Pentobarbital modulates transmitter effects on mouse spinal neurones grown in tissue culture

Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice

Traumatic brain injury (TBI) can initiate a very complex disease of the central nervous system (CNS), starting with the primary pathology of the inciting trauma and subsequent inflammatory and CNS tissue response. Delirium has long been regarded as an almost inevitable consequence of moderate to severe TBI, but more recently has been recognized as an organ dysfunction syndrome with potentially mitigating interventions. The diagnosis of delirium is independently associated with prolonged hospitalization, increased mortality and worse cognitive outcome across critically ill populations. Investigation of the unique problems and management challenges of TBI patients is needed to reduce the burden of delirium in this population. In this narrative review, possible etiologic mechanisms behind post-traumatic delirium are discussed, including primary injury to structures mediating arousal and attention and secondary injury due to progressive inflammatory destruction of the brain parenchyma. Other potential etiologic contributors include dysregulation of neurotransmission due to intravenous sedatives, seizures, organ failure, sleep cycle disruption or other delirium risk factors. Delirium screening can be accomplished in TBI patients and the presence of delirium portends worse outcomes. There is evidence that multi-component care bundles including an analgesia-prioritized sedation algorithm, regular spontaneous awakening and breathing trials, protocolized delirium assessment, early mobility and family engagement can reduce the burden of ICU delirium. The aim of this review is to summarize the approach to delirium in TBI patients with an emphasis on pathogenesis and management. Emerging CNS-active drug therapies that show promise in preclinical studies are highlighted.

GABAA receptor: Positive and negative allosteric modulators

gamma-Aminobutyric acid (GABA)-mediated inhibitory neurotransmission and the gene products involved were discovered during the mid-twentieth century. Historically, myriad existing nervous system drugs act as positive and negative allosteric modulators of these proteins, making GABA a major component of modern neuropharmacology, and suggesting that many potential drugs will be found that share these targets. Although some of these drugs act on proteins involved in synthesis, degradation, and membrane transport of GABA, the GABA receptors Type A (GABAAR) and Type B (GABABR) are the targets of the great majority of GABAergic drugs. This discovery is due in no small part to Professor Norman Bowery. Whereas the topic of GABABR is appropriately emphasized in this special issue, Norman Bowery also made many insights into GABAAR pharmacology, the topic of this article. GABAAR are members of the ligand-gated ion channel receptor superfamily, a chloride channel family of a dozen or more heteropentameric subtypes containing 19 possible different subunits. These subtypes show different brain regional and subcellular localization, age-dependent expression, and potential for plastic changes with experience including drug exposure. Not only are GABAAR the targets of agonist depressants and antagonist convulsants, but most GABAAR drugs act at other (allosteric) binding sites on the GABAAR proteins. Some anxiolytic and sedative drugs, like benzodiazepine and related drugs, act on GABAAR subtype-dependent extracellular domain sites. General anesthetics including alcohols and neurosteroids act at GABAAR subunit-interface trans-membrane sites. Ethanol at high anesthetic doses acts on GABAAR subtype-dependent trans-membrane domain sites. Ethanol at low intoxicating doses acts at GABAAR subtype-dependent extracellular domain sites. Thus GABAAR subtypes possess pharmacologically specific receptor binding sites for a large group of different chemical classes of clinically important neuropharmacological agents. This article is part of the "Special Issue Dedicated to Norman G. Bowery".

Modulation of Tonic GABA Currents by Anion Channel and Connexin Hemichannel Antagonists

Anion channels and connexin hemichannels are permeable to amino acid neurotransmitters. It is hypothesized that these conductive pathways release GABA, thereby influencing ambient GABA levels and tonic GABAergic inhibition. To investigate this, we measured the effects of anion channel/hemichannel antagonists on tonic GABA currents of rat hippocampal neurons. In contrast to predictions, blockade of anion channels and hemichannels with NPPB potentiated tonic GABA currents of neurons in culture and acute hippocampal slices. In contrast, the anion channel/hemichannel antagonist carbenoxolone (CBX) inhibited tonic currents. These findings could result from alterations of ambient GABA concentration or direct effects on GABA_A receptors. To test for effects on GABA_A receptors, we measured currents evoked by exogenous GABA. Coapplication of NPPB with GABA potentiated GABA-evoked currents. CBX dose-dependently inhibited GABA-evoked currents. These results are consistent with direct effects of NPPB and CBX on GABA_A receptors. GABA release from hippocampal cell cultures was directly measured using HPLC. Inhibition of anion channels with NPPB or CBX did not affect GABA release from cultured hippocampal neurons. NPPB reduced GABA release from pure astrocytic cultures by 21%, but the total GABA release from astrocytes was small compared to that of mixed cultures. These data indicate that drugs commonly used to antagonize anion channels and connexin hemichannels may affect tonic currents via direct effects on GABA_A receptors and have negligible effects on ambient GABA concentrations. Interpretation of experiments using NPPB or CBX should include consideration of their effects on tonic GABA currents.

