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Volume 16, Number 23,
Issue of December 1, 1996
pp. 7711-7724
Copyright ©1996 Society for Neuroscience
Multiple NPY Receptors Coexist in Pre- and Postsynaptic Sites:
Inhibition of GABA Release in Isolated Self-Innervating SCN
Neurons
Gong Chen and
Anthony N. van
den Pol
Section of Neurosurgery, Yale University School of Medicine, New
Haven, Connecticut 06520
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
REFERENCES
ABSTRACT
Although NPY has been shown to influence the action of many
transmitters in the brain, modulation of GABA, the primary inhibitory transmitter, has not been detected with electrophysiology. Using whole-cell patch-clamp recording, we found that NPY has a large modulatory effect on GABAergic neurons of the suprachiasmatic nucleus
(SCN) that act as the circadian clock in the mammalian brain. NPY,
acting at both Y1- and Y2-like receptors, reduced the frequency of
spontaneous miniature inhibitory postsynaptic currents while having
little effect on the postsynaptic GABA receptors, suggesting a
presynaptic mechanism of NPY action. In single self-innervating neurons, application of either Y1 or Y2 agonists to the same neuron significantly inhibited the evoked autaptic GABA release. The use of
single-neuron microcultures has allowed the demonstration that a single
peptide, NPY, has two different receptors coded for by different genes
in the same axon terminal. The Y1 and Y2 agonists also inhibited
whole-cell calcium currents when applied to the same neuron, indicating
a coexistence of Y1- and Y2-like receptors in the postsynaptic cell
body. The self-innervating cell model we use here may be applicable
generally for discriminating presynaptic versus postsynaptic actions of
other neurotransmitters and neuromodulators and locating their subtype
receptors.
Key words:
NPY;
GABA;
suprachiasmatic nucleus;
NPY receptor;
Y1-Y5
receptors;
presynaptic;
postsynaptic;
autapse;
microculture
INTRODUCTION
The suprachiasmatic nucleus (SCN) of the
hypothalamus controls circadian rhythms in mammals (Moore and Eichler,
1972 ; Stephan and Zucker, 1972 ; Inouye and Kawamura, 1979 ; Ralph et
al., 1990 ; van den Pol and Dudek, 1993 ). NPY is found in axons in the
SCN that originate in the intergeniculate leaflet (Harrington et al., 1985 ; Card and Moore, 1989 ; Botchkina and Morin, 1995 ). The SCN contains one of the highest concentrations of NPY in the mammalian CNS
(Allen et al., 1983 ; Chronwall et al., 1985 ; Pelletier, 1990 ). Most SCN
neurons are GABAergic (van den Pol and Tsujimoto, 1985 ; Okamura et al.,
1989 ; Moore and Speh, 1993 ), and GABA is found in 50% of all
presynaptic axons in the SCN (Decavel and van den Pol, 1990 ). Many of
these arise from intrinsic axons of the SCN (van den Pol, 1980 ). GABA
may be colocalized with NPY in some SCN axon terminals (Francois-Bellan
et al., 1990 ). NPY administration into the SCN phase shifts the
circadian rhythms (Albers and Ferris, 1984 ; Shibata and Moore, 1993 ),
and the GABA receptor antagonist bicuculline can block this phase shift
(Huhman et al., 1995 ), suggesting a functional interaction between GABA
and NPY in SCN. Although NPY can play an important role in SCN phase
shifts (Albers and Ferris, 1984 ; Moore and Card, 1990 ; Shibata and
Moore, 1993 ), little is known about the cellular mechanisms of NPY
action in the SCN.
NPY may activate different subtypes of receptors. In the past NPY
receptors generally have been divided into two cloned types, Y1 and Y2
(Wahlestedt et al., 1990 ; Herzog et al., 1993 ; Colmers and Bleakman,
1994 ; Gerald et al., 1995 ; Nakamura et al., 1995 ; Rose et al., 1995 ).
With the recent cloning of new NPY receptors, including Y4 (Bard et
al., 1995 ) and two different Y5 receptors, one cloned from
mouse (Y5m, Weinberg et al., 1996 ) and one cloned from
rat (Y5r, Gerald et al., 1996 ), the pharmacology of NPY
actions has become more complicated. However, in some limited respects, Y4 and Y5 receptors show different sensitivity to Y1 and Y2 agonists and can be considered to demonstrate preferential Y1- or Y2-like properties.
NPY is one of the most abundant peptides in the nervous system
(Tatemoto et al., 1982 ; Adrian et al., 1983 ). Cytochemically, NPY
colocalizes with neurotransmitters such as noradrenaline (Simonneaux et
al., 1994 ), GABA (Hendry et al., 1984 ) and other peptides (Chronwall et
al., 1984 ) in presynaptic nerve terminals. NPY receptors modulate neurotransmitter release (Wahlestedt et al., 1986 ; Colmers et al.,
1987 , 1991 ; Wiley et al., 1990 ; Simonneaux et al., 1994 ), hormone and
peptide secretion (McDonald et al., 1985 ; Walker et al., 1988 ; Kalra et
al., 1992 ; Larsen et al., 1994 ; Scheenen et al., 1995 ), whole-cell
calcium currents (Bleakman et al., 1991 ; Wiley et al., 1993 ; McQuiston
et al., 1996 ), and gene expression (Li et al., 1994 ; Garcia de Yebenes
et al., 1995 ) in both peripheral and CNS.
In a previous study based on digital imaging, we found that NPY reduced
GABA-mediated calcium rises in synaptically coupled developing neurons
(Obrietan and van den Pol, 1996 ). In the present study, we investigated
the mechanism and site of action of NPY modulation in SCN neurons at
the single-cell level by using whole-cell patch-clamp recording to
study single self-innervating (autaptic) neurons in a microculture
model. Autaptic connections have been reported in the SCN on the basis
of ultrastructural evidence (Guldner and Wolff, 1978 ) and in other
brain regions such as the cortex (Lubke et al., 1996 ). Autaptic neuron
microcultures have been found to be a useful tool in elucidating
synaptic functions, especially in establishing the amino acid
transmitter identity of living neurons (Furshpan et al., 1986 ; Bekkers
and Stevens, 1991 ; Johnson, 1994 ). Furthermore, the same mechanisms and
neurotransmitters that exist in cultured neurons also have been
detected in homologous regions in vivo or in brain slices.
