The neurons responsible for the onset of sleep are thought to be located in the preoptic area and more specifically, in the ventrolateral preoptic nucleus (VLPO). Here we identify sleep-promoting neurons in vitro and show that they represent an homogeneous population of cells that must be inhibited by systems of arousal during the waking state. We find that two-thirds of the VLPO neurons are multipolar triangular cells that show a low-threshold spike. This proportion matches that of cells active during sleep in the same region. We then show, using single-cell reverse transcriptase followed by polymerase chain reaction, that these neurons probably contain gamma-aminobutyric acid (GABA). We also show that these neurons are inhibited by noradrenaline and acetylcholine, both of which are transmitters of wakefulness. As most of these cells are also inhibited by serotonin but unaffected by histamine, their overall inhibition by transmitters of wakefulness is in agreement with their relative inactivity during waking with respect to sleep. We propose that the reciprocal inhibitory interaction of such VLPO neurons with the noradrenergic, serotoninergic and cholinergic waking systems to which they project is a key factor for promoting sleep.

SUMMARY1. Intracellular recordings were obtained from cerebellar nuclear neurones in the isolated brain stem-cerebellar preparation of guinea-pigs in vitro. The electrical properties of the cells were quite similar to those reported in in vitro slice studies. They had an average resting potential of -567 +18 mV, an input resistance of 238 + 4-9 MQ, and a time constant of 125 + 27 ms. The action potentials had an average amplitude of 57-3 + 528 mV (n = 20).2. In addition to the ionic mechanisms required for the generation of the fast action potential, cerebellar nuclear neurones displayed a low-threshold Ca2"-dependent spike which produced a powerful rebound excitation following anodal break. This type of electroresponsiveness was absent in the slice preparation. 3. The anodal break response was further enhanced by the presence of a noninactivating Na+ conductance similar to that described in Purkinje cells.4. Following electrical stimulation of the cerebellar cortex or the underlying white matter, excitatory and inhibitory synaptic potentials (EPSP-IPSP sequences) could be recorded in cerebellar nuclear neurones. The EPSPs were elicited by direct activation of collaterals of mossy or climbing fibre afferents. The IPSPs followed direct or orthodromic Purkinje cell activation. 5. The integrity of the olivo-cerebellar system was tested by the administration of harmaline which produced powerful EPSP-IPSP sequences or pure IPSPs in cerebellar nuclear neurones. These IPSPs were often followed by a rebound firing of the cells.6. These results indicate that the olivo-cerebellar pathway, in addition to its activation of the cerebellar cortex, exerts a powerful and complex set of synaptic events on cerebellar nuclear cells. As such it is a true afferent system, having a distinct role in cerebellar physiology.

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and attacks of muscle atonia triggered by strong emotions (cataplexy). Narcolepsy is caused by hypocretin (orexin) deficiency, paralleled by a dramatic loss in hypothalamic hypocretin-producing neurons. It is believed that narcolepsy is an autoimmune disorder, although definitive proof of this, such as the presence of autoantibodies, is still lacking. We engineered a transgenic mouse model to identify peptides enriched within hypocretin-producing neurons that could serve as potential autoimmune targets. Initial analysis indicated that the transcript encoding Tribbles homolog 2 (Trib2), previously identified as an autoantigen in autoimmune uveitis, was enriched in hypocretin neurons in these mice. ELISA analysis showed that sera from narcolepsy patients with cataplexy had higher Trib2-specific antibody titers compared with either normal controls or patients with idiopathic hypersomnia, multiple sclerosis, or other inflammatory neurological disorders. Trib2-specific antibody titers were highest early after narcolepsy onset, sharply decreased within 2-3 years, and then stabilized at levels substantially higher than that of controls for up to 30 years. High Trib2-specific antibody titers correlated with the severity of cataplexy. Serum of a patient showed specific immunoreactivity with over 86% of hypocretin neurons in the mouse hypothalamus. Thus, we have identified reactive autoantibodies in human narcolepsy, providing evidence that narcolepsy is an autoimmune disorder.

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