How theories evolved concerning the mechanism of action of barbiturates

The barbiturate phenobarbital has been in use in the treatment of epilepsy for 100 years. It has long been recognized that barbiturates act by prolonging and potentiating the action of γ-aminobutyric acid (GABA) on GABA(A) receptors and at higher concentrations directly activating the receptors. A large body of data supports the concept that GABA(A) receptors are the primary central nervous system target for barbiturates, including the finding that transgenic mice with a point mutation in the β3 GABA(A) -receptor subunit exhibit diminished sensitivity to the sedative and immobilizing actions of the anesthetic barbiturate pentobarbital. Although phenobarbital is only modestly less potent as a GABA(A) -receptor modulator than pentobarbital, phenobarbital is minimally sedating at effective anticonvulsant doses. Possible explanations for the reduced sedative effect of phenobarbital include more regionally restricted action; partial agonist activity; reduced propensity to directly activate GABA(A) receptors (possibly including extrasynaptic receptors containing δ subunits); and reduced activity at other ion channel targets, including voltage-gated calcium channels. In recent years, substantial progress has been made in defining the structural features of GABA(A) receptors responsible for gating and allosteric modulation by drugs. Although the precise sites of action of barbiturates have not yet been defined, the second and third transmembrane domains of the β subunit appear to be critical; binding may involve a pocket formed by β-subunit methionine 286 as well as α-subunit methionine 236. In addition to effects on GABA(A) receptors, barbiturates block AMPA/kainate receptors, and they inhibit glutamate release through an effect on P/Q-type high-voltage activated calcium channels. The combination of these various actions likely accounts for their diverse clinical activities. Despite the remarkable progress of the last century, there is still much to learn about the actions of barbiturates that can be applied to the discovery of new, more therapeutically useful agents.

Effects of standard anticonvulsant drugs on different patterns of epileptiform discharges induced by 4-aminopyridine in combined entorhinal cortex-hippocampal slices

Application of 4-aminopyridine (4-AP) has previously been reported to produce different patterns of epileptiform discharges in entorhinal cortex (EC)-hippocampal slices: recurrent short discharges (RSDs) in hippocampal area CA1, seizure-like events (SLEs) and negative-going potentials (NGPs) in the medial entorhinal cortex (mEC). Using recordings of field potentials, we investigated the pharmacological effects of the clinically employed standard anticonvulsant drugs phenytoin (PHT), carbamazepine (CBZ), valproic acid (VPA) and phenobarbital (PHB) and those of pentobarbital (PB) on 4-AP-induced epileptiform activity. The anticonvulsant drugs showed different effects: SLEs were completely blocked by all tested drugs. Valproic acid, which suppressed all epileptiform activities, seemed to have the most fundamental effect of all drugs on 4-AP induced activity, because under phenytoin and carbamazepine, some epileptiform activity was still observable. The RSDs in hippocampal area CA1 of the hippocampus did not respond to the different anticonvulsants. In contrast, PB decreased the frequency of the RSDs in CA1 and enhanced the frequency of the NGPs in the EC. We propose that the activities induced by 4-AP in the combined entorhinal cortex-hippocampal slices may provide an in vitro model for the development of new drugs against difficult-to-treat focal epilepsy.

Barbiturates impair astrocyte glutamate uptake

Barbiturates are widely used as neuroprotective agents during status epilepticus and during surgical procedures that cause cerebral ischemia. The efficacy of this practice is unproved, however, and while barbiturates may counter neuronal excitotoxicity, they can also inhibit mitochondrial ATP production. Since glutamate uptake is energetically costly, mitochondrial inhibition could impair glutamate uptake. To examine this possibility, glutamate uptake was measured in primary rat astrocyte cultures in the presence of several barbiturates. Different barbiturates had differing effects on glutamate uptake at normal glucose concentrations, but all potentiated inhibition of glutamate uptake during glucose deprivation. Thiamylal and thiopental were the most potent barbiturates examined, with 0.3 mM causing approximately 40% reduction in glutamate uptake rates. Barbiturates also potentiated ATP depletion during glucose deprivation, supporting mitochondrial inhibition as the mechanism of these effects. These findings suggest that barbiturates can, under some conditions, impair glutamate uptake at concentrations relevant to their clinical use.

Ionic mechanisms of spontaneous GABAergic events in rat hippocampal slices exposed to 4-aminopyridine

Ionic mechanisms of spontaneous GABAergic events in rat hippocampal slices exposed to 4-aminopyridine. J. Neurophysiol. 78: 2582-2591, 1997. Ion-selective (H+ and K+) microelectrode techniques as well as conventional extra- and intracellular recordings were used to study the ionic mechanisms of propagating spontaneous GABAergic events (SGEs) in rat hippocampal slices exposed to 4-aminopyridine (4-AP, 50-100 mu M). All experiments were made in the presence of antagonists of ionotropic glutamate receptors [10 mu M 6-nitro-7-sulphamoylbenzoquinoxaline-2,3-dione (NBQX) and 40 mu M -2-amino-5-phosphonopentanoic acid (AP5)]. The SGEs were composed of a negative-going change in field potential with a temporally coincident increase (0.7 +/- 0.3 mM; mean +/- SE) in extracellular K+ ([K+]o) and an alkaline transient (0.01-0.08 units) in extracellular pH (pHo) in stratum radiatum of the area CA1. Simultaneous intracellular recordings showed a triphasic hyperpolarization-depolarization-late hyperpolarization response in pyramidal cells. Application of pentobarbital sodium (PB, 100 mu M) decreased the interval between SGEs from a mean value of 35 to approximately 20 s and shortened the period of refractoriness of stimulus-evoked propagating events. This was accompanied by an increase in the amplitude of the field potential response of the [K+]o and the pHo shifts and of the depolarizing phase of the pyramidal-cell response. The SGEs were completely blocked by the gamma-aminobutyric acid-A (GABAA) receptor antagonist, picrotoxin (PiTX; 100 mu M). The amplitudes of the negative-going field potential and of the depolarizing phase of the pyramidal-cell response as well as the ionic shifts associated with SGEs were strongly suppressed in the nominal absence of CO2/HCO-3. There was a five-fold increase in the interevent interval, and propagating SGEs could not be evoked by stimuli given at intervals shorter than approximately 2-3 min. Exposure to inhibitors of carbonic anhydrase, benzolamide (BA; 10 micro M) or ethoxyzolamide (EZA; 50 mu M) fully blocked the alkaline pHo transients and turned them into acid shifts. The poorly membrane-permeant BA had no discernible effect on the other components of the SGEs, but application of EZA had effects reminiscent to those of CO2/HCO-3-free medium. Addition of the GABAA receptor-permeant weak-acid anion, formate (20 mM) reestablished the SGEs that were first suppressed by exposure to the CO2/HCO-3-free medium. No SGEs were seen in the presence of a similar concentration of the GABAA receptor-impermeant anion propionate. Unlike the alkaline transients associated with HCO-3-driven SGEs, those supported by formate were not blocked by BA. The present data suggest that an inward current carried by bicarbonate is necessary for the generation of SGEs and that the GABAA receptor-mediated excitatory coupling among GABAergic interneurons is essentially dependent on the availability of intracellular bicarbonate.