Single SCN neurons in multicelled cultures express circadian rhythms of
electrical activity similar to the electrical rhythms found in
vivo (Bos and Mirmiran, 1990; Welsh et al., 1995 ). Even
epileptiform electrical activity and long-term potentiation have been
found in single isolated neurons from regions of the brain where the
same phenomena are found in situ (Segal, 1991 , 1994 ; Tong et
al., 1996 ).
In the present paper we use single self-innervating neurons primarily
because they provide a simple model system to study the mechanisms of
action of modulators on neurotransmission in the absence of the large
number of heterogeneous synaptic interactions that occur in brain
slices or in multicelled cultures. This is important in light of the
different NPY responses that have been reported in the SCN with
extracellular recording in slices that include excitation (Mason et
al., 1987 ), inhibition or excitation (Albers et al., 1990 ), or
excitation followed by inhibition (Liou and Albers, 1991 ). We
demonstrate here with single-neuron microcultures that NPY Y1- and
Y2-like receptors coexist in the same SCN neuron and that both
receptors mediate the inhibition of presynaptic GABA release and
postsynaptic whole-cell calcium currents. The single self-innervating
neuron microculture seems to be a useful model to differentiate
presynaptic versus postsynaptic effects of transmitters and their
modulators and to locate subtype receptors in a single neuron.
MATERIALS AND METHODS
Cell culture
Two types of SCN cultures were used in the present study. One
was a multicellular culture with a high density of neurons in the
culture dish that formed a substantial number of synaptic connections.
The other was a microculture of single isolated neurons in
microislands.
Multicellular culture. The multicellular culture of SCN
neurons is similar to previously described cultures of hypothalamic neurons (Chen et al., 1995 ). Briefly, the brain was taken from postnatal 1-d-old Sprague Dawley rats anesthetized with Nembutal and
cut coronally in 400 µm brain slices, and the suprachiasmatic nuclei
were punched out with beveled hollow needles (22 G) or dissected out by
fine forceps from the brain slice containing the chiasma. The SCN
tissues were then incubated for 30-40 min in an enzyme solution
containing 10 U/ml papain, 0.5 mM EDTA, 1.5 mM
CaCl2, and 0.2 mg/ml L-cysteine. After enzyme
treatment, the tissues were washed twice with culture medium and
mechanically triturated in culture medium to dissociate cells. After
centrifuging (1600 rpm) and discarding the supernatant to remove the
debris of dead cells or connective tissues, we resuspended the cells and plated them on the center of coverslips coated with
poly-D-lysine (1 mg/ml) in 35 mm culture dishes. The
culture density was ~50,000 cells/cm2. The culture medium
contained minimal essential medium (Life Technologies, Gaithersburg,
MD) supplemented with 10% fetal calf serum (HyClone, Logan, UT) and
Serum Extender (Collaborative Research, Bedford, MA), 100 U/ml
penicillin/streptomycin, and 6 gm/l glucose. The cultured cells were
maintained in an incubator at 37°C and 5% CO2 for up to
4 weeks and fed twice weekly. Cytosine arabinoside (5 µM)
was added to cultures after 2 d of plating to inhibit the proliferation of astrocytes.
Microculture. Most steps in the formation of microcultures
were similar to those described for the above multicellular cultures. The main differences were that the coverslips were specially treated and the total plating density was very low. The coating of the cover
glass is a modification of previous methods (Furshpan et al., 1986 ;
Bekkers and Stevens, 1991 ; Johnson, 1994 ). The 35 mm coverslips were
covered first with a thin layer of 0.15% agarose solution and allowed
to dry. A slide on which a grid of 81 squares (each 1 × 1 mm) had
been scratched was used as a template and placed under culture dishes
(containing agarose-coated coverslips) to guide the applying of
droplets of poly-D-lysine. A micropipette (tip broken to
20-80 µm), connected with a syringe, was filled with
poly-D-lysine solution (0.5 mg/ml) and used to apply a
microdrop of the solution to the center of each grid square on the
cover glasses. The water in each microdrop evaporated within a few
minutes, and dots of poly-D-lysine, with a diameter of
100-500 µm, provided an adhesive substrate for neurons. A very low
density of cells (~2000-5000 cells/cm2) was plated on the
cover glasses containing the poly-D-lysine dots. Only those
neurons sitting on the poly-D-lysine dots survived. There
were usually 1-8 neurons falling on each poly-D-lysine dot after plating. Two weeks later, ~3-6 dots (microislands) in each dish
contained only a single neuron, usually accompanied by astrocytes confined within the dots. In some microcultures, astrocytes
(8000-10,000/cm2) were plated 2 d before plating
neurons onto coverslips containing dots of poly-D-lysine to
help neuronal growth. There were no perceptible differences between the
microcultures with and without preplated astrocytes, probably because
all the surviving neurons in the microcultures without preplated
astrocytes also were accompanied by astrocytes coming from the
dissociated tissues. Cytosine arabinoside (5 µM) was
added to cultures on the fourth day of plating neurons (or astrocytes)
to arrest astrocyte proliferation. The microcultures were maintained
similarly to the mass cultures and fed once weekly. The
electrophysiological recording usually was performed in microcultures older than 19 d in vitro (DIV).
Intracellular labeling and staining. A typical SCN neuron
microculture is illustrated in Figure 2A. The neuron
was filled with 1% biocytin during whole-cell recording. After
filling, cells were fixed in 4% paraformaldehyde and 0.1%
glutaraldehyde for several hours. Plasma membranes were permeabilized
with 0.3% Triton X-100 and labeled with an avidin-horseradish
peroxidase complex (Vector Labs, Burlingame, CA). After washing in PBS,
cultures were incubated in diaminobenzidine and hydrogen peroxide until the labeled cells were brown. This reaction product was then
intensified with 0.1% osmium tetroxide for 1 min. Cells not filled
with biocytin showed no color, and labeled cells had a dark brown or
black appearance.
Fig. 2.
NPY reversibly blocks the evoked autaptic GABA
release in single-neuron microcultures. A, A single SCN
neuron in a microisland culture. The neuron was filled by biocytin
during whole-cell recording and stained with avidin-HRP.
B, C, Action potentials and the following autaptic IPSPs initiated by a brief current injection (2 msec, 20 pA)
recorded in the single neuron illustrated in A.
B, The evoked autaptic IPSP was reversibly blocked by
bicuculline (BIC, 30 µM).
C, The evoked autaptic IPSP also was reversibly blocked by NPY (200 nM).
