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Revealing the Precise Role of Calretinin Neurons in Epilepsy: We Are on the Way. Neurosci Bull 2021; 38:209-222. [PMID: 34324145 PMCID: PMC8821741 DOI: 10.1007/s12264-021-00753-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/24/2021] [Indexed: 02/03/2023] Open
Abstract
Epilepsy is a common neurological disorder characterized by hyperexcitability in the brain. Its pathogenesis is classically associated with an imbalance of excitatory and inhibitory neurons. Calretinin (CR) is one of the three major types of calcium-binding proteins present in inhibitory GABAergic neurons. The functions of CR and its role in neural excitability are still unknown. Recent data suggest that CR neurons have diverse neurotransmitters, morphologies, distributions, and functions in different brain regions across various species. Notably, CR neurons in the hippocampus, amygdala, neocortex, and thalamus are extremely susceptible to excitotoxicity in the epileptic brain, but the causal relationship is unknown. In this review, we focus on the heterogeneous functions of CR neurons in different brain regions and their relationship with neural excitability and epilepsy. Importantly, we provide perspectives on future investigations of the role of CR neurons in epilepsy.
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Saffari R, Grotefeld K, Kravchenko M, Zhang M, Zhang W. Calretinin +-neurons-mediated GABAergic inhibition in mouse prefrontal cortex. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109658. [PMID: 31145926 DOI: 10.1016/j.pnpbp.2019.109658] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/17/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
The prefrontal cortex (PFC) is a center for executive and cognitive functions. Although many studies have been carried out to elucidate the role of different subtypes of GABAergic neurons in other brain areas, their functional relevance in PFC is still not fully understood. Calretinin+-GABAergic neurons are heterogeneous in their morphology and intrinsic properties. Previous studies showed an involvement of CR+-GABAergic neurons in the disinhibition of the other GABAergic neurons in neocortex and hippocampus. Furthermore, the loss of CR+- and PV+-interneurons in human brain has been linked to the vulnerability of the interneurons and to the overall increase in the network excitability associated with mental diseases. In the present study, the intensity of CR+-neuropil was higher in layer II/III, whereas the intensity of PV+-neuropil was higher in deeper layers within the PFC. In addition, pronounced CR expression was detected in layer II and III of prelimbic and infralimbic cortex whereas they were less abundant in anterior cingulate cortex and motor cortex 2. Our results showed that bipolar CR+- neurons in layer V not only feedback inhibited multipolar CR+- and other interneurons in layer II/III, but the majority of bipolar CR+-neurons in layer II/III also provide long-range forward-inhibition to pyramidal neurons in deeper layers of PFC. Thus, given the importance of the neuronal network of PFC in central control of emotion and cognition and in the pathology of mental diseases, CR+-GABAergic neuron-mediated feed-forward and -backward modulation within PFC would differentially modulate the downstream limbic activity and subsequently shape the cognitive and emotional behavior.
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Affiliation(s)
- Roja Saffari
- Laboratory of molecular psychiatry, Department of psychiatry, University of Münster, Germany
| | - Kirsten Grotefeld
- Laboratory of molecular psychiatry, Department of psychiatry, University of Münster, Germany
| | - Mykola Kravchenko
- Laboratory of molecular psychiatry, Department of psychiatry, University of Münster, Germany
| | - Mingyue Zhang
- Laboratory of molecular psychiatry, Department of psychiatry, University of Münster, Germany
| | - Weiqi Zhang
- Laboratory of molecular psychiatry, Department of psychiatry, University of Münster, Germany.
