic conditions as measured in our previous work. The model predicts that asymmetries in response to dark as compared to light flashes are flash-duration dependent. This somewhat surprising prediction is tested and confirmed in intracellular recordings from the optically intact in vivo eye of the cat (Experiment 1). The model implies that the gain of H-cells should be related rather directly to the sustained (baseline) membrane potential. We performed three additional experiments to test this idea. Experiment 2 concerns response vs intensity (R-I-) curves for various flash-diameters and background-sizes with background luminance varying over a 4 log unit range. Results support the assumption of a rather strict coupling between flash sensitivity (gain) and the sustained level of hyperpolarization. In Experiment 3 we investigate this relation for both dark and light flashes given on each of four background light levels. The results suggest that there are fixed minimum and maximum hyperpolarization levels, and that the baseline hyperpolarization for a given illumination thus also sets the available range for dark and light flash-responses. The question then arises whether, or how this changes during dark adaptation, when the rod contribution to H-cell responses gradually increases. The fourth experiment therefore studies the relationship between gain and hyperpolarization level during prolonged dark-adaptation. The results show that the rod contribution increases the polarization range of H-cells, but that the gain and polarization level nevertheless remain directly coupled. H-cell models relying on a close coupling between polarization level and gain thus remain attractive options.
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Affiliation(s)
- W A van de Grind
- Helmholtz Institute and Comparative Physiology, Universiteit Utrecht, The Netherlands
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13
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Krizaj D, Witkovsky P. Effects of submicromolar concentrations of dopamine on photoreceptor to horizontal cell communication. Brain Res 1993; 627:122-8. [PMID: 8293292 DOI: 10.1016/0006-8993(93)90755-c] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Dopamine has been postulated to act as an intraretinal messenger for light adaptation by biasing retinal circuits to favor cone over rod inputs to second- and third-order neurons. As an experimental test, we studied the effects of dopamine and related ligands on rod to horizontal cell synaptic transfer. Rods and horizontal cells (HC) were recorded from simultaneously. Red and green light-emitting diodes were modulated sinusoidally in counterphase at 1 Hz and their relative intensities adjusted to elicit a rod null. Dark-adapted HC's also showed a null, but exposure to 0.5-1.0 microM dopamine, which corresponds to the endogenous levels, elicited a large imbalance in the HC response while the rod null was maintained. Similar effects were achieved with either a D1 dopamine agonist, SKF 38393 (20 microM) or a D2 dopamine agonist, quinpirole HCl (1 microM). Correspondingly, the frequency range over which the HC responded to red flickering lights increased very substantially. Exposure to a D2, but not a D1 dopamine agonist increased rod flicker, but not as dramatically as in the HC. These data indicate that the synaptic gains of rod and cone transmission to a second order retinal neuron are modifiable by endogenous levels of dopamine. Secondly, the bandpass of rod flicker is altered by dopamine, acting through a D2 dopamine receptor.
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Affiliation(s)
- D Krizaj
- Department of Ophthalmology, New York University Medical Center, NY 10016
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Wu SM. Chapter 2 Signal transmission and adaptation-induced modulation of photoreceptor synapses in the retina. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0278-4327(91)90007-o] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Witkovsky P, Shi XP. Slow light and dark adaptation of horizontal cells in the Xenopus retina: a role for endogenous dopamine. Vis Neurosci 1990; 5:405-13. [PMID: 2124922 DOI: 10.1017/s0952523800000493] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A role for endogenous dopamine in the control of rod and cone contributions to a second-order retinal neuron, the horizontal cell (HC) was studied in the Xenopus retina. Relative rod and cone contributions were estimated from HC responses to scotopically balanced 491- and 650-nm flashes. In eyecups prepared in light then placed in darkness, cone input to the HC slowed and diminished on a time scale of hours. The decline in cone input was balanced by a slow growth of rod input to the HC. Administration of D-amphetamine, a dopamine releasing agent, restored the light-adapted waveform. The kinetics of slow light adaptation were examined by recording HC responses from eyecups that had been dark-adapted previously for 11-14 h. When test flashes fell on a dark field, cone input to the HC grew for 2-4 h, reached a plateau, and later declined. If, however, flashes were superimposed on a weak background field, cone input to the HC continued to increase monotonically at about 10%/h. This increase was abolished by superfusion with a nonspecific dopamine receptor blocker, cis-flupenthixol (50 microM), resulting in the complete suppression of cone-to-horizontal cell synaptic transfer and the enhancement of rod-to-horizontal cell communication. Subcutaneous injection of reserpine, a drug that depletes dopamine stores (2 mg/kg on 1-4 successive days), or intraocular injection of the dopamine neurotoxin, 6-hydroxydopamine (10-30 micrograms) slowed and reduced the amplitude of cone input to the HC, even in completely light-adapted eyes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Witkovsky
- Daniel B. Kirby Eye Institute, Department of Ophthalmology, New York University Medical Center, NY 10016
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Sullivan JM, Lasater EM. An unusually small potassium current that is well-suited to a retinal neuron which is chronically depolarized. Brain Res 1990; 528:130-2. [PMID: 2245330 DOI: 10.1016/0006-8993(90)90204-o] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Here we describe a sustained outward potassium current (IK) in retinal horizontal cells (HCs). IK is unusually small over the range of membrane potentials normally experienced by these cells, which are chronically depolarized. We hypothesize that this unique IK will reduce the amount of neurotransmitter required to shift the cell's membrane potential over a wide range, and will minimize the redistribution of potassium ions across the post-synaptic membrane when the cell is depolarized.
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Affiliation(s)
- J M Sullivan
- Department of Physiology, University of Utah School of Medicine, Salt Lake City 84108
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17
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Abstract
Although electrical coupling between rods and cones in the retina has been assumed to be static, it has now been shown that rod-cone coupling can be strengthened by light. Increment threshold measurements reveal that cone input to rods increases progressively as background light becomes brighter. Current injection into cones produces larger responses in adjacent rods in the presence of background light than in darkness. Weak coupling under dark-adapted conditions facilitates synaptic transmission of small rod signals, and strong coupling under light-adapted conditions enhances transmission of large cone signals.
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Affiliation(s)
- X L Yang
- Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030
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