The formation of dendritic spines during development and their structural plasticity in the adult brain are critical aspects of synaptogenesis and synaptic plasticity. Actin is the major cytoskeletal source of dendritic spines, and polymerization/depolymerization of actin is the primary determinant of spine motility and morphogenesis. Some, but not all, postmortem studies in schizophrenia have identified reduced dendritic spine density in neurons of the hippocampal formation and dorsolateral prefrontal cortex (for review, see Honer et al., 2000); however, little is known about the underlying pathogenic mechanisms affecting synaptic function in the disease.

Many different factors and proteins are known to control dendritic spine development and remodeling (see Ethell and Pasquale, 2005). Comprehensive investigation of the effectors and signaling pathways involved in regulating actin dynamics may provide insight into the molecular mechanisms mediating altered cortical microcircuitry in the...  Read more

The formation of dendritic spines during development and their structural plasticity in the adult brain are critical aspects of synaptogenesis and synaptic plasticity. Actin is the major cytoskeletal source of dendritic spines, and polymerization/depolymerization of actin is the primary determinant of spine motility and morphogenesis. Some, but not all, postmortem studies in schizophrenia have identified reduced dendritic spine density in neurons of the hippocampal formation and dorsolateral prefrontal cortex (for review, see Honer et al., 2000); however, little is known about the underlying pathogenic mechanisms affecting synaptic function in the disease.

Many different factors and proteins are known to control dendritic spine development and remodeling (see Ethell and Pasquale, 2005). Comprehensive investigation of the effectors and signaling pathways involved in regulating actin dynamics may provide insight into the molecular mechanisms mediating altered cortical microcircuitry in the disease.

David Lewis and colleagues have previously reported reduced spine density in the basilar dendrites of pyramidal neurons in laminar III of the DLPFC (though this is not clearly a laminar-specific finding). In their current study, Hill et al. extended these investigations to examine gene expression levels for members of the RhoGTPase family of intracellular signaling molecules (e.g., Cdc42, Rac1, RhoA, Duo), and Debrin, an F-actin binding protein, all of which are critical signal transduction molecules involved in spine formation and maintenance. Their aim was to determine whether alterations in the expression of one of more molecules may underlie the reduced spine density seen in the disorder. Hill et al. report that reductions in Cdc42 and Duo mRNA are observed in the DLPFC in schizophrenia and correlate with spine density on deep layer III pyramidal neurons. This paper provides preliminary evidence that "gene expression levels of certain mRNAs encoding proteins known to be key regulators of dendritic spines are reduced in the DLPFC in schizophrenia." However, the paper also reports that these two mRNAs are reduced in lamina where significant reductions in spine density are not observed in schizophrenia. These results may suggest, as the authors discuss, that reduced expression of Cdc42 and Duo might contribute to, but is not sufficient to cause reduced, spine density.

Synaptic dysfunction has received increasing attention as a key feature of schizophrenia’s neuropathology and possibly its genetic etiology (Law et al., 2004). Neuregulin 1 (NRG1), a lead schizophrenia susceptibility gene, is known to be a critical upstream regulator of signal transduction pathways modulating cytoskeletal dynamics, playing pivotal roles in synapse formation and function. We have previously reported that isoform-specific alterations of the NRG1 gene and its primary receptor, ErbB4, are apparent in the brain in schizophrenia and related to genetic risk for the disease (Law et al, 2005a, Law et al, 2005b). Altered NRG1/ErbB4 signaling in schizophrenia may be a pathway to aberrant cortical neurodevelopment and synaptic function via dysregulation of specific intracellular signaling pathways linked to actin. The lack of significant alterations in gene expression levels for proteins such as Rac1 and RhoA in the DLPFC (gray matter, as reported by Hill and colleagues) in schizophrenia might be because the primary defect may not lie with the expression of these molecules but with the upstream modulation of their function and activity. Therefore, investigation of the proteins themselves, their phosphorylation status and activity, will be useful in understanding how genes effect molecular pathways that mediate biological risk for schizophrenia. The study of intracellular signaling cascades may be a route to a closer understanding of the biological mechanisms underpinning the association of genes such as NRG1 and ErbB4 with schizophrenia and their relationship to its neuropathology.

References:

Ethell IM, Pasquale EB. Molecular mechanisms of dendritic spine development and remodeling. Prog Neurobiol. 2005 Feb;75(3):161-205. Epub 2005 Apr 2. Review. Abstract

Honer G, Young C, and Falkai P, 2000. Synaptic Pathology in the Neuropathology of Schizophrenia, Progress and interpretation. Oxford University Press, edited by Paul J Harrison and Gareth W. Roberts, pp105-136.