[View Larger Version of this Image (24K GIF file)]
Electrophysiological recording
Whole-cell voltage-clamp and current-clamp recordings were made
with an Axoclamp-2B amplifier (Axon Instruments, Foster City, CA) or a
List EPC-7 amplifier. Patch pipettes were pulled from thin-wall
borosilicate glass (World Precision Instruments, Sarasota, FL). The
pipette resistance after filling with the electrode solution was 4-6
M . The seal resistance was ~10 G after forming a tight seal.
The series resistance after breaking through the tip membrane patch was
15-28 M and partially (40-60%) compensated by the amplifier. Data
were acquired with AxoData software (Axon Instruments) and processed by
Axograph software (Axon Instruments) and Igor Pro software
(WaveMetrics) on an Apple Macintosh computer. The data sampling rate
was 1-10 kHz, filtered at 1 kHz by an 8-pole Bessell filter (Frequency
Devices, Haverhill, MA). The presynaptic release in an autaptic neuron
was evoked by a brief positive current injection (2 msec, 10-40 pA) in
current-clamp mode or a voltage pulse (2 msec, 60-70 mV) in
voltage-clamp mode. In some voltage-clamp experiments, the capacitance
current induced by the brief voltage pulse was subtracted by using P/4
protocol (see below). The postsynaptic GABA response was evoked by a
brief pressure ejection of GABA (50 µM, 50 msec, 4-7.5
psi), through a micropipette (2-3 µm tip diameter) connected to a
pneumatic microinjector (Narishige USA, Greenvale, NY) under computer
control. The recording chamber was perfused constantly by bath solution
at a rate of 1.5-2 ml/min. NPY, its analogs, and bicuculline were
applied mainly through a series of glass flow pipes (400 µm inner
diameter) fed by gravity. Alternatively, these drugs occasionally were
applied by adding them to the perfusing solution. Experiments were
performed at room temperature (22°C), as done in previous studies
(Bekkers and Stevens, 1991 ; Tong et al., 1996 ). The data are reported
as mean ± SEM, and paired Student's t tests were used
in comparing two groups of data.
Solutions
The standard bath solution contained (in mM): 162.5 NaCl, 2.5 KCl, 2 CaCl2, 10 HEPES, and 10 glucose, pH 7.3. TTX (1 µM) and AP5 (100 µM)/CNQX (10 µM) were added into bath solution when spontaneous GABA
activity was recorded. Two types of pipette solutions were used to
record GABA-mediated events (spontaneous or evoked). One contained (in
mM): 145 KMeSO4, 1 MgCl2, 10 HEPES,
2 K4-BAPTA, 4 Mg-ATP, and 0.5 Na2-GTP, pH 7.3. When this pipette solution is used, the reversal potential for
GABA-gated Cl channels is more negative than the resting
membrane potential and resulted in the normal direction of IPSPs or
IPSCs. The other pipette solution contained (in mM): 145 KCl, 10 HEPES, 2 K4-BAPTA, 4 Mg-ATP, and 0.5 Na2-GTP, pH 7.3. With this pipette solution, the reversal
potential for GABA-gated Cl channels is close to 0 mV and
resulted in an opposite direction of IPSPs or IPSCs to the normal
direction. The advantage of the KCl-based pipette solution is to
provide a greater driving force for the GABA-gated Cl
channels and increase the amplitude of recorded IPSPs or IPSCs. For the
recording of whole-cell barium currents, the bath solution contained
(in mM): 114.5 NaCl, 40 TEA-Cl, 2.5 KCl, 5 BaCl2, 10 HEPES, and 10 glucose plus 1 µM
TTX, pH 7.3; the pipette solution contained 135 CsCl, 2 K4-BAPTA, 10 HEPES, 4 Mg-ATP, 0.5 Na2-GTP, and
10 creatine phosphate, plus 50 IU/ml creatine phosphokinase, pH 7.3. The sodium and potassium currents were blocked by TTX and the
combination of TEA+, Ba2+, and Cs+.
The leak current and the capacitance current were subtracted by a P/4
protocol, i.e., four subpulses with opposite direction and 1/4
amplitude of the main command voltage pulse were applied to induce leak
and capacitance currents and then subtracted from the main evoked
current.
Pharmacological agents
GABA, ( )-bicuculline methiodide (BIC),
D,L-2-amino-5-phosphonopentanoic acid (AP5),
cyano-2,3-dihydroxy-7-nitroquinoxaline (CNQX), tetrodotoxin (TTX),
tetraethylammonium hydrochloride (TEA-Cl), Mg-ATP, phosphocreatine, and
phosphocreatine kinase were purchased from Sigma (St. Louis, MO).
Neuropeptide Y (NPY, porcine), [Leu31,
Pro34]-NPY, NPY 13-36, and PYY were obtained from
Peninsula Labs (Belmont, CA).
RESULTS
NPY inhibits GABAergic spontaneous activity
Although NPY has been found to inhibit noradrenergic,
acetylcholinergic, and glutamatergic neurotransmission in some neuronal systems, direct evidence of NPY modulation of GABA, the most important inhibitory transmitter in the CNS, is lacking. In cultured SCN neurons,
inhibitory GABAergic events dominated spontaneous activity. NPY (80 nM, 2-4 min) substantially inhibited the GABA-mediated spontaneous activity, as shown in Figure
1A. Four successive traces in each
condition of control, NPY application, and after wash are displayed in
Figure 1A1. The frequency, but not the amplitude, of
spontaneous events was reduced significantly by NPY, and the inhibition
was reversible. TTX (1 µM) was maintained in the bath solution to prevent action potential-dependent release of GABA. Glutamate receptor antagonists AP5 (100 µM) and CNQX (10 µM) also were included in the bath solution to abolish
excitatory events. The spontaneous GABAergic events are upward in the
current-clamp mode because of the KCl-based pipette solution, and all
of these events were blocked by bicuculline (30 µM), a
GABAA receptor antagonist (see Fig. 4). Data from 10 neurons examined are summarized in Figure 1A2. NPY
(80 nM) reduced the frequency of spontaneous activity to
51.5 ± 6.1% of the control (p < 0.01, paired t test) with little effect on the amplitude of the
spontaneous events, suggesting a presynaptic mechanism of the NPY
action. In 4 of 10 neurons, the reduction of the frequency of
spontaneous activity showed continuing recovery, but not full recovery,
after 20 min of buffer rinse of NPY. Although long-term experiments
were beyond the scope of the current work, these preliminary
observations were consistent with our previous finding in immature SCN
neurons that NPY may have exerted long-lasting effects on GABA release
(Obrietan and van den Pol, 1996 ).