Effect of pyrethroids on pentobarbital-induced sleeping time in relation to the chemical structure

The effect of pyrethroids on pentobarbital-induced sleeping time was examined in mice. Pentobarbital-induced sleeping time was defined as the time interval from loss of righting reflex to reappearance of righting reflex. Mice were administered pyrethroids orally 2 h before the intraperitoneal injection of pentobarbital at a dose of 45 mg/kg. Pyrethroids with a cyano group on the alcohol moiety, such as cyphenothrin, cypermethrin, fenvalerate and fenpropathrin shortened the pentobarbital-induced sleeping time, while pyrethroids with an ethynyl group on the acid moiety, such as prallethrin, furamethrin and empenthrin, prolonged sleeping time. Pyrethroids with neither a cyano nor an ethynyl group had no effect on sleeping time. We, thus, found a clear relationship between the chemical structure of pyrethroids and their effect on pentobarbital-induced sleeping time.

Trichloroethanol potentiation of gamma-aminobutyric acid-activated chloride current in mouse hippocampal neurones

1. The action of 2,2,2-trichloroethanol on gamma-aminobutyric acid (GABA)-activated Cl- current was studied in mouse hippocampal neurones in tissue culture by use of whole-cell patch-clamp recording. 2. Trichloroethanol increased the amplitude of currents activated by 1 microM GABA or 0.1 microM muscimol. Trichloroethanol, 1-25 mM, potentiated current activated by 1 microM GABA in a concentration-dependent manner with an EC50 of 3.0 +/- 1.4 mM and a maximal response (Emax) of 576 +/- 72% of control. 3. Trichloroethanol potentiated currents activated by GABA concentrations < 10 microM, but did not increase the amplitude of currents activated by concentrations of GABA > or = 10 microM. Despite marked potentiation of currents activated by low concentrations of GABA, trichloroethanol did not significantly alter the EC50, slope, or Emax of the GABA concentration-response curve. 4. Trichloroethanol, 5 mM, potentiated GABA-activated current in neurones in which ethanol, 10-500 mM, did not. The effect of trichloroethanol was not altered by the putative ethanol antagonist, Ro 15-4513. Trichloroethanol did not potentiate currents activated by pentobarbitone. 5. In the absence of exogenous GABA, trichloroethanol at concentrations > or = 2.5 mM activated a current that appeared to be carried by Cl- as its reversal potential changed with changes in the Cl- gradient and as it was inhibited by the GABAA antagonists, bicuculline methiodide and picrotoxin. 6. Since trichloroethanol is thought to be the active metabolite of chloral hydrate and other chloral derivative anaesthetics, potentiation of the GABA-activated current in central nervous system neurones by trichloroethanol may contribute to the sedative/hypnotic effects of these agents.

GABA and pentobarbital potentiation of chloride influx into microsacs is influenced by incubation time

GABA-mediated chloride influx into rat cerebral cortical microsacs, and its potentiation by pentobarbital (PB), was studied in incubations lasting 50 or 3000 ms. The 3000 ms assays were carried out manually, while the 50 ms assays were performed in a quench flow machine. The EC50 of the GABA effect and the Hill coefficient were both lower at the longer incubation times. Percent increase of the effect of GABA (at EC30 concentration) by pentobarbital was greater in the 3000 ms than in the 50 ms incubations. Preincubation of microsacs with PB for 5 s before the 50 ms incubation with GABA, did not increase the effect of PB beyond that obtained by adding PB into the incubation only. This finding is consistent with earlier ones cited, which imply that only PB binding that occurs after GABA has bound can potentiate the effect of GABA, and suggests that the concentrations of PB and GABA required to enhance chloride influx in vivo may be higher than those commonly reported in the literature.