Law AJ, Weickert CS, Hyde TM, Kleinman JE, Harrison PJ. Reduced spinophilin but not microtubule-associated protein 2 expression in the hippocampal formation in schizophrenia and mood disorders: molecular evidence for a pathology of dendritic spines. Am J Psychiatry. 2004 Oct;161(10):1848-55. Abstract

Law, 2005a. Soc Neurosci Abstract, SFN Annual Meeting, Washington DSC, 2005. Neuregulin1 and schizophrenia: A pathway to altered cortical circuits. Also See SfN 2005 research news: Cortical Deficits in Schizophrenia: Have Genes, Will Hypothesize.

Law 2005b ACNP Abstract, Neuropsychopharmacology, vol. 30, Supplement 1. SNPing away at NRG1 and ErbB4 gene expression in schizophrenia.

The study of Ghashghaei and colleagues provides a remarkable insight into the function of neuregulin 1 (NRG1), and NRG2 in adult neurogenesis. The study demonstrates that NRG1(2)/ErbB4 signaling influences the proliferation, differentiation, organization, and migration of adult neural progenitor cells in the subventricular zone (SVZ) and rostral migratory stream (RMS), in a ligand- and cell-dependent fashion. Using immunohistochemistry, Ghashghaei and colleagues first demonstrate that NRG1, NRG2, and ErbB4 are expressed by distinct cell types in the SVZ and RMS, notably ErbB4 and NRG1 by polysialylated neural cell adhesion molecule positive (PSA-NCAM+) neuroblasts, and ErbB2/3/4 by a subset of GFAP+ cells. These observations extend the group's previous studies of NRG1 and ErbB4 in the RMS (Anton et al., 2004). In their current study, Ghashghaei went on to examine the effects of exogenous infusion of NRG1 and NRG2 on neurogenesis in the RMS of adult mice. Interestingly, NRG1 was shown to decrease the...  Read more

The study of Ghashghaei and colleagues provides a remarkable insight into the function of neuregulin 1 (NRG1), and NRG2 in adult neurogenesis. The study demonstrates that NRG1(2)/ErbB4 signaling influences the proliferation, differentiation, organization, and migration of adult neural progenitor cells in the subventricular zone (SVZ) and rostral migratory stream (RMS), in a ligand- and cell-dependent fashion. Using immunohistochemistry, Ghashghaei and colleagues first demonstrate that NRG1, NRG2, and ErbB4 are expressed by distinct cell types in the SVZ and RMS, notably ErbB4 and NRG1 by polysialylated neural cell adhesion molecule positive (PSA-NCAM+) neuroblasts, and ErbB2/3/4 by a subset of GFAP+ cells. These observations extend the group's previous studies of NRG1 and ErbB4 in the RMS (Anton et al., 2004). In their current study, Ghashghaei went on to examine the effects of exogenous infusion of NRG1 and NRG2 on neurogenesis in the RMS of adult mice. Interestingly, NRG1 was shown to decrease the initiation of neuroblast migration from the SVZ to the RMS by inducing the rapid aggregation of cells in the SVZ. The consequence of this rise in NRG1 was a decrease in the number of PSA-NCAM+ cells in the RMS and GABA+ cells in the olfactory bulb, demonstrating that ectopic or elevated expression of NRG1 prevents differentiation and migration of neurons from the adult SVZ to the RMS.

The study is particularly interesting in terms of the role of NRG1/ErbB4 signaling in directional cell migration. Flames et al. (2004) recently reported that NRG1 (specifically the Ig containing family of isoforms, e.g., Types I, II and IV; for review, see Harrison and Law, 2006) functions as a long distance chemoattractant for ErbB4 positive GABAergic interneurons migrating from the medial ganglionic eminence to the developing cortex. The observation that NRG1 is a chemoattractant in other brain regions may appear somewhat contradictory to the findings of Ghashghaei, which suggest that in-vivo NRG1 actually inhibits migration of neurons from the SVZ (at least when introduced ectopically). However, it would seem that these two findings are actually consistent. Ghashghaei and colleagues ectopically infused NRG1 into the lateral ventricles of adult mice. The subsequent aggregation of cells in the SVZ demonstrates that NRG1 indeed acts as a chemoattractant, not in an obvious manner by inducing the cells to migrate away, but simply by "attracting" them to aggregate or "clump" where they are (subsequently preventing migration to the RMS). So in fact, both the studies of Flames and Ghashghaei show that NRG1 is chemotactic to specific populations of neurons and cells, whether it is expressed at a distance and cells preferentially migrate toward it, or in the immediate environment and cells are attracted to migrate to, or stay in its vicinity.