Fig. 1.
NPY reduces mIPSP frequency but has little effect
on postsynaptic GABA responses. A1, Consecutive traces
showing that NPY (80 nM) reduced the miniature inhibitory
postsynaptic potentials (mIPSPs) in the presence of TTX (1 µM) and glutamate receptor antagonists AP5 (100 µM) and CNQX (10 µM). The upward IPSPs are attributable to a KCl-based pipette solution. A2,
Quantification indicating that NPY depressed the mIPSP frequency to
approximately one-half of the control (p < 0.01). B, NPY has little effect on postsynaptic GABA
responses. B1, Pressure-ejected (5 psi, 50 µM) GABA-induced postsynaptic responses before, during,
and after the application of NPY (200 nM).
B2, Quantitative illustration of the null effect of NPY
on postsynaptic GABA responses (p > 0.1).
[View Larger Version of this Image (21K GIF file)]
Fig. 4.
Both NPY Y1- and Y2-like receptors mediate the
inhibition of miniature spontaneous GABA activity. A,
Superimposed four consecutive traces illustrating
control mIPSCs in the presence of TTX and AP5/CNQX. B,
NPY Y1 receptor agonist, [Leu31, Pro34]-NPY
(80 nM) reduced the mIPSC frequency. C, The
inhibition of [Leu31, Pro34]-NPY was
reversible. D, NPY Y2 receptor agonist NPY 13-36 (80 nM) also reduced the mIPSC frequency recorded from the same
neuron. E, All of the mIPSCs were abolished by 30 µM bicuculline. F, Quantitative analysis
showing that both [Leu31, Pro34]-NPY and NPY
13-36 significantly reduced the mIPSC frequency to <60% of the
control.
[View Larger Version of this Image (33K GIF file)]
To address directly the question of whether NPY inhibited the
postsynaptic GABA receptors, we used a pneumatic microinjector to
pressure-eject GABA (50 µM) onto neurons through a
micropipette (2-3 µm tip). A typical example is illustrated in
Figure 1B. NPY (200 nM) applied for ~2
min had little effect on the GABA-evoked postsynaptic responses (Fig.
1B1). Data shown in Figure 1B2 are from all 13 neurons examined. NPY had no consistent effect on postsynaptic GABA receptor responses. In 4 of 13 neurons, we observed an increase of ~20%, rather than a decrease, in the GABA response after NPY application, whereas in three neurons there was a 10-13% decrease of the GABA response after NPY application. In the other six
neurons, the GABA responses were not affected by NPY. Together, after
normalizing the control response as 100%, the relative response to
GABA in the presence of NPY was 103.7 ± 3.5%, not significantly different from the control (p > 0.1). This
indicates that NPY inhibits the GABA neurotransmission of SCN neurons
mainly via a presynaptic mechanism.
The effect of NPY on cell input resistance was examined by injecting a
series of current pulses to evoke a series of voltage changes in the
current-clamp mode. In eight neurons tested, NPY (80-200
nM) had little effect on the cell input resistance. The average cell input resistance before and during NPY application was
1.3 ± 0.2 and 1.2 ± 0.2 G , respectively. The effect of
NPY on the resting membrane potential was examined also. In 11 neurons tested, NPY (80-200 nM) slightly hyperpolarized 8 neurons,
depolarized 2 neurons, and had no effect on 1 neuron. The average
resting potentials before and after NPY application were 58.0 ± 1.6 and 59.7 ± 1.7 mV, respectively.
Presynaptic inhibition of NPY on autaptic GABA release
Previous studies on the mechanism of NPY action were performed in
mass cell cultures or brain slices (Wahlestedt et al., 1986 ; Walker et
al., 1988 ; Colmers et al., 1991 ; Bleakman et al., 1992 ; Simonneaux et
al., 1994 ; Obrietan and van den Pol, 1996 ). Because results were
obtained from a net of many neurons, it is difficult to know how NPY
acts on a single neuron and whether NPY Y1 and Y2 subtype receptors
cofunction in the same neuron. The present study used single-neuron
microcultures in which a single neuron in a microisland formed synapses
with itself. In our single-neuron microcultures of SCN cells, 47 neurons showing autaptic responses were GABAergic and only 4 neurons
were not, confirming that the majority of SCN neurons are GABAergic.
Figure 2A shows a typical single
autaptic SCN neuron in a microisland culture, filled with biocytin
during electrophysiological recording and fixed and stained with
avidin-HRP after the completion of experiments. Traces shown in Figure
2B,C are electrical responses recorded from the
illustrated neuron. The neuron was current-clamped, and a brief
positive current injection (20 pA, 2 msec) invariably evoked a single
action potential, followed by a large evoked IPSP (Fig.
2B, control trace). The IPSP was
reversibly blocked by 30 µM bicuculline (BIC,
Fig. 2B, middle trace), indicating its
GABAergic origin. Figure 2C shows that NPY (200 nM) reversibly blocked the GABAergic IPSP. In the presence
of NPY, the large IPSP that follows the action potential was totally
eliminated. Similarly, NPY (200 nM) totally blocked the
evoked GABA response in another two autaptic neurons and, in a fourth
neuron, reduced the autaptic GABA response to 28% of the control. In
only one neuron tested did NPY have no effect on the evoked autaptic
response. Thus, NPY strongly inhibits presynaptic GABA release in
single SCN neurons.
A traditional way to identify a presynaptic versus a postsynaptic
effect of a chemical is to examine its effect on the frequency of
miniature spontaneous activity and postsynaptic responses, as
illustrated in Figure 1. In studying the mechanism of NPY action, we
found that single-neuron microcultures are ideal for discriminating a
presynaptic versus a postsynaptic effect of neurotransmitters or
neuromodulators. Figure 3 illustrates such a scenario,
in which a presynaptic and/or a postsynaptic effect are evident
concurrently after a single application of NPY. Autaptic transmitter
release was evoked by a brief voltage pulse (2 msec, 60 mV) under
voltage-clamp (holding potential = 60 mV) condition. A
postsynaptic response was evoked by a brief pressure ejection (50 msec,
5 psi) of 50 µM GABA onto the recording neuron under
computer control. Figure 3A shows both an evoked autaptic
response and a postsynaptic GABA response in the same sweep. In Figure
3B, NPY (200 nM) abolished the presynaptic
response while leaving the postsynaptic response unaffected. The box in
Figure 3B demonstrates that the sodium action current was
not blocked by NPY. Figure 3C illustrates that the NPY
inhibition is reversible. In Figure 3D, bicuculline (30 µM) blocked both the pre- and postsynaptic responses,
indicating that both are mediated by GABAA receptors.