Relative anticonvulsant effects of GABAmimetic and GABA modulatory agents

Anticonvulsant properties of compounds that enhance GABA-mediated inhibition through modulatory sites on the GABAA receptor [phenobarbital (PB), clonazepam (CZP), alpha-ethyl-alpha-methyl-gamma-thiobutyrolactone (alpha-EMTBL)] were compared with anticonvulsant effects of compounds believed to be antagonists at these modulatory sites (Ro15-1788 and alpha-isopropyl-alpha-methyl-gamma-butyrolactone gamma-IMGBL)] and to 4,5,6,7-tetrahydroisoxazolo-[4,5-c]-pyridin-3-ol (THIP, GABAA receptor agonist), (+/-) baclofen (GABAB receptor agonist), and gamma-vinyl GABA, a compound that increases endogenous GABA. The compounds were tested for their ability to block experimental seizures caused by maximal electroshock, pentylenetetrazol, picrotoxin, methyl-6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM), bicuculline (BIC), aminophylline, strychnine, and t-butyl-bicyclophosphorothionate (TBPS) in mice. CZP blocked all but strychnine seizures. PB was also highly effective, blocking all but TBPS seizures. alpha-EMTBL, representing a new class of experimental anticonvulsant drugs, prevented all seizures except strychnine (STR)- and aminophylline-induced seizures. The antagonists are effective only against one convulsant stimulus. Ro15-1788 and alpha-IMGBL prevented only DMCM- and pentylenetetrazol (PTZ)-induced seizures, respectively. THIP and gamma-vinyl GABA both blocked only BIC and picrotoxin seizures. Baclofen had no anticonvulsant activity. These data demonstrate that compounds that increase neuronal inhibition by potentiating the action of GABA have a broader spectrum of anticonvulsant action than either antagonists or GABAmimetic agents or compounds that increase endogenous GABA.

Effects of sedatives on GABA-mediated chloride flux into cerebral cortical microsacs prepared from emotional and non-emotional mice

Some strains of rats and mice express increased momentary fear or emotionality when exposed to a novel environment. Previous studies have found significantly fewer diazepam binding sites in the brains of Balb/cJ mice compared to C57BL and AKR/J mice and this has been suggested to contribute to the increased emotionally of the 'nervous' Balb strain. The influx of 36Cl into cerebral cortical microsacs was used to functionally assess the effects of GABA, diazepam and pentobarbital in the Balb mice compared to nonemotional animals (C57 and ICR mice). Slight differences in the ability of GABA to increase chloride influx were found among the three strains. Pentobarbital potentiation of GABA-mediated chloride flux was slightly higher in the ICR mice compared to Balb and C57. Diazepam potentiation of the effects of GABA, however, was significantly decreased in the Balb mice, strengthening the hypothesis that the benzodiazepine receptor is involved in mediating animal emotionality.

Potentiation of gamma-aminobutyric acid-mediated chloride flux by pentobarbital and diazepam but not ethanol

The influx of 36Cl- into cerebral cortical and cerebellar microsacs from ICR mice and Sprague-Dawley rats was studied in incubations lasting 3 s, 500 ms, or 21 ms. In the 3-s assay, 10-40 mM ethanol did not affect either basal or gamma-aminobutyric acid (GABA)-mediated Cl- flux, at any GABA concentration tested. Only at a concentration of 600 mM did ethanol potentiate Cl- flux in both mouse and rat preparations. Ethanol (20 mM) also did not affect the significant potentiation of GABA-mediated flux produced by 50 microM pentobarbital or 2 microM diazepam in ICR mouse microsacs. In 21- and 500-ms incubations (quench-flow method), 50 microM pentobarbital significantly potentiated GABA-mediated Cl- flux in rat cortical microsacs, but 10-50 mM ethanol did not. These studies suggest that some as yet unrecognized factor is essential for ethanol enhancement of GABA-mediated Cl- flux, as reported by others in brain homogenates and in tissue culture.

The relative potency of pentobarbital in suppressing the kainic acid- or the N-methyl-D-aspartic acid-induced enhancement of cGMP in cerebellar cells

Primary cultures of rat cerebellar cells were pretreated with various dosages of pentobarbital before the addition of kainic acid or N-methyl-D-aspartic acid in order to assess effects of this drug on the enhancement of cyclic guanosine-3',5'-phosphate (cyclic GMP) mediated by these excitatory agonists. Pentobarbital significantly suppressed kainic acid-induced increases in this cyclic nucleotide at concentrations as low as 5 microM but was only effective in suppressing the N-methyl-D-aspartic acid enhancement at dosages of 100 microM or greater. These data suggest that this barbiturate is a more effective depressant of the stimulatory effects of kainic acid as compared to N-methyl-D-aspartic acid.

Differences among effects of sedative-hypnotic drugs on GABA-mediated chloride flux: quench flow studies

The effects of 40 microM pentobarbital (PB), 1 microM diazepam (DZ) and 50 mM ethanol (EtOH) on gamma-aminobutyric acid (GABA)-mediated chloride flux into rat cerebral cortical microsacs were studied during 50 ms incubations with 36Cl. A quench-flow machine was used, allowing for preincubations and incubation of precise duration. A 1 s preincubation with PB did not increase the already significant effect of PB on GABA-mediated flux during the 50 ms incubation, but the 1 s preincubation was necessary for showing the effect of diazepam. EtOH had no effect, whether or not it was added in the preincubation. When microsacs were preincubated with 32 microM GABA for 1 s, far greater potentiation of the GABA effect was seen when the PB was also present during the preincubation than when it was only introduced in the incubation. Preincubation with both DZ and GABA also had a greater effect than merely adding DZ into the incubation, after the preincubation with GABA. Ethanol had no effect when added either during or after the 1 s preincubation with GABA. The different effects of these sedatives on GABA-mediated chloride flux are strongly suggestive of different loci or mechanisms of action.

Enhancement of current induced by superfusion of GABA in locus coeruleus neurons by pentobarbital, but not ethanol

gamma-Aminobutyric acid (GABA), pentobarbital and ethanol were applied by bath superfusion to rat locus coeruleus (LC) neurons in a brain slice preparation. The GABA-induced current and conductance increase was measured with single-electrode voltage clamp. Pentobarbital potentiated the GABA-induced current and conductance increase in all LC neurons tested. In contrast, ethanol did not alter the current and conductance increase induced by bath application of GABA to LC neurons.