In the past few years, NRG1 and ErbB4 have both been identified as potential susceptibility genes for schizophrenia. The aim now is to determine the molecular and biological mechanisms by which the genes confer risk for the disease. In terms of schizophrenia, we have previously demonstrated that the Type I isoform of NRG1 is elevated in the hippocampus (and prefrontal cortex; see Hashimoto et al., 2004) in the disease and that expression of the novel Type IV isoform is related to disease-associated sequence variants within the NRG1 gene (Law et al., 2006). Furthermore, we have recently demonstrated that these changes are accompanied by altered expression of specific isoforms of the ErbB4 receptor, consistent with that of Silberberg et al., 2006 (Law et al., 2005). Ghashghaei and colleagues provide the first direct evidence that ectopic or elevated expression of NRG1 in the brain can perturb cell migration. In light of this and other evidence, our findings in schizophrenia may translate into altered neuronal migration, cortical development and possibly neurogenesis in the disease.

At present, the exact links between altered NRG1/ErbB4 signaling and the pathophysiology of schizophrenia are unknown and potentially numerous (i.e., synaptogenesis, neurotransmitter function, neuronal migration, differentiation, glia formation and function, myelination). Studies such as that of Ghashghaei et al. provide insight into the normal role of NRG1/ErbB4 signaling in neurodevelopment and the adult brain which is essential if we are to understand the pathogenic role of the NRG1 gene and its receptors in disease.

References:

Anton ES, Ghashghaei HT, Weber JL, McCann C, Fischer TM, Cheung ID, Gassmann M, Messing A, Klein R, Schwab MH, Lloyd KC, Lai C. Receptor tyrosine kinase ErbB4 modulates neuroblast migration and placement in the adult forebrain. Nat Neurosci. 2004 Dec;7(12):1319-28. Epub 2004 Nov 7. Abstract

Flames N, Long JE, Garratt AN, Fischer TM, Gassmann M, Birchmeier C, Lai C, Rubenstein JL, Marin O. Short- and long-range attraction of cortical GABAergic interneurons by neuregulin-1. Neuron. 2004 Oct 14;44(2):251-61. Abstract

Hashimoto et al., 2004, Mol. Psychiatry 9, 299-307.

Law et al (a) 2006. Neuregulin 1 (NRG1) transcripts are differentially expressed in schizophrenia and regulated by 5’ SNPs associated with the disease. PNAS

Also See SfN 2005 SRF research news: Cortical Deficits in Schizophrenia: Have Genes, Will Hypothesize

Law 2005, SNPing away at NRG1 and ErbB4 gene expression in schizophrenia Neuropsychopharmacology, vol. 30, Supplement 1.

In contrast to its once barren form, the table of potential causative genes for schizophrenia is now stocked to feast level (Straub and Weinberger, 2006). In keeping with the culinary theme, we suggest that this recent paper by Chang-Gyu Hahn and Hoau-Yan Wang is “a full course meal”!

Appetizer: An Important Biological Problem
If one assumes that alterations in NRG-1 account for at least some of the liability to developing schizophrenia, then it is only reasonable to look to the NRG-1 receptors for clues as to how and where NRG-1 may be acting. However, there are three known NRG-1 receptors that mediate a myriad of biological functions, almost all of which could be argued to be relevant to schizophrenia pathology. This paper draws our attention to one NRG-1 receptor, ErbB4, showing this receptor to be a probable NRG-1 partner in mediating this pathology. Recent studies provide further support that ErbB4 may be integral to the development of schizophrenia by demonstrating its gene to...  Read more

In contrast to its once barren form, the table of potential causative genes for schizophrenia is now stocked to feast level (Straub and Weinberger, 2006). In keeping with the culinary theme, we suggest that this recent paper by Chang-Gyu Hahn and Hoau-Yan Wang is “a full course meal”!

Appetizer: An Important Biological Problem
If one assumes that alterations in NRG-1 account for at least some of the liability to developing schizophrenia, then it is only reasonable to look to the NRG-1 receptors for clues as to how and where NRG-1 may be acting. However, there are three known NRG-1 receptors that mediate a myriad of biological functions, almost all of which could be argued to be relevant to schizophrenia pathology. This paper draws our attention to one NRG-1 receptor, ErbB4, showing this receptor to be a probable NRG-1 partner in mediating this pathology. Recent studies provide further support that ErbB4 may be integral to the development of schizophrenia by demonstrating its gene to be a potential susceptibility gene (Norton et al., 2006; Silberberg et al., 2006; Nicodemus et al., in press). So, genetic and neurobiological evidence suggest the authors selected their NRG-1 receptor wisely.

