Selective antagonism by benzodiazepines of neuronal responses to excitatory amino acids in the cerebral cortex

Lorazepam-induced effects on silent period and corticomotor excitability

TMS studies on the CNS effects of benzodiazepines have provided contradictory results. The objective of this study is to describe the effects of lorazepam on silent period (SP) and corticomotor excitability. Twelve healthy male subjects (median age 35 years) were studied at baseline, following i.v. lorazepam administration and after reversal of the benzodiazepine effects with i.v. flumazenil. Lorazepam was given at a low-dose in one subject (0.0225 mg/kg bolus + 2 microg/kg/h infusion) and at a high-dose (0.045 mg/kg bolus + 2.6 microg/kg/h infusion) in the rest. Threshold (Thr) was measured at 1% steps. SPs were investigated with two complementary methods. First, SPs were elicited using a wide range of stimulus intensities (SIs) (from 5 to 100% maximum SI at 5% increments). At each SI, four SPs were obtained and the average value of SP duration was used to construct a stimulus/response (S/R) curve of SI versus SP .The resulting S/R curves were then fitted to a Boltzman function, the best-fit values of which were statistically compared for each experimental condition (i.e., baseline vs. lorazepam vs. flumazenil). Second, a large number of SPs (n=100) was elicited during each of the three experimental conditions using blocks of four stimuli with an intensity alternating between MT and 200% MT. This method was employed so as to reveal the dynamic, time-varying effects of lorazepam and flumazenil on SP duration at two stimulus intensity (SI) levels. MEP recruitment curves were constructed at rest and during activation and fitted to a Boltzman function the best-fit values of which were statistically compared for each experimental condition. Lorazepam at a low dose did not affect Thr, SP, or the active MEP recruitment curves. The high dose also had no effect on Thr and the active MEPs whereas the resting MEP recruitment curves were depressed post-lorazepam at the higher range of stimulus intensities. With regard to SP, the Max value of the S/R curve decreased from 251+/-4.6 ms at baseline to 215.2+/-3.1 ms post-lorazepam (P<0.01). V50 also decreased significantly (from 47.92+/-0.9% to 43.73+/-0.81%, P<0.01) whereas there was no significant change regarding slope and SP Thr. The statistical analysis of the SP S/R curves as well as the study of SPs at two SI levels revealed that lorazepam reduced SP duration when high intensity stimuli were used (>60%). In contrast, at low SIs a small increase in SP duration was noted post-drug. Enhancement of GABAergic inhibition by lorazepam results in a reduction of SP duration when high SIs is used. At the lower range of SIs, a small but statistically significant increase in SP duration is observed. The kinetic behavior of this phenomenon as well as the possible underlying mechanisms are discussed.

Electrophysiology of benzodiazepine receptor ligands: multiple mechanisms and sites of action

Electrophysiology of BZR ligands has been reviewed from different points of view. A great effort was made to critically discuss the arguments for and against the temporarily leading hypothesis of the mechanism of action of BZR ligands, the GABA hypothesis. As has been discussed at length in the present article, an impressive body of electrophysiological and biochemical evidence suggests an enhancement of GABAergic inhibition in CNS as a mechanism of action of BZR agonists. Biochemical data even indicate a physical coupling between GABA recognition sites and BZR which, together with the effector site build-up by Cl- channels, form a supramolecular GABAA/BZR complex. By binding to a specific site on this complex, BZR agonists allosterically increase and BZR inverse agonists decrease the gating of GABA-linked Cl- channels, whereas BZR antagonists bind to the same site without an appreciable intrinsic activity and block the binding and action of both agonists as well as inverse agonists. While this model is supported by many electrophysiological experiments performed with BZR ligands in higher nanomolar and lower micromolar concentrations, it does not explain much controversial data from animal behavior and, more importantly, is not in line with electrophysiological effects obtained with low nanomolar BZ concentrations. The latter actions of BZR ligands in brain slices occur within a concentration range compatible with concentrations of BZ observed in CSF fluid, which would be expected to be found in the biophase (receptor level) during anxiolytic therapy in man. Enhanced K+ conductance seems to be a suitable candidate for this effect of BZR ligands. This direct action on neuronal membrane properties may underlie the many electrophysiological observations with extremely low systemic doses of BZR ligands in vivo which demonstrated a depressant effect on spontaneous neuronal firing in various CNS regions. Skeletomuscular spasticity and epilepsy are two neurological disorders, where both the enhanced GABAergic inhibition and increased K+ conductance may contribute to the therapeutic effect of BZR agonists, since electrophysiological and behavioral studies strongly support GABA-dependent as well as GABA-independent action of BZR ligands elicited by low to intermediate doses of BZ necessary to evoke anticonvulsant and muscle relaxant effects. Somewhat higher doses of BZR ligands, inducing sedation and sleep, lead perhaps to the only pharmacologically relevant CNS concentrations (ca. 1 microM) which might be due entirely to increased GABAergic inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