Increased response of cerebellar cGMP to kainate but not NMDA or quisqualate following barbital withdrawal from dependent rats

Female Sprague-Dawley rats were maintained on a diet of powdered food containing barbital for 8 weeks before the drug was abruptly withdrawn. Twenty-four hours later both barbital-dependent and control rats were injected intracerebroventricular (i.c.v.) with saline or one of four doses of kainic acid (KA) or in a separate experiment with saline or one of three doses of N-methyl-D-aspartic acid (NMDA) or of quisqualic acid (QA). After 4.5 min, the animals were killed by focused microwave irradiation, and the cerebella were collected. The levels of cyclic guanosine 3',5' monophosphate (cGMP) were markedly elevated in the cerebella of barbital-withdrawn rats when compared to controls. When compared to saline treatment, KA, at all dosages, resulted in a significantly greater elevation of cerebellar cGMP in the barbital-withdrawn rats than was induced by drug withdrawal alone. Only the two higher dosages of KA produced a significant elevation of this parameter in the control rats. Unlike KA, neither QA or NMDA produced any greater elevations of cGMP in barbital withdrawn rats than were induced by drug withdrawal alone. These collective results suggest that there is an increase in the response to KA but not QA or NMDA following the withdrawal of barbital from dependent rats.

Sodium pentobarbitone enhances responses of thalamic relay neurones to GABA in rat brain slices

1. In rat isolated thalamic slices, intracellular recordings were made of responses to electrophoretically applied gamma-aminobutyric acid (GABA) in the absence and presence of sodium pentobarbitone (NaPb). 2. Responses to electrophoretically applied GABA were biphasic in the majority of neurones studied. They consisted of an early, negative-going and later, positive-going phase, when recorded close to reversal potential. 3. An increase in the GABA ejection current caused an enhancement of the late positive-going phase, along with a shift in the reversal potential of the whole response to a more positive value. These changes were accompanied by an increase in GABA-induced conductance (decrease in resistance) and an increase in the duration of the response. 4. Application of NaPb to the GABA response produced similar effects, namely an enhancement of the late positive-going phase, a shift in the reversal potential to a more positive value, an increase in conductance and an increase in duration. 5. GABA-mediated inhibitory postsynaptic potentials (i.p.s.ps) were evoked by electrical stimulation of the nucleus reticularis thalami. Application of NaPb caused an increase in the duration of the i.p.s.p. and a shift in its reversal potential to a more positive value.

Pentobarbital augments serotonin-mediated inhibition of cerebellar Purkinje cells

The ability of pentobarbital to modify the direct effects of iontophoretically ejected serotonin on the firing rates of cerebellar Purkinje cells was examined. Serotonin elicited inhibition, excitation, or a biphasic effect on cerebellar Purkinje cells. With continuous application of iontophoretic pentobarbital at currents found to potentiate GABA-induced inhibition, serotonin-mediated inhibitions were also augmented consistently. When application of serotonin elicited excitation, including a late component of biphasic responses, iontophoretic pentobarbital converted the effect to, primarily, inhibition. Besides increasing the magnitude of serotonin-mediated inhibition, iontophoretic pentobarbital increased the duration of this effect. In another series of experiments using pentobarbital rather than urethan as the anesthetic, serotonin-mediated inhibition was significantly augmented for all ejection currents tested. The GABA antagonists bicuculline, pentylenetetrazole and picrotoxin attenuated pentobarbital augmentation of serotonin-elicited inhibition. We conclude that serotonin-mediated inhibition of Purkinje cells is modifiable by pentobarbital and this effect bears a strong semblance to the actions of barbiturates on GABAergic neurotransmission.

Anticonvulsive activity of several excitatory amino acid antagonists against barbital withdrawal-induced spontaneous convulsions

Several excitatory amino acid antagonists were tested for an ability to prevent spontaneous convulsions seen during the barbital abstinence syndrome in rats. Barbital-dependent animals were continuously infused intracerebroventricularly (i.c.v.) for the first 48 h following barbital withdrawal with either saline, 2-amino-7-phosphonoheptanoic acid (APH), magnesium sulfate, glutamyldiethyl ester (GDEE) or cis-2,3-piperidine dicarboxylic acid (PDA) using the highest dosages which did not affect normal behavior of the rats. All animals were observed continuously from 12 to 48 h postwithdrawal and the number of spontaneous convulsions observed in each animal was recorded. After this time, animals were killed by focused microwave irradiation and the cerebellas were collected for determination of cyclic guanosine monophosphate (cGMP) levels. While both APH and MgSO4 dramatically prevented convulsions, only APH prevented the withdrawal-induced elevation of cerebellar cGMP. PDA and GDEE had no statistically significant effect on either cerebellar cGMP levels or on convulsive activity. Although the effect of GDEE was not statistically significant, the number of convulsions was reduced to 1/3 those seen in control animals. These data implicate N-methyl-d-aspartate (NMDA) receptor-mediated pathways in seizure activity associated with the barbital abstinence syndrome and show that the withdrawal-induced elevation of cerebellar cGMP can occur without the induction of convulsions.