Similar results were obtained in two other single autaptic neurons.
This is the first time that NPY has been demonstrated to inhibit
synaptic neurotransmission by acting only presynaptically, but not on
postsynaptic receptors in a single neuron.
Fig. 3.
NPY inhibits presynaptic GABA release, but not the
postsynaptic GABA response, in the same autaptic SCN neuron.
A, Presynaptically released GABA (triggered by 2 msec,
60 mV voltage pulse) induced IPSC and pressure-ejected GABA-evoked
response in the same recording. B, NPY (200 nM) eliminated the presynaptic release but did not affect
the postsynaptic response. The box shows the sodium
action current in the presence of NPY. C, The inhibition
of NPY on presynaptic release was reversible. D,
Bicuculline abolished both the pre- and the postsynaptic GABA
responses. Capacitance currents and action currents were
truncated.
[View Larger Version of this Image (16K GIF file)]
Both NPY Y1- and Y2-like receptors coexist in the same
SCN neuron
A further question regarding presynaptic NPY inhibition is,
through which subtype NPY receptor does NPY act? We pursued this question initially by examining the effect of NPY Y1 and Y2 receptor agonists on the miniature spontaneous activity in multicelled cultures.
Although recent evidence has revealed several NPY receptors, they have
differential sensitivities to activation by [Leu31,
Pro34]-NPY (Y1-like: Y1, Y4, Y5) and NPY13-36 (Y2-like:
Y2). Y5m and Y5r show greater sensitivity to [Leu31,
Pro34]-NPY but also respond weakly to NPY13-36 (Gerald et
al., 1996 ; Weinberg et al., 1996 ). As in the experiments shown in
Figure 1A, TTX and AP5/CNQX were included in the bath
solution to prevent action potential-mediated release of transmitters
and to block glutamate receptors. Figure
4A-E shows a typical example of the effect of Y1 agonist [Leu31, Pro34]-NPY (80 nM) and Y2 agonist NPY 13-36 (80 nM) on the
spontaneous activity. Both agonists reduced the frequency, but not the
amplitude, of the spontaneous events, and for both the inhibition were
reversible. Bicuculline eliminated all the spontaneous events,
indicating their GABAergic properties. The spontaneous events were
inward in voltage clamp because of the use of a KCl-based pipette
solution. The general effect of Y1 and Y2 receptor agonists is
summarized in Figure 4F. By normalizing the frequency
of the spontaneous activity in the control condition to 100%,
[Leu31, Pro34]-NPY (80 nM)
reduced the frequency to 59.3 ± 5.5% of the control (p < 0.01, n = 11), and NPY
13-36 (80 nM) reduced the frequency to 57.4 ± 9% of
the control (p < 0.05, n = 10).
For both agonists the inhibition was significant and reversible. These
experiments demonstrate that NPY inhibits the GABA neurotransmission in
SCN neurons through both Y1- and Y2-like receptors.
The above experiments on multicellular cultures demonstrated that both
NPY Y1- and Y2-like receptors are involved in the action of NPY on SCN
cells. However, whether the two subtype receptors coexist in the same
neuron or are distributed among different neurons was not clear. A
single-neuron microculture provides an opportunity to study the
distribution of Y1- and Y2-like receptors in single neurons. In total,
30 single autaptic neurons were examined to study the effect of
[Leu31, Pro34]-NPY (80 nM) and
NPY 13-36 (80 nM) on the evoked autaptic responses. In all,
9 of 30 neurons showed no reduction or <10% reduction in the evoked
responses by both agonists. Different neurons showed different
sensitivity to Y1 and Y2 agonists. [Leu31,
Pro34]-NPY reduced the evoked response by up to 88%, and
NPY 13-36 reduced the response by up to 84%. Some neurons were more
sensitive to the Y1 agonist and less sensitive to the Y2 agonist, some
showed the opposite response, and some were equally sensitive to both agonists. The sequential application of Y1 and Y2 agonists was random
among neurons. Some neurons were given the Y1 agonist first and then
the Y2 agonist, and in others the opposite procedure was used. In most
cases, the first application gave the larger inhibition, but in some
cases the second application produced larger inhibition. Figure
5A illustrates a representative of the action
of both [Leu31, Pro34]-NPY and NPY 13-36 in
the same autaptic neuron. Both agonists were applied for 2 min, and the
evoked responses were reduced gradually during the application of the
agonists. The recording traces corresponding to the four points in the
graph (i, ii, iii, iv) are illustrated
on the top panel. Both [Leu31, Pro34]-NPY and
NPY 13-36 substantially inhibited the evoked response in the same
neuron, indicating the coexistence of Y1 and Y2 receptors in the
presynaptic nerve terminals. In this particular neuron, the inhibition
through Y1 receptors was larger than through Y2 receptors. Figure
5B summarizes the data of the 21 neurons sensitive to
[Leu31, Pro34]-NPY and NPY 13-36 and also the
data on NPY (80 nM) and PYY (80 nM).
[Leu31, Pro34]-NPY reduced the evoked
response by 48.7 ± 7.0% (p < 0.002;
n = 15), and NPY 13-36 reduced the evoked response by
30.4 ± 6.5% (p < 0.02; n = 14). NPY reduced the response by 41.4 ± 10.7%
(p < 0.02; n = 10). PYY reduced
the evoked response in one neuron by 100% and by 39% in another
neuron. The strong inhibitory effect of PYY reduces the possibility of
a significant involvement in these neurons of a putative Y3 subtype of
NPY receptor that is insensitive to PYY (Colmers and Bleakman, 1994 ).
Fig. 5.
NPY Y1 and Y2 agonists both inhibit the evoked
autaptic GABA release in the same single SCN neuron. A,
[Leu31, Pro34]-NPY (80 nM) and
NPY 13-36 (80 nM) both substantially inhibited the evoked
autaptic IPSC. The recording traces on the top
panel correspond to the four points (i,
ii, iii, iv) in the graph below. B, Group data showing the reduction of the evoked IPSC
by NPY, [Leu31, Pro34]-NPY, NPY 13-36, and
PYY.