The role of adenosine in the central actions of the benzodiazepines

1. Evidence is presented which indicates that the central actions of the benzodiazepines cannot be fully accounted for by assuming an action only at the GABAA-Cl- channel supramolecular complex. 2. The hypothesis is presented, together with supporting evidence, that inhibition of adenosine uptake can account for many of the actions of the benzodiazepines. 3. New findings showing that Ro 15-1788 and Ro 5-4864 have both potentiative and antagonistic interactions with adenosine are discussed. 4. The proconvulsant beta-carbolines are shown to be adenosine antagonists. 5. The concept that benzodiazepine action may involve several mechanisms is presented.

Effects of anticonvulsants on responses to excitatory amino acids applied topically to rat cerebral cortex

1. Five clinically used anticonvulsants were examined to find out if they block the effects of excitatory amino acids in the cerebral cortex of urethane anaesthetised rats. 2. Compounds were tested by topical application to the cortical surface and following their intraperitoneal injection at anticonvulsant doses. 3. Pentobarbital and diphenylhydantoin blocked the effect of quisqualic acid but only at concentrations higher than the therapeutically relevant levels. 4. Pentobarbital and diphenylhydantoin did not alter the effects of N-methyl-D,L-aspartic acid (NMDLA) or kainic acid. 5. Diazepam prevented the kainic acid-induced development of distorted somatosensory evoked potentials (SEPs) at therapeutically relevant levels. 6. Diazepam had no effect on NMDLA or quisqualic acid. 7. Carbamazepine and chlormethiazole had no effect on NMDLA, kainic acid or quisqualic acid. 8. The anticonvulsive effects of these drugs, with the exception of diazepam, probably do not involve antagonism of endogenous EAAs.

Ro 15-1788 both antagonizes and potentiates adenosine-evoked depression of cerebral cortical neurons

The effects of Ro 15-1788, a benzodiazepine antagonist with some agonist properties, were studied on adenosine and adenosine 5'-N-ethyl-carboxamide (NECA)-evoked depressions of rat cerebral cortical neuronal activity. Iontophoretically applied Ro 15-1788 had both antagonistic and potentiative interactions with adenosine. Reductions in the magnitude of adenosine-evoked depressions of firing were evident during the period of Ro 15-1788 application, with a long-lasting potentiative effect becoming apparent upon termination of the Ro 15-1788 application. Depressions of cell firing evoked by NECA, an uptake-resistant analog of adenosine, were antagonized by Ro 15-1788, with no subsequent potentiation. Larger applications of Ro 15-1788 had a depressant action on neuronal firing, which was antagonized by caffeine (20 mg/kg), an adenosine receptor blocker. These results indicate that Ro 15-1788 may be an antagonist at the adenosine receptor as well as a potentiator of the adenosine response. The prolongation of the adenosine depression is likely to be the result of a persistent inhibition of adenosine uptake by Ro 15-1788. These diverse effects on the adenosine response may account for some of the complex behavioral actions of Ro 15-1788.

The effect of diazepam and Ro 15-1788 on extracellular ascorbic acid, DOPAC and 5-HIAA in the striatum of anaesthetized and conscious freely moving rats, as measured by differential pulse voltammetry

The effects of diazepam (10 mg/kg i.p.) and the central benzodiazepine receptor antagonist, Ro 15-1788 (30 mg/kg i.p.), on extracellular ascorbate, 3,4-dihydroxyphenylacetic acid (DOPAC) and 5-hydroxyindoleacetic acid (5-HIAA) were examined using differential pulse voltammetry in anaesthetized and freely moving rats. In anaesthetized animals, diazepam did not significantly alter the heights of peak 1 (ascorbate) or peak 3 (5-HIAA), but significantly reduced that of peak 2 (DOPAC). In freely moving rats, diazepam greatly reduced the heights of all 3 peaks. Ro 15-1788, injected 2 h after diazepam, reversed the effect of diazepam on peak 3, but not on peaks 1 and 2.