2-Amino-7-phosphonoheptanoic acid, a selective antagonist of N-methyl-D-aspartate, prevents barbital withdrawal-induced convulsions and the elevation of cerebellar cyclic GMP in dependent rats

Female Sprague-Dawley rats were maintained on a diet of barbital for 8 weeks, a period of time previously shown to result in tolerance to and dependence on the drug. After completing this course, the barbital was abruptly withdrawn and the selective antagonist of N-methyl-d-aspartate (NMDA), 2-amino-7-phosphonoheptanoic acid (APH), or saline was infused intracerebroventricularly over 48 hr. Control rats which had not received barbital, were similarly infused with either saline or APH. All animals were observed for 12-48 hr following the withdrawal of the barbital; spontaneous convulsions, previously reported to be numerous and severe after withdrawal of the drug, were counted and graded according to severity. Forty-eight hr after withdrawal of barbital, the rats were killed by focussed microwave irradiation and cerebellae were collected for later determination of levels of cGMP. Nine convulsions occurred in 29 rats withdrawn from barbital and infused intracerebroventricularly with APH, this contrasted markedly with 61 convulsions seen in 29 animals withdrawn from the drug and infused with saline. There was a 3-fold elevation of levels of cGMP in the saline-infused, barbital-withdrawn rats when compared to control rats infused with saline. This evaluation was markedly, although not completely, prevented by the intracerebroventricular infusion of APH. These data provide evidence that dicarboxylic amino acid pathways, specifically those acting through NMDA receptors, are involved in seizure activity seen following abrupt abstinence from barbital.

Responses to GABA by isolated insect neuronal somata: pharmacology and modulation by a benzodiazepine and a barbiturate

Mechanically dissociated neuronal somata from the thoracic ganglia of Locusta migratoria and Schistocerca gregaria were viable in vitro for hours and were current- and voltage-clamped to record the responses evoked by brief pressure applications of gamma-aminobutyric acid (GABA) in the presence of various modulators. The application of GABA and muscimol, but not baclofen, produced a hyperpolarization and concurrent increase in the membrane conductance. The current underlying this response reversed at -65 mV, was evoked in all cells tested and showed outward rectification. In 6 of 74 Locusta neurones but not in the neurones of Schistocerca, GABA and muscimol evoked a biphasic response. The initial, fast phase was indistinguishable from the GABA-evoked current seen in all neurones. The remaining predominant, slow and long-duration component of the response was an inward current over the membrane potential range 0 to -80 mV, increasing with hyperpolarization. The GABAA antagonists bicuculline and pitrazepin were without effect on the fast GABA response while picrotoxin was a potent blocker of both the fast and the slow GABA responses. Flunitrazepam enhanced the amplitude of the fast response by up to 70% without increasing its duration. Sodium pentobarbital enhanced both the amplitude and the duration of the fast GABA response. We conclude that the locust thoracic neuronal GABA receptor/channel complex resembles the vertebrate GABAA receptor in having associated modulatory receptor sites for benzodiazepines and barbiturates, but differs from it in terms of the pharmacology of the GABA receptor itself.

Reinterpretation of the literature indicates differential sensitivities of long-sleep and short-sleep mice are not specific to alcohol

This paper reviews the findings and conclusions of the literature pertinent to the Long-Sleep and Short-Sleep selectively-bred lines of mice and challenges the widely-held notion that the selective breeding program was successful in separating alleles for specific sensitivities to just alcohol. Rather, it is argued that these lines of mice were selected for differing activity of a more general process. Recent evidence, as well as reevaluated previous evidence, indicates that Long-Sleep mice are more sensitive to the soporific effects of three major classes of CNS depressants (alcohols, barbiturates, and benzodiazepines), as well as many other anesthesia-inducing compounds (adenosine, chloral hydrate, trichloroethanol, paraldehyde, nitrous oxide, enflurane, and isoflurane). Further, much evidence also supports the conclusion that most of these hypnotic-depressants and anesthetics could exert their soporific influence by a potentiation of GABA activity. The other characteristic of interest in this regard is susceptibility to convulsions. Short-Sleep mice have significantly lower thresholds to both flurothyl-induced and bicuculline-induced convulsions, as well as being more likely to suffer from paroxysms during ethanol withdrawal.

Biphasic actions of pentobarbital on synaptic transmission

The effects of pentobarbital were studied on synaptic transmission in the rat hippocampal slice preparation. Low concentrations of pentobarbital (0.04 - 0.1 mM) produced an increase in the Schaffer collateral to CA 1 evoked EPSP and population field potential amplitudes. Higher concentrations of pentobarbital (0.2 - 1.0 mM) produced depression of field potential amplitudes. Pentobarbital altered synaptic transmission by affecting both pre- and post-synaptic functions. Analysis of input/output curves suggest the presynaptic site is most sensitive.

The action of general anaesthetics on acetylcholine-induced inhibition in the central nervous system of Helix

The effects of general anaesthetics, thiopentone, etomidate, minaxolone and ketamine were studied on identified voltage-clamped neurones of Helix aspersa. At concentrations of 0.1-0.5 mM, thiopentone, etomidate and minaxolone had no effect on the resting conductance of identified cells, D1 and D2. Ketamine at a concentration of 0.1-0.5 mM depolarized and excited the cells. All four anaesthetics tested depressed a chloride-dependent inhibitory response to acetylcholine (ACh) in cells D1 and D2 at concentrations of 0.1-0.5 mM in a dose-dependent and reversible manner with no change in the reversal potential of the response. These results show that general anaesthetics can block the transmitter-evoked chloride-mediated increases in membrane conductance in Helix neurones.