Main Course: A New Approach
The novel postmortem-stimulation approach used by Hahn and colleagues represents an important advance in the field of schizophrenia research. Through extensive validation of this protocol, this research group has paved the way for future experimentation into the molecular activation of proteins within the schizophrenic brain. More specifically, while previous studies have only been able to draw conclusions about the static state of the schizophrenic brain, this article has introduced a novel method for examining dynamic signaling systems in postmortem brains of patients with schizophrenia. For example, based on the finding that certain splice variant ErbB4 mRNAs are elevated in the prefrontal cortex of these individuals (Silberberg et al., 2006), one would assume that ErbB4 protein should also be elevated in these patients. But Hahn et al. demonstrate that schizophrenic individuals show only marginal increases in prefrontal cortical ErbB4 protein levels, which could suggest that ErbB4 protein plays little role in the pathology of schizophrenia. However, using the more dynamic postmortem-stimulation approach, the authors showed that ErbB4 signaling is, in fact, greatly enhanced in the prefrontal cortex of patients with this disease, leading to the alternative interpretation that ErbB4 protein may play significant roles in schizophrenia. In other words, this postmortem-stimulation protocol extends the examination of human postmortem brain protein from quantification to the functional level. We view this method as a powerful approach that will be important in translating genetic susceptibility into molecular mechanisms of the disease process. The postmortem-stimulation approach also gave rise to the observation that schizophrenic patients exhibit reduced prefrontal cortical NMDA receptor signaling capacity. This finding is highly significant because it is the first evidence directly linking reduced prefrontal cortical NMDA receptor function to schizophrenia. However, whether NRG-1-ErbB4 signaling is a major contributor to NMDA receptor hypofunction is debatable since the attenuation of NMDA receptor phosphorylation by NRG-1 appears proportionally similar between controls and schizophrenic patients.

Side Dish: Dealing with Antipsychotic Drugs
Since most patients with schizophrenia have received antipsychotic drugs and these agents can have profound impact on brain systems, it is essential to determine whether changes observed in the brains of patients with schizophrenia are secondary to antipsychotic drug exposure. To address this issue, the authors took two important steps. Firstly, Hahn et al. examined whether antipsychotic drug exposure affected prefrontal cortical ErbB4 expression or signaling in their human study group and found no correlation between antipsychotic drug treatment and either of these measured variables. Secondly, the authors examined antipsychotic drug effects on prefrontal cortical ErbB4 signaling in mice implanted with a haloperidol-containing bioabsorbable polymer, which has a number of advantages. For example, it allows for long-term treatment of the animals (12 weeks) while minimizing handling. This duration of exposure is arguably more appropriate than some schedules used to examine chronic effects of antipsychotic drugs in rodents. Remarkably, haloperidol treatment caused a reduction in ErbB4 signaling in the mice, suggesting that a decrease in ErbB4 signaling is associated with the therapeutic effects of antipsychotic agents. What may have been more informative is to show whether haloperidol had any effect on ErbB4 protein levels without NRG-1 treatment. In addition, the authors could have considered examining antipsychotic drug effect in mice whose ages were more reflective of those of the investigated human cohort, which consisted of elderly individuals (65-92 years). Furthermore, while their analysis of antipsychotic drugs on ErbB4 expression and signaling in postmortem brain was noteworthy, the authors only examined the effects of antipsychotic drugs taken in the final month before death in a very aged sample population. Thus, it is difficult to ascertain whether ErbB4 expression or signaling is not affected by lifetime antipsychotic drug treatment, which can result in cellular and molecular consequences that can remain long after termination of therapy.

Dessert: Challenging the Field
Of course, the first thing the field needs to do is attempt to replicate these findings in another cohort of patients with schizophrenia compared to controls. Careful attention to matching for age, PMI, and gender, etc., as was done in this study, is critical. We suggest that using a young cohort of patients would help rule out potential confounds such as associated dementia and interaction with the aging process. However, it is recognized that many other potential confounds will still remain in most studies comparing schizophrenics to unaffected controls. These confounds include suffering from years of an unremitting illness that compromises normal social and environmental stimulation, increased incidence of cigarette smoking among patients with schizophrenia, and years of antipsychotic drug exposure. When the finding of schizophrenia-associated increased ErbB4 signaling capacity is replicated, then the task at hand will be to determine how possible genetic changes in the DNA at the NRG-1 or ErbB4 locus (representing one etiological route) could lead to a “hyperactivatable” ErbB4.