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Effects of neonatal ethanol on cerebral cortex development through adolescence. Brain Struct Funct 2019; 224:1871-1884. [PMID: 31049690 DOI: 10.1007/s00429-019-01881-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 04/19/2019] [Indexed: 02/03/2023]
Abstract
Neonatal brain lesions cause deficits in structure and function of the cerebral cortex that sometimes are not fully expressed until adolescence. To better understand the onset and persistence of changes caused by postnatal day 7 (P7) ethanol treatment, we examined neocortical cell numbers, volume, surface area and thickness from neonatal to post-adolescent ages. In control mice, total neuron number decreased from P8 to reach approximately stable levels at about P30, as expected from normal programmed cell death. Cortical thickness reached adult levels by P14, but cortical volume and surface area continued to increase from juvenile (P20-30) to post-adolescent (P54-93) ages. P7 ethanol caused a reduction of total neurons by P14, but this deficit was transient, with later ages having only small and non-significant reductions. Previous studies also reported transient neuron loss after neonatal lesions that might be partially explained by an acute acceleration of normally occurring programmed cell death. GABAergic neurons expressing parvalbumin, calretinin, or somatostatin were reduced by P14, but unlike total neurons the reductions persisted or increased in later ages. Cortical volume, surface area and thickness were also reduced by P7 ethanol. Cortical volume showed evidence of a transient reduction at P14, and then was reduced again in post-adolescent ages. The results show a developmental sequence of neonatal ethanol effects. By juvenile ages the cortex overcomes the P14 deficit of total neurons, whereas P14 GABA cell deficits persist. Cortical volume reductions were present at P14, and again in post-adolescent ages.
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Crocker-Buque A, Currie SP, Luz LL, Grant SG, Duffy KR, Kind PC, Daw MI. Altered thalamocortical development in the SAP102 knockout model of intellectual disability. Hum Mol Genet 2016; 25:4052-4061. [PMID: 27466188 PMCID: PMC5291236 DOI: 10.1093/hmg/ddw244] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/24/2016] [Accepted: 07/13/2016] [Indexed: 12/30/2022] Open
Abstract
Genetic mutations known to cause intellectual disabilities (IDs) are concentrated in specific sets of genes including both those encoding synaptic proteins and those expressed during early development. We have characterized the effect of genetic deletion of Dlg3, an ID-related gene encoding the synaptic NMDA-receptor interacting protein synapse-associated protein 102 (SAP102), on development of the mouse somatosensory cortex. SAP102 is the main representative of the PSD-95 family of postsynaptic MAGUK proteins during early development and is proposed to play a role in stabilizing receptors at immature synapses. Genetic deletion of SAP102 caused a reduction in the total number of thalamocortical (TC) axons innervating the somatosensory cortex, but did not affect the segregation of barrels. On a synaptic level SAP102 knockout mice display a transient speeding of NMDA receptor kinetics during the critical period for TC plasticity, despite no reduction in GluN2B-mediated component of synaptic transmission. These data indicated an interesting dissociation between receptor kinetics and NMDA subunit expression. Following the critical period NMDA receptor function was unaffected by loss of SAP102 but there was a reduction in the divergence of TC connectivity. These data suggest that changes in synaptic function early in development caused by mutations in SAP102 result in changes in network connectivity later in life.
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Affiliation(s)
- Alex Crocker-Buque
- Centre for Integrative Physiology and Patrick Wild Centre, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Stephen P Currie
- Centre for Integrative Physiology and Patrick Wild Centre, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Liliana L Luz
- Centre for Integrative Physiology and Patrick Wild Centre, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Seth G Grant
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - Kevin R Duffy
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS B3H 4R2, Canada
| | - Peter C Kind
- Centre for Integrative Physiology and Patrick Wild Centre, University of Edinburgh, Edinburgh EH8 9XD, UK .,Centre for Brain Development and Repair, InStem, Bangalore 560065, India
| | - Michael I Daw
- Centre for Integrative Physiology and Patrick Wild Centre, University of Edinburgh, Edinburgh EH8 9XD, UK
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Liu J, Liu B, Zhang X, Yu B, Guan W, Wang K, Yang Y, Gong Y, Wu X, Yanagawa Y, Wu S, Zhao C. Calretinin-positive L5a pyramidal neurons in the development of the paralemniscal pathway in the barrel cortex. Mol Brain 2014; 7:84. [PMID: 25404384 PMCID: PMC4246560 DOI: 10.1186/s13041-014-0084-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 11/04/2014] [Indexed: 01/06/2023] Open
Abstract
