Narcolepsy is a disabling sleep disorder affecting humans and animals. It is characterized by daytime sleepiness, cataplexy, and striking transitions from wakefulness into rapid eye movement (REM) sleep. In this study, we used positional cloning to identify an autosomal recessive mutation responsible for this sleep disorder in a well-established canine model. We have determined that canine narcolepsy is caused by disruption of the hypocretin (orexin) receptor 2 gene (Hcrtr2). This result identifies hypocretins as major sleep-modulating neurotransmitters and opens novel potential therapeutic approaches for narcoleptic patients.
We explored the role of hypocretins in human narcolepsy through histopathology of six narcolepsy brains and mutation screening of Hcrt, Hcrtr1 and Hcrtr2 in 74 patients of various human leukocyte antigen and family history status. One Hcrt mutation, impairing peptide trafficking and processing, was found in a single case with early onset narcolepsy. In situ hybridization of the perifornical area and peptide radioimmunoassays indicated global loss of hypocretins, without gliosis or signs of inflammation in all human cases examined. Although hypocretin loci do not contribute significantly to genetic predisposition, most cases of human narcolepsy are associated with a deficient hypocretin system.
Amyloid-β (Aβ) accumulation in the brain extracellular space is a hallmark of Alzheimer's disease (AD). The factors regulating this process are only partly understood. Aβ aggregation is a concentration-dependent process that is likely to be dependent on changes in brain interstitial fluid (ISF) levels of Aβ. Using in vivo microdialysis, we found that ISF Aβ levels correlated with wakefulness. ISF Aβ levels also significantly increased during acute sleep deprivation and during orexin infusion, whereas they decreased with infusion of a dual orexin receptor antagonist. Importantly, chronic sleep restriction significantly increased and a dual orexin receptor antagonist decreased Aβ plaque formation in amyloid precursor protein transgenic mice. Thus, the sleep-wake cycle and orexin may play a role in the pathogenesis of AD.Alzheimer's disease (AD) is the most common cause of dementia. The accumulation of the amyloid-β (Aβ) peptide in the brain extracellular space is a critical event in the pathogenesis of AD. Aβ is produced by neurons and secreted into the brain interstitial fluid (ISF). An initiating factor in AD pathogenesis occurs when soluble, monomeric Aβ undergoes a conformational change and converts into forms such as oligomers, protofibrils, and fibrils. The accumulation of these forms of Aβ is concentration-dependent and confers toxicity (1). Elucidating factors that regulate soluble Aβ levels is important for understanding AD pathogenesis. Synaptic activity regulates the release of Aβ from neurons into the ISF (2,3). How ISF Aβ is regulated by normal physiology is poorly understood.To investigate ISF Aβ metabolism, we monitored hippocampal Aβ levels using in vivo microdialysis in both wild-type mice and human APP transgenic (Tg2576) mice, which express a mutated form of human amyloid precursor protein (APP) (4). ISF Aβ was assessed in Tg2576 mice at 3 months of age, several months earlier than Aβ deposition begins. We found diurnal variation of ISF Aβ levels. Aβ levels were significantly increased during the dark period compared to the light period (Fig. 1A). ISF Aβ levels fluctuated over a 24-hour period with mean levels during the light period being ~75% of mean Aβ levels during the dark period (Fig. 1B). ISF Aβ levels were significantly correlated with the amount of time spent awake (Fig. 1, C-D). Conversely, ISF Aβ levels were negatively correlated with the amount of time spent
Neural activity in the noradrenergic locus coeruleus correlates with periods of wakefulness and arousal. However, whether tonic or phasic activity in these neurons is necessary or sufficient to induce behavioral state transitions and promote long-term arousal is unresolved. We used optogenetic tools in mice to demonstrate a frequency-dependent, causal relationship between locus coeruleus firing, cortical activity, sleep-to-wake transitions, and general locomotor arousal. Surprisingly, we also found that sustained, high-frequency stimulation of the locus coeruleus at frequencies 5 Hz and above caused reversible behavioral arrests. These results suggest that the locus coeruleus is finely tuned to regulate organismal arousal and that bursts of noradrenergic over-excitation cause behavioral attacks similar to those observed in neuropsychiatric disorders.
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