Doggie Bag: Nagging Questions
One of the caveats we would like to raise in attempting to link molecular neurobiological changes found in schizophrenic brain tissue with possible changes in DNA is that causative variants in any one susceptibility gene are expected to occur only in a minority of schizophrenic patients. Most measures performed on postmortem schizophrenic brains are made on small sample sizes, which likely show much heterogeneity in terms of etiology. In other words, only a handful of patients in this study would be expected to have a faulty NRG-1 gene; yet this subpopulation shows alterations in ErbB4 signaling as a group. The logical extension of this observation may be that there are multiple routes by which ErbB4 could be “hyperactivatable” (i.e., not solely through NRG-1 genetic liability). To sort this out, we need to work from the gene forward, and thus there is a need to identify causative variants in susceptibility genes and to use these as starting points for basic mechanistic molecular and cellular studies.

The study by Sardi et al. is truly remarkable. Their report of a novel ErbB4 cleavage-dependent mechanism regulating neuronal/astrocytic differentiation is groundbreaking, but their approach to unraveling and confirming this mechanism is more impressive. From their use of a yeast two-hybrid system in finding novel ErbB4 intracellular domain (E4ICD)-interacting factors to their meticulous experimental dissection of hypotheses and observations, the Corfas group has raised the bar in the investigation of mechanisms by which ErbB4 regulates neural precursor fates. In addition, the authors have shown that changes in E4ICD intracellular signaling pathways may produce cellular consequences distinct from those resulting from alterations in the activity of membrane-bound full-length ErbB4. More specifically, Sardi et al. illustrate that ErbB4 cleavage can regulate very early cell fates in the nervous system, while intact ErbB4 has mainly been examined in terms of its action at mature cortical synapses where its activation can dampen NMDA receptor function.

Recognition must also be...  Read more

The study by Sardi et al. is truly remarkable. Their report of a novel ErbB4 cleavage-dependent mechanism regulating neuronal/astrocytic differentiation is groundbreaking, but their approach to unraveling and confirming this mechanism is more impressive. From their use of a yeast two-hybrid system in finding novel ErbB4 intracellular domain (E4ICD)-interacting factors to their meticulous experimental dissection of hypotheses and observations, the Corfas group has raised the bar in the investigation of mechanisms by which ErbB4 regulates neural precursor fates. In addition, the authors have shown that changes in E4ICD intracellular signaling pathways may produce cellular consequences distinct from those resulting from alterations in the activity of membrane-bound full-length ErbB4. More specifically, Sardi et al. illustrate that ErbB4 cleavage can regulate very early cell fates in the nervous system, while intact ErbB4 has mainly been examined in terms of its action at mature cortical synapses where its activation can dampen NMDA receptor function.

Recognition must also be given to Pat McCaffrey and Hakon Heimer, who provided an excellent summary of the article and highlighted the significance of the paper to schizophrenia. In the manuscript, disruptions in E4ICD signaling are discussed in terms of their relevance to Alzheimer disease. Since aberrant neuregulin-1-ErbB4 signaling has been implicated in schizophrenia, one could hypothesize that alterations in E4ICD-associated interactions and/or in the nuclear translocation of E4ICD complexes may contribute to schizophrenia pathology as well. Hence, it will be important to test whether either or both of these ErbB4-signaling streams are in fact altered not only in Alzheimer disease, but also in schizophrenia.

The difficulty in linking ErbB4 to neuropathological mechanisms underlying schizophrenia may be due in part to the limited information that exists on early developmental processes of this illness. In their paper, Sardi et al. suggest disruptions in ErbB4-dependent mechanisms may lead to premature astrogenesis that could contribute to Alzheimer disease-associated gliosis. However, in thinking about the relevance of altered E4ICD signaling in schizophrenia, elevated glial formation has not been observed in the schizophrenic brain. In fact, expression of the glial marker, GFAP, has been shown to be reduced in postmortem brains of subjects with this disorder (Johnston-Wilson et al., 2000; Webster et al., 2005). On the other hand, recent investigations suggest elevated prefrontal cortical feed-forward neuregulin-1-ErbB4 signaling in schizophrenia (Hahn et al., 2006), and this increase could lead to GFAP reductions possibly through the mechanism proposed by Sardi et al. if this elevated signaling translated to greater E4ICD cleavage. However, whether the findings of Sardi et al. in neural precursor cells extend to cells of the adult human brain remains to be explored. Nevertheless, the Corfas group has opened new avenues of research in the field of schizophrenia and has provided a framework for future studies on the role ErbB4 signaling in this disease.