[View Larger Version of this Image (27K GIF file)]
Inhibition of whole-cell barium currents
Previous studies suggest that an inhibition of calcium currents
may underlie the inhibition of synaptic transmitter release (Colmers et
al., 1988 ; Walker et al., 1988 ; Toth et al., 1993 ). We therefore
explored whether the inhibition of NPY on GABA neurotransmission was
mediated by an inhibition of calcium currents in SCN neurons and
whether Y1- or Y2-like receptors were involved in the inhibition of the
calcium currents. The recorded neurons were held at 80 mV, and a
command pulse (80 mV, 40 msec) was applied to evoke a barium current
(through voltage-activated calcium channels). As in the effect on the
autaptic release, both Y1 and Y2 agonists were found to inhibit the
whole-cell barium currents (IBa) in SCN neurons.
Also similar to the autaptic release, Y1 and Y2 agonists produced
different inhibition of IBa in different
individual neurons. A typical example of the effect of both agonists in
the same neuron is shown in Figure 6. A1
shows that NPY 13-36 substantially suppressed the
IBa, and the suppression was reversible.
B1 shows that in the same neuron [Leu31,
Pro34]-NPY also reversibly inhibited the
IBa, although much less than did NPY 13-36. A2 and B2 illustrate the I-V curves
of IBa before and after the application of NPY
13-36 and [Leu31, Pro34]-NPY. Except for the
reduction of IBa by both agonists, the shape of
the I-V curves was not changed by either NPY 13-36 or
[Leu31, Pro34]-NPY. The potential at which
the IBa reached the peak was ~0 mV, and the
reversal potential for IBa was approximately +50
mV, not altered by NPY 13-36 and [Leu31,
Pro34]-NPY. Figure 7A
illustrates the typical time course of the action of NPY 13-36 and
[Leu31, Pro34]-NPY on the
IBa. The IBa was reduced
within 20 sec of the application of either agonist. In this particular
neuron, in contrast to the one shown in Figure 6, [Leu31,
Pro34]-NPY produced a greater inhibition than NPY 13-36. The inhibitory effect usually was washed out within 1-2 min, faster
than the recovery of the evoked release. CdCl2 (100 µM) reversibly abolished the IBa
(n = 4). The overall reduction of
IBa by NPY 13-36 (80 nM) and
[Leu31, Pro34]-NPY (80 nM) and by
NPY (80 nM) and PYY (80 nM) is summarized in
Figure 7B. NPY reduced the IBa by
32.9 ± 7.3% (p < 0.02; n = 7). [Leu31, Pro34]-NPY reduced the
IBa by 42.6 ± 7.1%
(p < 0.001; n = 18). NPY 13-36 reduced the IBa by 36.7 ± 7.2%
(p < 0.001; n = 17). PYY reduced the IBa by 23.2 ± 5.1%
(p < 0.01; n = 5). All 36 neurons (9-30 DIV) examined showed a reduction in the
IBa by NPY or its analogs, confirming a robust
expression of NPY receptors, including both Y1- and Y2-like receptors,
in SCN neurons. No developmental changes in NPY inhibition of
IBa and GABA release were observed in cultured
neurons examined.
Fig. 6.
NPY Y1- and Y2-like receptors mediate the
inhibition of whole-cell barium currents in the same SCN neuron.
A, Inhibition by Y2 agonist NPY 13-36 (80 nM). A1, Barium currents
(IBa) evoked by test potential from 80 mV
to 0 mV before, during, and after the application of NPY 13-36. A2, I-V curve of the
IBa before and during NPY 13-36 application.
B, Inhibition of IBa by Y1
agonist [Leu31, Pro34]-NPY (80 nM) in the same neuron. B1,
IBa before, during, and after the
application of [Leu31,
Pro34]-NPY. B2, I-V
curve IBa before and during
[Leu31, Pro34]-NPY
application. Notice that NPY 13-36 produced greater inhibition than
[Leu31, Pro34]-NPY in this
neuron. Neither NPY 13-36 nor [Leu31,
Pro34]-NPY changed the I-V relationship of
the barium currents.
[View Larger Version of this Image (24K GIF file)]
Fig. 7.
Time course of the action of Y1 and Y2 agonists on
barium currents. A, Typical example showing the rapid
inhibition by and the rapid recovery of IBa
after the application of NPY 13-36 and [Leu31,
Pro34]-NPY. IBa was inhibited
within 20-30 sec on application of NPY 13-36 or [Leu31,
Pro34]-NPY and returned to the control level within 2 min
after washing out the agonists. In this neuron, [Leu31,
Pro34]-NPY produced greater inhibition than NPY 13-36. B, Summarized data showing the reduction of
IBa by NPY, [Leu31,
Pro34]-NPY, NPY 13-36, and PYY. The amount of reduction in
IBa was comparable to the reduction in the
evoked IPSC (see Fig. 5).
[View Larger Version of this Image (19K GIF file)]
Inhibition of IPSC and IBa in the same
SCN neuron
Because both the presynaptic release and the whole-cell barium
currents were inhibited by Y1- and Y2-like receptor agonists, a logical
question is whether there is any correlation between these two
inhibitory actions. We therefore examined the effect of NPY analogs on
both the evoked release and the barium currents in the same
self-innervating neuron. Figure 8 shows the results of
one such experiment. The effect of [Leu31,
Pro34]-NPY (80 nM) and NPY 13-36 (80 nM) was examined first on the evoked IPSCs and then on the
IBa. Figure 8A illustrates the
recording traces of the evoked IPSCs and the
IBa, corresponding to those points specified in
Figure 8B. Both the evoked IPSCs and the
IBa were inhibited by [Leu31,
Pro34]-NPY and NPY 13-36. The relative amount of reduction
in the amplitude of the evoked IPSCs by [Leu31,
Pro34]-NPY ( 83%) and NPY 13-36 ( 77%) correlated with
the reduction of IBa ( 89% and 52%,
respectively). The reduction and the recovery of
IBa seemed to be rapid, whereas those of the
evoked IPSCs were relatively gradual. Similar results were observed in
four other single autaptic neurons on the inhibition of both the evoked
IPSCs and the IBa by NPY analogs. The overall
correlation coefficient between the reduction of IPSCs and
IBa among the five neurons examined was positive
(r = 0.56). The recorded whole-cell barium currents
were evoked mainly through calcium channels at the cell body. Because
of the technical difficulties in using patch pipettes to record
directly from single boutons, we cannot directly measure calcium
currents at the presynaptic terminals. However, on the working
assumption that NPY exerts similar actions in the terminal and
perikaryon of the same cell, NPY inhibition of presynaptic GABA release
may be mediated by inhibition of calcium channels in the presynaptic
nerve terminals.
