Among patients with acute stroke who had last been known to be well 6 to 24 hours earlier and who had a mismatch between clinical deficit and infarct, outcomes for disability at 90 days were better with thrombectomy plus standard care than with standard care alone. (Funded by Stryker Neurovascular; DAWN ClinicalTrials.gov number, NCT02142283 .).

The mitogen-activated protein kinase (MAPK) cascade has been intensely studied as a primary biochemical pathway through which a variety of extracellular stimuli initiate and regulate processes of cellular transformation. That MAPKs are abundantly expressed in postmitotic neurons, however, suggests different yet currently unknown functions for this cascade in the mature nervous system. Here we report that the MAPK cascade is required for hippocampal long term potentiation (LTP), a robust and widely studied form of synaptic plasticity. We observed that PD 098059, a selective inhibitor of the MAPK cascade, blocked MAPK activation in response to direct stimulation of the NMDA receptor as well as to LTP-inducing stimuli. Furthermore, inhibition of the MAPK cascade markedly attenuated the induction of LTP. PD 098059, however, had no effect on the expression of established LTP, and the MAPK cascade was not persistently activated during LTP expression. Our observations provide the first demonstration of a role for the MAPK cascade in the activity-dependent modification of synaptic connections between neurons in the adult mammalian nervous system.The mitogen-activated protein kinase (MAPK) 1 cascade has been classically studied as a critical biochemical pathway involved in cellular transformation events such as cell proliferation and determination. Such work has delineated a pathway by which growth factor receptor activation initiates a complex cascade leading to the activation of Ras, Raf, and MEK, a dual-specific kinase that activates MAPKs via phosphorylations on both threonine and tyrosine residues (reviewed in Refs. 1 and 2).Although this cascade is typically studied in the context of mitotic cell regulation, its components are actually most abundantly expressed in postmitotic neurons of the developed nervous system (3, 4). At present, however, little is known about the physiologic roles of this cascade in mature neurons. We have begun to investigate the possible involvement of the MAPK cascade in the activity-dependent modulation of synaptic connections between neurons, a putative mechanism for the neuronal basis of learning and memory. In particular, we have examined the role of the MAPK cascade in hippocampal long term potentiation (LTP), a widely studied form of synaptic plasticity (reviewed in Refs. 5 and 6). Recently, we reported that p42 MAPK (extracellular signalregulated kinase 2) is activated during the induction of LTP in area CA1 of the hippocampus (7). Though this observation identifies the MAPK cascade as a potential component of the LTP induction cascades in area CA1, the physiologic necessity of MAPK activation during LTP induction remains to be established. To address this question, we have utilized the compound PD 098059 (8, 9), a recently described inhibitor of MEK, to block activation of the MAPK cascade during the delivery of LTP-inducing stimuli. Here we report that inhibition of the MAPK cascade greatly attenuates the induction but not expression of LTP in area CA1. Our observations provide ...

Activation of the mitogen-activated protein kinase (MAPK) cascade recently was discovered to play an important role in synaptic plasticity in area CA1 of rat hippocampus. However, the upstream mechanisms regulating MAPK activity and the downstream effectors of MAPK in the hippocampus are uncharacterized. In the present studies we observed that hippocampal MAPK activation is regulated by both the PKA and PKC systems; moreover, we found that a wide variety of neuromodulatory neurotransmitter receptors (metabotropic glutamate receptors, muscarinic acetylcholine receptors, dopamine receptors, and beta-adrenergic receptors) couple to MAPK activation via these two cascades. In additional studies we observed that PKC is a powerful regulator of CREB phosphorylation in area CA1. MAPK plays a critical role in transcriptional regulation by PKC, because MAPK activation is a necessary component for increased CREB phosphorylation in response to the activation of this kinase. Surprisingly, we also observed that MAPK activation is necessary for PKA coupling to CREB phosphorylation in area CA1. Overall, these studies indicate an unexpected richness of diversity in the regulation of MAPK in the hippocampus and suggest the possibility of a broad role for the MAPK cascade in regulating gene expression in long-term forms of hippocampal synaptic plasticity.

Although classically studied as regulators of cell proliferation and differentiation, mitogen-activated protein kinases (MAPKs) are highly expressed in post-mitotic neurons of the adult nervous system. We have begun investigating the potential role of MAPKs in the regulation of synaptic plasticity in mature neurons. In particular, we have studied the regulation of two MAPK isoforms, p44 and p42 MAPK, in hippocampal long term potentiation (LTP), a system widely studied as a model for the cellular basis of learning and memory. We have found that p42 MAPK, but not p44 MAPK, is activated in area CA1 following direct stimulation of two required components of the LTP induction cascades: protein kinase C and the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor. Furthermore, we have demonstrated that p42 MAPK, but not p44 MAPK, is activated in area CA1 in response to LTP-inducing high frequency stimulation and that this activation requires NMDA receptor stimulation. These data demonstrate that p42 MAPK can be regulated in an activity-dependent manner in the hippocampus and identify it as a potential component of the LTP induction cascades in area CA1. Such observations suggest that p42 MAPK might be an important regulator of synaptic plasticity in post-mitotic neurons.It is widely assumed that information storage within the nervous system is rooted in the activity-dependent modulation of synaptic interactions between neurons. Long term potentiation (LTP) 1 is an example of a long lasting, use-dependent increase in synaptic efficacy, which can be elicited with brief pulses of high-frequency stimulation (1). Although the biochemical cascades that subserve LTP remain largely unknown, it is well established that LTP at the Schaffer collateral inputs in area CA1 of the hippocampus requires stimulation of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor, postsynaptic calcium flux, and activation of several protein kinase cascades (reviewed in Ref. 2). At present, however, little is known about the signaling components downstream of these protein kinases. It is also unclear whether additional, parallel pathways triggered by NMDA receptor stimulation contribute to LTP induction.Mitogen-activated protein kinases (MAPKs) are a family of serine/threonine protein kinases which have classically been studied as regulators of cell proliferation and differentiation. In particular, MAPKs have been identified as primary effectors of growth factor receptor signaling, a cascade that includes activation of Ras, Raf and MEK, the dual-specific protein kinase that activates MAPKs via phosphorylations on threonine and tyrosine residues (reviewed in Ref.3). Interestingly, two MAPK isoforms, p44 MAPK and p42 MAPK, are widely expressed in post-mitotic neurons in the mammalian nervous system (4, 5), an observation that suggests MAPKs might contribute to the regulation of neuronal function in the adult brain.Several studies have demonstrated that MAPKs are activated following stimulation of neurotransmitter receptors, protein...

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