References:

Johnston-Wilson N.L., Sims C.D., Hofmann J.-P., Anderson L., Shore A.D., Torrey E.F. and Yolken R.H. (2000) Disease-specific alterations in frontal cortex brain proteins in schizophrenia, bipolar disorder, and major depressive disorder. Mol. Psychiatry. 5: 142-149. Abstract

Webster M.J., O'Grady J., Kleinman J.E. and Weickert C.S. (2005) Glial fibrillary acidic protein mRNA levels in the cingulate cortex of individuals with depression, bipolar disorder and schizophrenia. Neuroscience. 133: 453-461. Abstract

Hahn C.G., Wang H.Y., Cho D.S., Talbot K., Gur R.E., Berrettini W.H., Bakshi K., Kamins J., Borgmann-Winter K.E., Siegel S.J., Gallop R.J., Arnold S.E. (2006) Altered neuregulin 1-erbB4 signaling contributes to NMDA receptor hypofunction in schizophrenia. Nat. Med. 12: 824-828. Abstract

The article by Kargieman and colleagues further specifies the cellular mechanisms underlying the actions of clozapine in a model of pharmacologically induced cortical dysfunction. Separately, clozapine has been demonstrated to be capable of reducing or eliminating the complex behavioral and cognitive impairments elicited by acutely administered NMDA antagonists (Geyer et al., 2001; Idris et al., 2005; Lipina et al., 2005), and these cellular mechanisms shown by Kargieman et al. may represent the level of interaction between clozapine and phencyclidine-like drugs.

What is surprising from so many of these studies is the quality of the reversal of effects produced by clozapine, despite the fact that it (like most other antipsychotic drugs) has limited efficacy both at an individual and population level. Furthermore, there remain many reports in the literature demonstrating that while some cognitive and symptomatic domains in schizophrenia...  Read more

The article by Kargieman and colleagues further specifies the cellular mechanisms underlying the actions of clozapine in a model of pharmacologically induced cortical dysfunction. Separately, clozapine has been demonstrated to be capable of reducing or eliminating the complex behavioral and cognitive impairments elicited by acutely administered NMDA antagonists (Geyer et al., 2001; Idris et al., 2005; Lipina et al., 2005), and these cellular mechanisms shown by Kargieman et al. may represent the level of interaction between clozapine and phencyclidine-like drugs.

What is surprising from so many of these studies is the quality of the reversal of effects produced by clozapine, despite the fact that it (like most other antipsychotic drugs) has limited efficacy both at an individual and population level. Furthermore, there remain many reports in the literature demonstrating that while some cognitive and symptomatic domains in schizophrenia are improved by clozapine, others clearly are not (Goldberg and Weinberger, 1996; Bilder et al., 2002). Why, then, is clozapine so effective in the PCP model? One concern, of course, is that its effects are related to a specific type of pharmacological interaction; one certainly needs to see clozapine's effects in other models that do not involve the acute administration of an NMDA antagonist.

Notably, several groups have been studying the effects of long-term administration of phencyclidine, sometimes followed by washout of the NMDA antagonist, to develop an alternative type of model that may depend upon the neuroadaptations resulting from blockade of NMDA receptors, rather than on the acute pharmacological action itself (Jentsch et al., 1997; Balla et al., 2003; Amitai et al., 2007, and many others). Whilst the specific validity of any one of these approaches is debatable, what appears to be clear is that the ability of clozapine to reverse behavioral or neurochemical deficits is much more tenuous. Is this a weakness of these models, or does it mean they are actually more realistic in their predictions?

Based upon these facts, one is left with a number of questions. First, is a model that predicts that clozapine is completely effective at blocking psychopathology or pathophysiology valid? Second, is the action of clozapine in any one model based upon one kind of manipulation really that provocative? And finally (and perhaps most importantly), is developing models that explain how clozapine works really in our best interest, or is it time to move beyond models that predict marginal gains from existing drugs, in order to look to targets flowing from the new valid genetic mechanisms that appear to hold the keys to the next generation of treatments for schizophrenia?