Fig. 8.
Inhibition of both barium currents and the evoked
autaptic GABA release in the same SCN neuron. A,
Recording traces showing the inhibition of the evoked
IPSCs and the IBa by [Leu31,
Pro34]-NPY and NPY 13-36. Each trace
corresponds to a point in B.
B, Comparison between the inhibition of the evoked IPSC
and the IBa by [Leu31,
Pro34]-NPY and NPY 13-36 in the same neuron. Note that the
relative amount of the inhibition of the evoked IPSC is proportional to the amount of the inhibition of the IBa. The
time course of the inhibition and the recovery of the evoked IPSC is
slower than and follows the IBa.
[View Larger Version of this Image (22K GIF file)]
DISCUSSION
The present study with SCN neurons provides for the first time
direct electrophysiological evidence that NPY modulates inhibitory GABA
neurotransmission in the CNS. Studies in other regions of the brain,
for instance in hippocampal slices, found that NPY selectively inhibits
excitatory glutamatergic release without a direct effect on GABA
release (Klapstein and Colmers, 1993 ).
Coexistence of NPY Y1- and Y2-like receptors in the same
SCN neuron
The most striking results of the present study are the coexistence
of NPY Y1- and Y2-like receptors in both presynaptic axon terminals and
postsynaptic neuronal soma of the same GABAergic cell and the
demonstration that both Y1- and Y2-like receptors mediate the
inhibition of presynaptic GABA release and whole-cell calcium (barium)
currents in SCN neurons. These results would not be achieved without
the use of single self-innervating neuron microcultures. Our present
study indicates two advantages of such single-neuron microcultures in
identifying presynaptic versus postsynaptic effects of
neurotransmitters and neuromodulators and in locating and
discriminating their (subtype) receptors. Previous studies have
indicated that more than one NPY subtype receptor might exist in some
preparations. In rat nodose neurons, both Y1 and Y2 receptor agonists
modulate calcium currents, although with opposite effects (Wiley et
al., 1993 ). In the rat pineal gland, NPY inhibited presynaptic
noradrenaline release via the activation of Y2 receptors, but it
decreased cyclic AMP elevation induced by -adrenaline through a Y1
receptor pathway (Simonneaux et al., 1994 ), although it is not known
whether Y1 and Y2 receptors were in the same cell. In rat dentate
granule cells, NPY inhibited calcium currents mainly by the activation
of Y1 receptors but also via Y2 receptors in some neurons (McQuiston et
al., 1996 ). In both nodose neurons and dentate granule neurons, only
30% of neurons responded to both Y1 and Y2 receptor agonists.
In contrast, in the present study almost all of the NP4-sensitive SCN
neurons responded to both agonists. The whole-cell barium currents were
inhibited in most neurons tested for Y1 and Y2 agonists, although
different individual neurons showed different sensitivities to each
agonist. This suggests a substantial expression of both Y1- and Y2-like
receptors in SCN neurons, at least in the neuron soma. In addition to
the inhibition of whole-cell barium currents, the evoked presynaptic
GABA release assessed in single autaptic neurons in microcultures also
was inhibited by both Y1 and Y2 agonists in the majority of SCN neurons
(>70%), indicating a coexistence of Y1- and Y2-like receptors at
presynaptic nerve terminals of the same SCN neuron. Furthermore, both
the presynaptic release and whole-cell barium currents were inhibited
by Y1 and Y2 agonists in the same neuron. These experiments demonstrate
that NPY Y1- and Y2-like receptors coexist in both presynaptic nerve
terminals and the postsynaptic cell body in SCN neurons, as depicted by the diagram in Figure 9. The recent demonstration that
Y4 and Y5 receptors are expressed in the SCN (Bard et al., 1995 ; Gerald et al.; 1996; Weinberg et al., 1996 ) suggests that they could contribute substantially to the effects detected in the present experiment. NPY Y1 and Y4 receptors show greater activation by the
agonist [Leu31, Pro34]-NPY and Y2 receptors
by NPY13-36, but not [Leu31, Pro34]-NPY. Y5r
(Gerald et al., 1996 ) and Y5m (Weinberg et al., 1996 ) have a greater
sensitivity to the Y1 agonist but also have a mild (10-15 times
smaller) response to the Y2 agonist. Our previous work showing that the
NPY agonist PYY3-36 evoked a large postsynaptic depression of glutamate
actions in the SCN (van den Pol et al., 1996 ) is consistent with the
expression of the Y5r receptor. However, a single NPY receptor such as
Y5r could not account for responses to both Y1 and Y2 agonists, because
the results in the present study demonstrate that some SCN neurons are
more sensitive to the Y2 agonist and less to the Y1 agonist, some are
the reverse, and some are equally sensitive to Y2 and Y1 agonists.
These data indicate that the relative expression of multiple NPY
receptors differs between SCN neurons. As agonists and antagonists that are more selective for the different NPY receptors become available, their use in the SCN should clarify further the roles of the different NPY receptors found here.
Fig. 9.
Schematic diagram showing the coexistence of NPY
Y1- and Y2-like receptors in both the presynaptic nerve terminals and
the postsynaptic cell body.