Background The rodent barrel cortex has been established as an ideal model for studying the development and plasticity of a neuronal circuit. The barrel cortex consists of barrel and septa columns, which receive various input signals through distinct pathways. The lemniscal pathway transmits whisker-specific signals to homologous barrel columns, and the paralemniscal pathway transmits multi-whisker signals to both barrel and septa columns. The integration of information from both lemniscal and paralemniscal pathways in the barrel cortex is critical for precise object recognition. As the main target of the posterior medial nucleus (POm) in the paralemniscal pathway, layer 5a (L5a) pyramidal neurons are involved in both barrel and septa circuits and are considered an important site of information integration. However, information on L5a neurons is very limited. This study aims to explore the cellular features of L5a neurons and to provide a morphological basis for studying their roles in the development of the paralemniscal pathway and in information integration. Results 1. We found that the calcium-binding protein calretinin (CR) is dynamically expressed in L5a excitatory pyramidal neurons of the barrel cortex, and L5a neurons form a unique serrated pattern similar to the distributions of their presynaptic POm axon terminals. 2. Infraorbital nerve transection disrupts this unique alignment, indicating that it is input dependent. 3. The formation of the L5a neuronal alignment develops synchronously with barrels, which suggests that the lemniscal and paralemniscal pathways may interact with each other to regulate pattern formation and refinement in the barrel cortex. 4. CR is specifically expressed in the paralemniscal pathway, and CR deletion disrupts the unique L5a neuronal pattern, which indicates that CR may be required for the development of the paralemniscal pathway. Conclusions Our results demonstrate that L5a neurons form a unique, input-dependent serrated alignment during the development of cortical barrels and that CR may play an important role in the development of the paralemniscal pathway. Our data provide a morphological basis for studying the role of L5a pyramidal neurons in information integration within the lemniscal and paralemniscal pathways.
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Affiliation(s)
- Junhua Liu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Bin Liu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - XiaoYun Zhang
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Baocong Yu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Wuqiang Guan
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, 200032, PR China.
| | - Kun Wang
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Yang Yang
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Yifan Gong
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Xiaojing Wu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China.
| | - Yuchio Yanagawa
- Department of Genetic and Behavioral Neuroscience, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Japan.
| | - Shengxi Wu
- Department of Anatomy, Histology and Embryology, K.K. Leung Brain Research Centre, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, PR China.
| | - Chunjie Zhao
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Anatomy and Neuroscience, Medical School, Southeast University, Nanjing, 210009, PR China. .,Center of Depression, Beijing Institute for Brain Disorders, Beijing, 100069, PR China.
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Cauli B, Zhou X, Tricoire L, Toussay X, Staiger JF. Revisiting enigmatic cortical calretinin-expressing interneurons. Front Neuroanat 2014; 8:52. [PMID: 25009470 PMCID: PMC4067953 DOI: 10.3389/fnana.2014.00052] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/05/2014] [Indexed: 12/18/2022] Open
Abstract
Cortical calretinin (CR)-expressing interneurons represent a heterogeneous subpopulation of about 10-30% of GABAergic interneurons, which altogether total ca. 12-20% of all cortical neurons. In the rodent neocortex, CR cells display different somatodendritic morphologies ranging from bipolar to multipolar but the bipolar cells and their variations dominate. They are also diverse at the molecular level as they were shown to express numerous neuropeptides in different combinations including vasoactive intestinal polypeptide (VIP), cholecystokinin (CCK), neurokinin B (NKB) corticotrophin releasing factor (CRF), enkephalin (Enk) but also neuropeptide Y (NPY) and somatostatin (SOM) to a lesser extent. CR-expressing interneurons exhibit different firing behaviors such as adapting, bursting or irregular. They mainly originate from the caudal ganglionic eminence (CGE) but a subpopulation also derives from the dorsal part of the medial ganglionic eminence (MGE). Cortical GABAergic CR-expressing interneurons can be divided in two main populations: VIP-bipolar interneurons deriving from the CGE and SOM-Martinotti-like interneurons originating in the dorsal MGE. Although bipolar cells account for the majority of CR-expressing interneurons, the roles they play in cortical neuronal circuits and in the more general metabolic physiology of the brain remained elusive and enigmatic. The aim of this review is, firstly, to provide a comprehensive view of the morphological, molecular and electrophysiological features defining this cell type. We will, secondly, also summarize what is known about their place in the cortical circuit, their modulation by subcortical afferents and the functional roles they might play in neuronal processing and energy metabolism.