References:

Amitai N, Semenova S, Markou A. Cognitive-disruptive effects of the psychotomimetic phencyclidine and attenuation by atypical antipsychotic medications in rats. Psychopharmacology (Berl). 2007 Sep;193(4):521-37. Abstract

Balla A, Sershen H, Serra M, Koneru R, Javitt DC. Subchronic continuous phencyclidine administration potentiates amphetamine-induced frontal cortex dopamine release. Neuropsychopharmacology. 2003 Jan;28(1):34-44. Abstract

Bilder RM, Goldman RS, Volavka J, Czobor P, Hoptman M, Sheitman B, Lindenmayer JP, Citrome L, McEvoy J, Kunz M, Chakos M, Cooper TB, Horowitz TL, Lieberman JA. Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry. 2002 Jun;159(6):1018-28. Abstract

Geyer MA, Krebs-Thomson K, Braff DL, Swerdlow NR. Pharmacological studies of prepulse inhibition models of sensorimotor gating deficits in schizophrenia: a decade in review. Psychopharmacology (Berl). 2001 Jul;156(2-3):117-54. Abstract

Goldberg TE, Weinberger DR. Effects of neuroleptic medications on the cognition of patients with schizophrenia: a review of recent studies. J Clin Psychiatry. 1996;57 Suppl 9:62-5. Abstract

Idris NF, Repeto P, Neill JC, Large CH. Investigation of the effects of lamotrigine and clozapine in improving reversal-learning impairments induced by acute phencyclidine and D-amphetamine in the rat. Psychopharmacology (Berl). 2005 May;179(2):336-48. Abstract

Jentsch JD, Redmond DE Jr, Elsworth JD, Taylor JR, Youngren KD, Roth RH. Enduring cognitive deficits and cortical dopamine dysfunction in monkeys after long-term administration of phencyclidine. Science. 1997 Aug 15;277(5328):953-5. Abstract

Lipina T, Labrie V, Weiner I, Roder J. Modulators of the glycine site on NMDA receptors, D-serine and ALX 5407, display similar beneficial effects to clozapine in mouse models of schizophrenia. Psychopharmacology (Berl). 2005 Apr;179(1):54-67. Abstract

The paper by Kargieman et al. provides an interesting perspective on the effects of PCP on activity in the prefrontal cortex. Dr. Javitt brings up an excellent point in his commentary that the study highlights the importance of PCP in this preparation as a model of slow-wave sleep disturbances in schizophrenia. In anesthetized animals, field potential recordings resemble the up and down states observed in slow-wave sleep. These states are driven by NMDA receptors and, accordingly, NMDA antagonists such as PCP and ketamine should reduce them as reported. The odd thing about NMDA antagonists is that they themselves can be used as anesthetics to produce a state where slow delta oscillations predominate. For instance, robust up and down states or slow oscillations at or below delta are observed when ketamine is used as an anesthetic. Therefore, NMDA antagonists can induce a state where delta activity is prominent, yet if the subject is already in that state, the effect of the drug is to reduce such activity.

So this also may be the case with PCP. There are numerous EEG studies...  Read more

The paper by Kargieman et al. provides an interesting perspective on the effects of PCP on activity in the prefrontal cortex. Dr. Javitt brings up an excellent point in his commentary that the study highlights the importance of PCP in this preparation as a model of slow-wave sleep disturbances in schizophrenia. In anesthetized animals, field potential recordings resemble the up and down states observed in slow-wave sleep. These states are driven by NMDA receptors and, accordingly, NMDA antagonists such as PCP and ketamine should reduce them as reported. The odd thing about NMDA antagonists is that they themselves can be used as anesthetics to produce a state where slow delta oscillations predominate. For instance, robust up and down states or slow oscillations at or below delta are observed when ketamine is used as an anesthetic. Therefore, NMDA antagonists can induce a state where delta activity is prominent, yet if the subject is already in that state, the effect of the drug is to reduce such activity.

So this also may be the case with PCP. There are numerous EEG studies showing that PCP significantly increases activity in the delta band of awake humans or animals (Stockard et al., 1976; Matsuzaki and Dowling, 1985; Mattia et al.,1988; Marquis et al., 1989; Yamamoto, 1997; Sebban et al., 2002), yet reduces power in this band of anesthetized animals. Moreover, schizophrenics appear to have a significant increase in frontal delta oscillations when awake (Wuebben and Winterer, 2001), yet exhibit slow-wave sleep disturbances and lower delta count when asleep (Ganguli et al., 1987). How is that?

It may be a matter of perspective. In the awake state the cortex is highly desynchronized and firing is quite irregular with power in a variety of high-frequency bands and neurons firing at every phase angle of the field potential. With anesthetics, higher frequencies become unsustainable. Using realistic network model simulations, Durstewitz and Gabriel (2007) showed that if you come from a regime which is quite irregular and then reduce NMDA, you get clear delta wave oscillations, but as you keep reducing NMDA, these delta oscillations will become progressively reduced as well. So in the awake state, reductions in NMDA currents should relatively decrease power in many bands yet enhance delta, but if the network is already in delta, as when the subject is anesthetized or asleep, NMDA reduction would decrease power in this band. Therefore, the results of Kargieman et al., when viewed in light of the literature obtained in awake subjects and schizophrenics, confirms a non-trivial and somewhat paradoxical prediction of the NMDA theory of schizophrenia and the PCP model.