[View Larger Version of this Image (20K GIF file)]
Inhibition of calcium currents
NPY has been demonstrated to inhibit whole-cell calcium (or
barium) currents or calcium influx in a number of neurons, mainly peripheral neurons such as rat dorsal root ganglion cells (Walker et
al., 1988 ; Ewald et al., 1989 ; Bleakman et al., 1991 ), rat myenteric
plexus neurons (Hirning et al., 1990 ), rat nodose ganglion neurons
(Wiley et al., 1993 ), rat superior cervical ganglion neurons (Foucart
et al., 1993 ; Toth et al., 1993 ), and central neurons such as rat
dentate granule cells (DGC; McQuiston et al., 1996 ). NPY inhibition
seems to be mediated by different NPY receptors in different types of
neurons. For example, in DGCs, NPY inhibited calcium currents mainly
through Y1-like receptors, and in less than one-third of the cells
Y2-like receptors were also involved (McQuiston et al., 1996 ). In
dorsal root ganglion neurons, NPY inhibited barium currents via a
Y2-like receptor (Bleakman et al., 1991 ). In nodose neurons, both Y1-
and Y2-like receptors were involved in modulating calcium currents but
with opposite actions, i.e., Y2 receptor agonist decreased calcium
currents, whereas Y1 receptor agonist increased calcium currents (Wiley et al., 1993 ). In contrast to previous studies, we demonstrate in the
present paper that both Y1- and Y2-like receptors coexist in the same
SCN neuron and both inhibit barium currents. Furthermore, SCN neurons
seem to be more sensitive to NPY than DGCs are. NPY inhibited only
20-30% of the calcium current (and less with barium currents) at a
high NPY concentration of 1 µM in DGCs (McQuiston et al.,
1996 ), whereas in the present study NPY inhibited 40-50% of barium
currents at a low concentration of 80 nM in SCN neurons. The site of NPY action is also different between neurons in the hippocampus and in the hypothalamus. In hippocampal pyramidal neurons,
NPY had no effect on barium currents but had an inhibitory effect on
presynaptic glutamate release (Bleakman et al., 1992 ). In DGCs, NPY had
an inhibitory effect on calcium currents but no effect on presynaptic
release (Klapstein and Colmers, 1993 ; McQuiston et al., 1996 ). In
contrast, the present study demonstrates that NPY inhibited both the
presynaptic GABA release and the whole-cell barium currents in SCN
neurons.
With digital calcium imaging, we showed an inhibitory effect of NPY on
GABA-mediated calcium rises in developing hypothalamic neurons
(Obrietan and van den Pol, 1996 ). This was based on a mechanism
involving a depolarized Cl reversal potential (Chen et
al., 1996 ) in which NPY inhibited GABA-mediated depolarizations
(Obrietan and van den Pol, 1996 ). In the present study, we show that
NPY can directly modulate voltage-gated calcium channels, independent
of GABA actions. In contrast to the presynaptic release, the whole-cell
barium currents responded rapidly to NPY and its analogs and also
recovered quickly after peptide washout. The inhibition of presynaptic
release by NPY was gradual, taking a longer time to reach its minimum
amplitude than the inhibition of whole-cell barium currents and usually taking longer to recover. This long-latency recovery of GABA release may serve as a partial mechanistic explanation for the NPY-mediated extended depression of GABA-raised calcium levels in developing SCN
neurons (Obrietan and van den Pol, 1996 ).
The primary excitatory input to the SCN is glutamatergic, both from
retina and nonretinal sources (Kim and Dudek, 1991 ), and glutamate has
been shown to raise the cytosolic calcium of SCN neurons (van den Pol
et al., 1992 ). A large proportion of glutamate-evoked calcium rises is
attributable to the opening of voltage-gated calcium channels. The
direct NPY inhibition of calcium currents demonstrated in the present
paper would serve to reduce glutamate-mediated calcium rises in SCN
perikarya (van den Pol et al., 1996 ), potentially serving to reduce the
effectiveness of retinal glutamate in activating gene transcription in
a circadian time-dependent manner (Rea, 1989 ; Kornhauser et al., 1990 ;
Rusak et al., 1990 ).
Inhibition of GABA release and functional role of NPY in SCN
The NPY concentration in the rat SCN displays diurnal fluctuations
(Calza et al., 1990 ). This diurnal change in NPY concentration may be
important in modulating the circadian rhythm. NPY administration into
the SCN phase shifts the circadian rhythm (Albers and Ferris, 1984 ;
Medanic and Gillette, 1993 ; Shibata and Moore, 1993 ; Huhman and Albers,
1994 ), and the direction of the phase shift is dependent on circadian
time. The NPY-mediated phase shift can be antagonized by bicuculline
(Huhman et al., 1995 ), suggesting that the action of NPY on circadian
rhythms may be mediated by modulation of GABA transmission. This is
consistent with the present paper that shows a dramatic inhibition of
GABA release by NPY in SCN neurons. Morphological evidence provides
further support for this interaction in that GABA terminals and NPY
terminals are in direct apposition or converge on the same postsynaptic
targets in the rat SCN; NPY colocalizes with GABA, probably in axons
from the intergeniculate leaflet of the thalamus (Francois-Bellan et
al., 1990 ).
The density of NPY fibers in the SCN is particularly high; in addition,
NPY axons are found throughout the medial hypothalamus (Chronwall et
al., 1985 ), including those regions of the hypothalamus that receive
SCN innervation. Our finding that NPY inhibits transmitter release from
presynaptic SCN axons suggests that NPY may be able to modulate the
actions of SCN GABAergic axons not only within the nucleus but also at
the terminals outside the nucleus by the same presynaptic mechanism
described in the present paper.
Most SCN neurons are GABAergic (van den Pol and Tsujimoto, 1985 ;
Okamura et al., 1989 ; Decavel and van den Pol, 1990 ; Moore and Speh,
1993 ; present study), and many SCN neurons have local axon collaterals
that terminate on other SCN cells (van den Pol, 1980 ). That NPY reduces
calcium currents could explain previous observations with extracellular
recording that NPY is inhibitory (Albers et al., 1990 ). That excitatory
actions of NPY may exist (Mason et al., 1987 ) could be explained by a
reduction in the presynaptic release of GABA, resulting in
disinhibition. We have also found that NPY reduces glutamate release
from excitatory axons in the SCN (van den Pol et al., 1996 ). This
observation, together with those reported in the present paper, could
account for complex response to NPY, including biphasic responses of
excitation and inhibition (Liou and Albers, 1991 ) depending on the time
course, mode of application, and circadian state of the SCN. Coupled
with the demonstration that single cells express more than one NPY receptor, these data underline the significant level of complexity of
NPY actions in the SCN.
FOOTNOTES
Received June 20, 1996; revised Aug. 29, 1996; accepted Sept. 5, 1996.
This work is supported by National Institutes of Health Grants NS 34887 and NS 10174, the National Science Foundation, and the Air Force Office
of Scientific Research. We thank Dr. Y. Yang for technical help.
Correspondence should be addressed to Dr. Anthony van den Pol, Section
of Neurosurgery, Yale University School of Medicine, 333 Cedar Street,
New Haven, CT 06520.
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