The effects of anaesthetics on the uptake and release of amino acid neurotransmitters in thalamic slices

1 The effect of thiopentone, methohexitone, urethane and ketamine on the uptake and release of gamma-aminobutyric acid (GABA) and D-aspartate by rat thalamic slices has been investigated. 2 A high, supra-anaesthetic concentration of methohexitone increased the uptake of both D-aspartate and GABA. 3 None of the anaesthetics used had any detectable effect upon the spontaneous release of either amino acid. 4 Urethane and ketamine had no effect upon the K+-stimulated release of either amino acid. 5 Methohexitone and thiopentone produced a biphasic dose-response on the K+-stimulated release of both amino acids; low concentrations enhanced release, high concentrations depressed release. 6 Bicuculline hydrochloride and picrotoxin both significantly reduced the barbiturate-induced enhancement of K+-stimulated amino acid release, but did not significantly alter the depression of K+-stimulated release at higher barbiturate concentrations. 7 Baclofen, either alone (1 microM to 1 mM), or tested against the barbiturates, had no detectable effect.

Antianalgesic action of thiamylal sodium in cats

The effects of thiamylal on the nociceptor-driven neural activity in the spinal cord were studied in decerebrate, non-anesthetized cats. Noxious stimulation was induced by the injection of bradykinin into the femoral artery and the neutral response in the lateral funiculus was measured by the multi-unit activity technique. The effects of thiamylal on the bradykinin-induced response were compared before and after the spinal cord transection, above the recording site. Thiamylal, 5 mg/kg i.v., potentiated the response significantly before the cord transection and depressed it after the transection. These findings indicate that the antianalgesic action of thiamylal is induced at the spinal cord level: although this anesthetic agent does have a direct intraspinal depressant action, the multisynaptic neural network of the supraspinal pain inhibition system is more susceptible to the actions of anesthetics, and the depression of this descending system by thiamylal results in a release of spinal cord nociceptive neural mechanisms from the supraspinal control.

Dual action of pentobarbitone on GABA binding: role of binding site integrity

The effects of pentobarbitone on the binding of gamma-aminobutyric acid (GABA) to crude synaptosomal rat brain membranes were studied. In extensively washed P2 membranes, pentobarbitone had a biphasic action: at concentrations ranging between 12.5 and 500 microM, pentobarbitone enhanced GABA binding in a concentration-dependent manner; at concentrations greater than 500 microM, this enhancement was progressively reversed towards control levels of GABA binding. The effect of pentobarbitone seen at higher concentrations may reflect a GABA-mimetic action, since similar concentrations enhanced diazepam binding to washed P2 membranes, an effect antagonized by bicuculline methochloride and picrotoxinin. When washed P2 membranes were incubated in 0.5% Triton X-100 (30 min at 37 degrees C), the enhancement of GABA binding by low concentrations of pentobarbitone was abolished, while at higher concentrations GABA binding was progressively inhibited, suggesting that the GABA-mimetic action is retained. When washed P2 membranes were subjected to high-frequency homogenization, the biphasic dose-response relationship for pentobarbitone was markedly shifted to the right. The choice of membrane preparation appears to be a critical factor in examining drug-receptor interactions in vitro, at least for those involving GABA and the barbiturates.

Diazepam and (--)-pentobarbital: fluctuation analysis reveals different mechanisms for potentiation of gamma-aminobutyric acid responses in cultured central neurons

Diazepam and (--)-pentobarbital each potentiate the increase in chloride ion conductance produced by gamma-aminobutyric acid (GABA) i voltage-clamped mouse spinal neurons grown in culture. Fluctuation analysis was used to compare the properties of elementary ion-channel events underlying the chloride conductance produced by GABA alone and during potentiation by the two drugs. Neither drug altered the conductance of an open ion channel, but both drugs affected the kinetics of channel activity. Diazepam increased the frequency of channel openings and either did not affect or slightly increased the average open-channel lifetime, whereas (--)-pentobarbital decreased the frequency of channel openings and increased average open-channel lifetime. These changes in the kinetics of GABA-activated ion channels can quantitatively account for the potentiation of GABA responses observed with the drugs. Thus, the drugs each increase the response to GABA but do not act on channel kinetics in the same manner.

Pentobarbitone slows the dissociation of GABA from rat brain synaptosomal binding sites

The dissociation of GABA from rat brain synaptosomal binding sites is characterized by an initial rapid phase followed by a slower phase which may represent dissociation of GABA from high affinity binding sites. The dissociation rate constant (K-1) calculated from this secondary phase is significantly reduced by pentobarbitone (100 micrometers). This result supports the finding that barbiturates increase the affinity of GABA for a high affinity binding site.

Handling-induced seizures and rotational behavior in th Mongolian gerbil

The aim of this report was to examine the relationship between sensory-induced seizures, cerebral laterality (as measured by rotation) and nigrostriatal asymmetry in Mongolian gerbils. Seizure resistant gerbils made proportionally more spontaneous turns to be preferred direction than sensitive animals. Three prototypical antiepileptic drugs strongly elicited rotational behavior (carbamazepine (10-20 mg/kg), diazepam (16 mg/kg) and pentobarbital (40 mg/kg)) and two others (phenobarbital 20-40 mg/kg) and ethosuximide (500 mg/kg)) also appeared to potentiate rotation; only diphenylhydantoin and trimethadione were effective. Two dopaminergic agonists, amphetamine (4 mg/kg) and apomorphine (16 mg/kg) enhanced rotation at anticonvulsant doses while the dopaminergic antagonist haloperidol reduced rotational behavior at a dose (1 mg/kg) which exacerbate seizure severity. Finally, surgical induction of nigrostriatal asymmetry by means of unilateral electrolytic striatal lesions reduced seizure severity; sham and bilateral striatal lesions had no significant effects on seizures. These results suggest that seizure activity and rotational behavior are inversely related and, furthermore, that the link between these two behaviors may be the asymmetry between nigrostriatal dopaminergic systems.

