GLUT1 is essential for human brain development and function, as evidenced by the severe epileptic encephalopathy observed in children with GLUT1 deficiency syndrome resulting from inherited loss-of-function mutations in the gene encoding this facilitative glucose transporter. To further elucidate the pathophysiology of this disorder, the zebrafish orthologue of human GLUT1 was identified, and expression of this gene was abrogated during early embryonic development, resulting in a phenotype of aberrant brain organogenesis consistent with the observed expression of Glut1 in the embryonic tectum and specifically rescued by human GLUT1 mRNA. Affected embryos displayed impaired glucose uptake concomitant with increased neural cell apoptosis and subsequent ventricle enlargement, trigeminal ganglion cell loss, and abnormal hindbrain architecture. Strikingly, inhibiting expression of the zebrafish orthologue of the proapoptotic protein Bad resulted in complete rescue of this phenotype, and this occurred even in the absence of restoration of apparent glucose uptake. Taken together, these studies describe a tractable system for elucidating the cellular and molecular mechanisms of Glut1 deficiency and provide compelling in vivo genetic evidence directly linking nutrient availability and activation of mitochondria-dependent apoptotic mechanisms during embryonic brain development.The cellular uptake of glucose is dependent in part upon the GLUT family of polytopic membrane transporters that facilitate the passive diffusion of this essential nutrient across membranes (1). GLUT1, the prototypic member of this protein family, is highly expressed in erythrocytes and the central nervous system and is believed to play an essential role in the homeostasis of brain glucose in the developing human infant (2). In support of this concept, infants with GLUT1 deficiency syndrome, a rare genetic disorder resulting from inherited heterozygous loss-of-function mutations in the gene encoding GLUT1, develop seizures, acquired microcephaly and profound developmental delay in association with profound hypoglycorrhachia (3). Despite considerable study of these patients, the neurochemical and neuropathologic consequences of GLUT1 deficiency during development are not well understood, and treatment of affected patients remains challenging.Although abundant in the extracellular milieu, the cellular uptake of glucose is precisely regulated by specific growth factors and signaling pathways (4). Cell culture studies reveal that inhibition of cellular glucose uptake dramatically increases apoptosis under conditions of growth factor restriction and that cell survival under such circumstances is dependent upon the regulation of glucose uptake and metabolism by the proto-oncogene Akt (5-7). A biochemical link between glucose homeostasis and apoptosis was further suggested by studies demonstrating an interaction between the proapoptotic protein, Bad, and the glycolytic enzyme, glucokinase (8). In support of these findings, a recent study now demonstrates a...