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Affiliation(s)
- Bruno Cauli
- Sorbonne Universités, UPMC University Paris 06, UM CR18, Neuroscience Paris Seine Paris, France ; Centre National de la Recherche Scientifique, UMR 8246, Neuroscience Paris Seine Paris, France ; Institut National de la Santé et de la Recherche Médicale, UMR-S 1130, Neuroscience Paris Seine Paris, France
| | - Xiaojuan Zhou
- Institute for Neuroanatomy, UMG, Georg-August-University Göttingen Göttingen, Germany
| | - Ludovic Tricoire
- Sorbonne Universités, UPMC University Paris 06, UM CR18, Neuroscience Paris Seine Paris, France ; Centre National de la Recherche Scientifique, UMR 8246, Neuroscience Paris Seine Paris, France ; Institut National de la Santé et de la Recherche Médicale, UMR-S 1130, Neuroscience Paris Seine Paris, France
| | - Xavier Toussay
- Sorbonne Universités, UPMC University Paris 06, UM CR18, Neuroscience Paris Seine Paris, France ; Centre National de la Recherche Scientifique, UMR 8246, Neuroscience Paris Seine Paris, France ; Institut National de la Santé et de la Recherche Médicale, UMR-S 1130, Neuroscience Paris Seine Paris, France
| | - Jochen F Staiger
- Institute for Neuroanatomy, UMG, Georg-August-University Göttingen Göttingen, Germany
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Paulussen M, Jacobs S, Van der Gucht E, Hof PR, Arckens L. Cytoarchitecture of the mouse neocortex revealed by the low-molecular-weight neurofilament protein subunit. Brain Struct Funct 2011; 216:183-99. [DOI: 10.1007/s00429-011-0311-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 03/13/2011] [Indexed: 12/20/2022]
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Muzzi P, Camera P, Di Cunto F, Vercelli A. Deletion of the citron kinase gene selectively affects the number and distribution of interneurons in barrelfield cortex. J Comp Neurol 2009; 513:249-64. [PMID: 19148892 DOI: 10.1002/cne.21927] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Citron kinase (CIT-K), a ser/thr kinase, is required during neurogenesis for cytokinesis of neuronal precursors. Deletion of the cit-k gene in mice (cit-k(-/-) mice) leads to a severe malformative central nervous system syndrome characterized by microencephaly, ataxia, and epileptic seizures; affected mice die by the third week of postnatal life. We have used NADPH-diaphorase histochemistry, immunostaining for calbindin, calretinin, parvalbumin, and glutamic acid decarboxylase 67 (GAD67), and histological staining to undertake qualitative and quantitative analyses of the morphology and distribution of interneurons in the barrelfield cortex of cit-k(-/-) mice. By postnatal day 13, lack of CIT-K results in profoundly altered cortical cell morphology: the infragranular layers are populated by large, binucleate interneurons bearing many more dendrites than in control mice, an anatomical profile that has also been reported for the cortex of humans with cortical dysplasias and epilepsy. Tessellation analyses reveal that a clustered distribution of interneurons is maintained in cit-k(-/-) mice, but that their nearest neighbor distance is significantly increased, and thus their density is reduced; the overall number of interneurons is more dramatically decreased in the absence of CIT-K than would be predicted on the basis of the reduced brain size of affected mice. This reduction of inhibitory gamma-aminobutyric acid (GABA)ergic neurons likely underlies the occurrence of epileptic seizures in the cit-k(-/-) mice. Furthermore, the altered distribution of NADPH-diaphorase-positive interneurons could be responsible for an impaired coupling of cortical activity to blood flow, also affecting cortical growth and functioning.