Reduced inhibition during epileptiform activity in the in vitro hippocampal slice

1. Intracellular recordings were made from CA1 pyramidal cells in the hippocampal slice in vitro. The responses to orthodromic and antidromic activation and to ionophoretically applied GABA were studied. 2. The epileptogenic agent sodium benzyl penicillin reduced the recurrent i.p.s.p. evoked by subthreshold antidromic stimulation. Reversal potential studies of the i.p.s.p. and resistance measurements showed that this reduction was mainly due to a decrease in i.p.s.p. conductance. 3. Penicillin also reduced the conductance and associated membrane potential changes induced by ejecting GABA near the soma or into the apical dendritic region. 4. The mixed e.p.s.p.-i.p.s.p. evoked by orthodromic stimulation was converted to a pure depolarizing potential as the i.p.s.p. was blocked. Concurrently the probability of discharge to a constant orthodromic stimulus was increased. Similar changes were seen in a low chloride solution. 5. The time course of the reduction of inhibition was similar to that of the enhanced orthodromic response seen after penicillin treatment. 6. We conclude that reduction of postsynaptic inhibition is partly responsible for the increased probability of orthodromic discharge caused by penicillin. The longer latency all-or-nothing burst seen in some cells, however, seems to require an additional mechanism, although reduced inhibition may facilitate the triggering of this burst.

Pentobarbital: stereospecific actions of (+) and (-) isomers revealed on cultured mammalian neurons

Stereoisomers of the barbiturate anesthetic pentobarbital were applied to mouse spinal neurons growing in tissue culture. Intracellular recordings of neuronal membrane properties revealed that the (+) and (-) isomers caused direct changes in membrane potential and conductance on some but not all of the cells tested. The action of the (+) isomer was predominantly excitatory, whereas the (-) isomer produced predominantly inhibitory responses. The (-) isomer was considerably more effective in potentiating inhibitory responses to the transmitter gamma-aminobutyric acid. The results show that pentobarbital has multiple effects on neuronal excitability and demonstrate the presence of stereospecific sites of barbiturate action on central neurons.

Effect of barbiturates on release endogenous amino acids from rat cortex slices

The potassium-stimulated, calcium-dependent release of endogenous GABA and glutamic acid was suppressed by pentobarbital. The ouabain and veratridine-stimulated fluxes of the amino acids, calcium-independent processes, were not suppressed by pentobarbital. Release of GABA and glutamic acid was not suppressed by pentobarbital in the presence of the calcium ionophore A23187. Of eight barbiturates studied at equimolar concentrations six were found to inhibit GABA release. Thiopental was the most potent, and phenobarbital and secobarbital were inactive.

Enhancement of GABA-mediated postsynaptic inhibition in cultured mammalian spinal cord neurons: a common mode of anticonvulsant action

Murine spinal cord neurons grown in dissociated cell culture were used to study the effects of barbiturate (phenobarbital, mephobarbital) and benzodiazepine (diazepam, chlordiazepoxide( anticonvulsants on amino acid responses. Both types of anticonvulsant augmented GABA-mediated postsynaptic inhibition without augmenting beta-alanine or glycine-mediated postsynaptic inhibition. Barbiturates, but not benzodiazepines, antagonized glutamate-mediated postsynaptic excitation. Augmentation of GABA-mediated inhibition by the anticonvulsants should contribute to their anticonvulsant action; antagonism of glutamate-mediated excitation by barbiturates should also contribute to their anticonvulsant action and could be at least in part responsible for their sedative actions.

Effect of pentobarbitone on the spontaneous efflux of gamma-amino acids from rabbit retina

The effect of pentobarbitone on the spontaneous release of radioactivity from rabbit retinas preloaded with [3H]GABA, [3H]DABA, [3H]beta-alanine and [3H]glycine was studied. In high concentration of pentobarbitone (10(-3)M) the rate of spontaneous efflux of neuronal [3H]GABA, [3H]DABA and [3H]beta-alanine was reduced but not that of [3H]glycine. Glial release of [3H]GABA was much less influenced. At lower concentrations (10(-4)-10(-5)M) there was an initial increase in the release of [3H]GABA, [3H]DABA and [oH]beta-alanine followed by a decrease, indicating several components in the release system for the amino acids.

Mechanisms of augmented field potential responses in the rat olfactory bulb

Olfactory bulb field potential and single unit responses to paired pulse stimulation of the lateral olfactory tract were observed in the rat. In agreement with previous reports, surgical levels of barbiturate anesthesia prolonged the period of diminution of the field potential responses to the test pulse relative to the effect seen under light anesthesia. Very deep barbiturate anesthesia (sufficient to depress the EEG) led to decreased responses to the primary pulse but augmented responses to the test pulse. Urethane and ether anesthesia produced augmented test responses without severely depressing the EEG and without producing a period of diminished test responses. Single unit recordings failed to show external plexiform layer units excited at the time of maximal augmentation of the field potential. Simultaneous single unit and field potential recordings showed that prolonged diminution of the field potential response was associated with prolonged suppression of unit responses to the test pulse, while augmented field potential responses were associated with decreased suppression of unit responses to the test pulse. These observations are most easily explained by the assumption of temporal facilitation in the synaptic output of mitral and tufted cells. This facilitation is masked by feedback inhibition under some conditions, particularly under barbiturate anesthesia.