Primary afferent neurotransmission is the fundamental first step in the central processing of sensory stimuli and is controlled by pre- and postsynaptic inhibitory mechanisms. Presynaptic inhibition (PSI) is probably the more powerful form of inhibitory control in all primary afferent fibers. A major mechanism producing afferent PSI is via a channel-mediated depolarization of their intraspinal terminals, which can be recorded extracellularly as a dorsal root potential (DRP). Based on measures of DRP latency it has been inferred that this primary afferent depolarization (PAD) of low-threshold afferents is mediated by minimally trisynaptic pathways with pharmacologically identified GABAergic interneurons forming last-order axo-axonic synapses onto afferent terminals. There is still no "squeaky clean" evidence of this organization. This paper describes recent and historical work that supports the existence of PAD occurring by more direct pathways and with a complex pharmacology that questions the proprietary role of GABA and GABA(A) receptors in this process. Cholinergic transmission in particular may contribute significantly to PAD, including via direct release from primary afferents.

Primary afferent neurotransmission is the fundamental first step in the central processing of sensory stimuli. A major mechanism producing afferent presynaptic inhibition is via a channel-mediated depolarization of their intraspinal terminals which can be recorded extracellularly as a dorsal root potential (DRP). Based on measures of DRP latency it has been inferred that this primary afferent depolarization (PAD) of low-threshold afferents is mediated by minimally trisynaptic pathways with GABAergic interneurons forming last-order axoaxonic synapses onto afferent terminals. We used an in vitro rat spinal cord preparation under conditions that restrict synaptic transmission to test whether more direct low-threshold pathways can produce PAD. Mephenesin or high divalent cation solutions were used to limit oligosynaptic transmission. Recordings of synaptic currents in dorsal horn neurons and population synaptic potentials in ventral roots provided evidence that conventional transmission was chiefly restricted to monosynaptic actions. Under these conditions, DRP amplitude was largely unchanged but with faster time to peak and reduced duration. Similar results were obtained following stimulation of peripheral nerves. Even following near complete block of transmission with high Mg 2ϩ /low Ca 2ϩ -containing solution, the evoked DRP was reduced but not blocked. In comparison, in nominally Ca 2ϩ -free or EGTA-containing solution, the DRP was completely blocked confirming that Ca 2ϩ entry mediated synaptic transmission is required for DRP genesis. Overall these results demonstrate that PAD of low-threshold primary afferents can occur by more direct synaptic mechanisms, including the possibility of direct negative-feedback or nonspiking dendroaxonic pathways.

Somatosensory input strength can be modulated by primary afferent depolarization (PAD) generated via presynaptic GABAA receptors on afferent terminals. We investigated whether acetylcholine (ACh) also provides modulatory actions on PAD via nicotinic acetylcholine receptors (nAChRs) using in vitro murine spinal cord nerve-attached models. Primary afferent stimulation-evoked dorsal root potentials (DRPs) were used as an indirect measure of PAD while evoked afferent transmission was recorded in the deep dorsal horn as extracellular field potentials (EFPs). Changes in afferent membrane excitability were inferred from DC-shifts in recorded dorsal roots or peripheral nerves. Of nAChR antagonists tested, D-tubocurarine (D-TC) depressed DRP amplitude the most (43% of control) and actions were restricted to the A-fiber-evoked DRP and selective depression of Aδ-evoked synaptic EFPs (36% of control). These actions occurred centrally as afferent excitability was unchanged. In comparison, ACh depressed evoked responses by different mechanisms. ACh produced coincident depolarizing DC-shifts in peripheral axons and intraspinally that corresponded temporally with reductions in the DRP and all afferent-evoked synaptic actions (31-37% of control). DC-shifts were produced via nAChRs on primary afferents: they were also seen with nAChR agonists (epibatidine and nicotine), blocked with D-TC but not GABAA receptor blockers, and retained after block of voltage-gated Na+ channels. Notably, prominent actions on evoked responses were comparably altered between two mouse strains, in rat, and when performed in different labs. Thus, nAChRs can regulate afferent excitability via two distinct mechanisms: by modulating central Aδ-afferent actions, and by broadly changing membrane polarization of all classes of primary afferents.

We are at a historic point in which scientists and Tibetan monastics are working together to investigate ancient questions of mind and matter, and to serve the best interests of humanity. To facilitate this collaboration, His Holiness the Dalai Lama supported the development of the Emory University-Tibet Science Initiative (ETSI), which reflects the first major change in the Tibetan monastic curriculum in six centuries. Over the course of a 6-year long curriculum, Tibetan monastics living in India have the opportunity to study science with experts in various disciplines. In 2019, ETSI graduated its first cohort of monastic students from a 6-year “implementation phase,” and now has entered the “sustainability phase.” A goal of the sustainability phase is to broaden the scope of ETSI and begin training monastics through research. The present paper provides an overview of a 3-year Research Training Program being developed for the sustainability phase. We first overview a pilot program that informed feasibility and potential structure for a broader Research Training Program at the monasteries and monastic universities in India. Next, we discuss the conceptual framework for the Research Training Program and four learning objectives that we hope to attain. We then discuss the specifics of the course design for the proposed 3-year research training curriculum, through which our goal is to transition from a more guided training experience to a less guided experience. Finally, we discuss challenges and opportunities that we expect to encounter in developing and implementing the program.