Benzodiazepine receptor ligand actions on GABA responses. Benzodiazepines, CL 218872, zopiclone

The effects on GABA (4-aminobutyric acid) responses of several benzodiazepine and nonbenzodiazepine benzodiazepine receptor ligands were examined using mouse spinal cord neurons in dissociated cell culture. Diazepam, clonazepam and nitrazepam enhanced GABA responses potently at low nanomolar concentrations. Diazepam and clonazepam were most potent with significant enhancement at 1 nM and peak enhancement of 80.7 and 50.2% at 10 nM respectively. Nitrazepam was least potent with no significant enhancement at 1 nM and enhancement of only 20.7% at 10 nM. The benzodiazepine antagonist, Ro 15-1788, blocked enhancement by diazepam but also weakly enhanced GABA responses at low micromolar concentrations, suggesting partial agonist activity. The convulsant benzodiazepine, Ro 5-4864, did not enhance GABA responses at any concentration tested but antagonized GABA responses at 1 microM and above. Diazepam shifted GABA dose-response curves to the left by decreasing the apparent KD but without altering the apparent Vmax (Lineweaver-Burk analysis). Two nonbenzodiazepine anxiolytic/anticonvulsants, CL 218872 and zopiclone, were weak enhancers of GABA responses at high nanomolar concentrations. These results with benzodiazepines, CL 218872 and zopiclone are consistent with their anxiolytic and anticonvulsant profile in vivo and with studies of their effects upon low affinity GABA binding in vitro.

Low-dose benzodiazepine neuronal inhibition: enhanced Ca2+-mediated K+-conductance

The water-soluble inhibitory benzodiazepine, midazolam, was applied in low nanomolar concentrations to CA1 hippocampal neurons in vitro, recorded intracellularly. The drug caused a long-lasting hyperpolarization and moderate conductance increase, which persisted with TTX-induced synaptic blockade or with intracellular injection of Cl- ions, but not in zero Ca2+ perfusate. Calcium spikes elicited in the presence of TTX were enhanced by midazolam. It was concluded that these low nanomolar concentrations, which did not enhance GABA actions, inhibited by augmenting Ca2+ mediated K+-conductance.

The excitatory effects of the specific benzodiazepine antagonist Ro14-7437, measured intracellularly in hippocampal CA1 cells

The specific benzodiazepine antagonist, Ro14-7437, in nanomolar concentrations, caused depolarization, increased spontaneous spiking, and conductance decrease when applied to CA1 cells in vitro. These effects were resistant to intracellularly injected Cl- ions or synaptic blockade by TTX, were prevented in Ca2+-free medium, and occurred with or without prior application of midazolam, an inhibitory benzodiazepine. Ca2+-mediated AHPs and Ca2+ spikes in TTX medium were diminished by the blocker, suggesting that Ro14-7437 acted by inhibiting Ca2+-mediated K+ conductance.

The effects of chlordiazepoxide on synaptic transmission and amino acid neurotransmitter release in slices of rat olfactory cortex

The rat olfactory cortex slice has been used to investigate the effects of chlordiazepoxide on evoked field potentials and the release of endogenous amino acid neurotransmitters (aspartate, glutamate, GABA and possibly taurine) which accompany electrical stimulation of the lateral olfactory tract. When single, low frequency stimuli were employed, chlordiazepoxide (2 microM-1 mM) depressed the amplitude of the field potential correlate of the depolarizing actions of the lateral olfactory tract excitatory transmitter (aspartate?) although aspartate release was unaffected. The field potential correlate of GABA-mediated presynaptic inhibition (late N-wave) was also depressed in amplitude but low drug concentrations (between approximately 2 and 50 microM) increased its peak duration . Effects of chlordiazepoxide on evoked inhibition were analyzed by giving paired stimuli such that the second stimulus occurred during the field potentials evoked by the first stimulus. Chlordiazepoxide (1-20 microM) increased the depression in amplitudes of the presynaptic massed action potential and late N-wave evoked by the second of a pair of stimuli compared with those evoked by the first stimulus suggesting that presynaptic inhibition was potentiated. These effects of chlordiazepoxide were accompanied by a significant reduction in aspartate release from the lateral olfactory tract terminals. Moreover, the drug effects on presynaptic inhibition and aspartate release were antagonized by picrotoxin (5 microM). On the other hand, chlordiazepoxide (1-50 microM) had no significant effect on postsynaptic inhibition. The results are discussed in terms of both the sites (presynaptic or postsynaptic) and mechanisms of action of chlordiazepoxide.

Interactions between the benzodiazepines, methylxanthines, and adenosine

Experimental evidence is cited in support of the proposal that benzodiazepines exert their anxiolytic effects by inhibiting the uptake of adenosine by central neurons and glia.