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Affiliation(s)
- Patrizia Muzzi
- Department of Anatomy, Pharmacology and Forensic Medicine, University of Torino, 10126 Torino, Italy
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Pletnikov MV, Ayhan Y, Nikolskaia O, Xu Y, Ovanesov MV, Huang H, Mori S, Moran TH, Ross CA. Inducible expression of mutant human DISC1 in mice is associated with brain and behavioral abnormalities reminiscent of schizophrenia. Mol Psychiatry 2008; 13:173-86, 115. [PMID: 17848917 DOI: 10.1038/sj.mp.4002079] [Citation(s) in RCA: 265] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A strong candidate gene for schizophrenia and major mental disorders, disrupted-in-schizophrenia 1 (DISC1) was first described in a large Scottish family in which a balanced chromosomal translocation segregates with schizophrenia and other psychiatric illnesses. The translocation mutation may result in loss of DISC1 function via haploinsufficiency or dominant-negative effects of a predicted mutant DISC1 truncated protein product. DISC1 has been implicated in neurodevelopment, including maturation of the cerebral cortex. To evaluate the neuronal and behavioral effects of mutant DISC1, the Tet-off system under the regulation of the CAMKII promoter was used to generate transgenic mice with inducible expression of mutant human DISC1 (hDISC1) limited to forebrain regions, including cerebral cortex, hippocampus and striatum. Expression of mutant hDISC1 was not associated with gross neurodevelopmental abnormalities, but led to a mild enlargement of the lateral ventricles and attenuation of neurite outgrowth in primary cortical neurons. These morphological changes were associated with decreased protein levels of endogenous mouse DISC1, LIS1 and SNAP-25. Compared to their sex-matched littermate controls, mutant hDISC1 transgenic male mice exhibited spontaneous hyperactivity in the open field and alterations in social interaction, and transgenic female mice showed deficient spatial memory. The results show that the neuronal and behavioral effects of mutant hDISC1 are consistent with a dominant-negative mechanism, and are similar to some features of schizophrenia. The present mouse model may facilitate the study of aspects of the pathogenesis of schizophrenia.
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Affiliation(s)
- M V Pletnikov
- Division of Neurobiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Henkel CK, Gabriele ML, McHaffie JG. Quantitative assessment of developing afferent patterns in the cat inferior colliculus revealed with calbindin immunohistochemistry and tract tracing methods. Neuroscience 2006; 136:945-55. [PMID: 16344162 PMCID: PMC1913559 DOI: 10.1016/j.neuroscience.2005.03.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Revised: 03/16/2005] [Accepted: 03/21/2005] [Indexed: 11/18/2022]
Abstract
The central nucleus of the inferior colliculus (CNIC) is comprised of an orderly series of fibrodendritic layers. These layers include integrative circuitry for as many as 13 different ascending auditory pathways, each tonotopically ordered. Calcium-binding proteins, such as calbindin-D28k (CB), may be useful neurochemical markers for specific subsets of afferent input in these layers and their spatial organization that are developmentally regulated. In this study, CB-immunohistochemistry was used to examine 1-42 postnatal-day-old kitten and adult cat CNIC and anterograde tracers were used to label afferent projections from the lateral superior olivary nucleus (LSO) to the CNIC at similar ages. A distinct axonal plexus that is CB-immunopositive is described. This CB-afferent compartment is present at birth and persists throughout the ages examined. Already at birth, the CB-immunostained plexus in kitten CNIC is organized into discrete bands that are approximately 75 microm thick and 500 microm long. In adult CNIC, the periodic banded pattern of CB-immunostained fibers is similar to that in kittens albeit bands are thicker (145 microm) and longer (700 microm). Growth in band thickness in adult cat appears proportional to growth of the IC, whereas length of the dense CB-immunostained bands is somewhat more focused in the central region of fibrodendritic layers. The banded pattern of the CB-immunostained plexus is well correlated with the location and dimension of afferent projections from the LSO in newborn kitten labeled with carbocyanine dye, 1,1'-dioctodecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate and in adult cat labeled with wheat germ agglutinin conjugated with horseradish peroxidase. The results reveal a neurochemical marker for one type of synaptic compartment in CNIC layers, banding, that is organized before hearing onset in kittens, but that may undergo some postnatal pruning.
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Affiliation(s)
- C K Henkel
- Wake Forest University School of Medicine, Department of Neurobiology and Anatomy, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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