References:

Durstewitz D, Gabriel T. Dynamical basis of irregular spiking in NMDA-driven prefrontal cortex neurons. Cereb Cortex. 2007 Apr;17(4):894-908. Epub 2006 Jun 1. Abstract

Ganguli R, Reynolds CF 3rd, Kupfer DJ. Electroencephalographic sleep in young, never-medicated schizophrenics. A comparison with delusional and nondelusional depressives and with healthy controls. Arch Gen Psychiatry. 1987 Jan;44(1):36-44. Abstract

Marquis KL, Paquette NC, Gussio RP, Moreton JE. Comparative electroencephalographic and behavioral effects of phencyclidine, (+)-SKF-10,047 and MK-801 in rats. J Pharmacol Exp Ther. 1989 Dec;251(3):1104-12. Abstract

Matsuzaki M, Dowling KC. Phencyclidine (PCP): effects of acute and chronic administration on EEG activities in the rhesus monkey. Electroencephalogr Clin Neurophysiol. 1985 Apr;60(4):356-66. Abstract

Mattia A, Marquis KL, Leccese AP, el-Fakahany EE, Moreton JE. Electroencephalographic, behavioral and receptor binding correlates of phencyclinoids in the rat. J Pharmacol Exp Ther. 1988 Aug;246(2):797-802. Abstract

Sebban C, Tesolin-Decros B, Ciprian-Ollivier J, Perret L, Spedding M. Effects of phencyclidine (PCP) and MK 801 on the EEGq in the prefrontal cortex of conscious rats; antagonism by clozapine, and antagonists of AMPA-, alpha(1)- and 5-HT(2A)-receptors. Br J Pharmacol. 2002 Jan;135(1):65-78. Abstract

Stockard JJ, Werner SS, Aalbers JA, Chiappa KH. Electroencephalographic findings in phencyclidine intoxication. Arch Neurol. 1976 Mar;33(3):200-3. Abstract

Wuebben Y, Winterer G. Hypofrontality -- a risk-marker related to schizophrenia? Schizophr Res. 2001 Mar 30;48(2-3):207-17. Abstract

Yamamoto J. Cortical and hippocampal EEG power spectra in animal models of schizophrenia produced with methamphetamine, cocaine, and phencyclidine. Psychopharmacology (Berl). 1997 Jun;131(4):379-87. Abstract

The newly published paper by Katherine Roche and Paul Roche reports SNAP-23 expression in neuron dendrites and examines the possible role of this neuronal SNAP-23 protein. To this point, SNAP-23 has traditionally been discussed in reference to vesicle trafficking in epithelial cells (see Rodriguez-Boulan et al., 2005 for review), so it is of interest to determine the function of SNAP-23 in neurons. Suh et al. report that surface NMDA receptor expression and NMDA-mediated currents are inhibited following SNAP-23 knockdown. Further, SNAP-23 knockdown results in a specific decrease in NR2B subunit insertion; previously, the NR2B subunit has been reported to preferentially localize to recycling endosomes compared to NR2A (Lavezzari et al., 2004). Given these findings, it is reasonable to conclude that SNAP-23 may be involved in maintaining NMDA receptor surface expression possibly by binding to NMDA-specific recycling endosomes....  Read more

The newly published paper by Katherine Roche and Paul Roche reports SNAP-23 expression in neuron dendrites and examines the possible role of this neuronal SNAP-23 protein. To this point, SNAP-23 has traditionally been discussed in reference to vesicle trafficking in epithelial cells (see Rodriguez-Boulan et al., 2005 for review), so it is of interest to determine the function of SNAP-23 in neurons. Suh et al. report that surface NMDA receptor expression and NMDA-mediated currents are inhibited following SNAP-23 knockdown. Further, SNAP-23 knockdown results in a specific decrease in NR2B subunit insertion; previously, the NR2B subunit has been reported to preferentially localize to recycling endosomes compared to NR2A (Lavezzari et al., 2004). Given these findings, it is reasonable to conclude that SNAP-23 may be involved in maintaining NMDA receptor surface expression possibly by binding to NMDA-specific recycling endosomes.

Interestingly, there is recent evidence that PKC-induced NMDA receptor insertion is mediated by another neuronal SNARE protein; postsynaptic SNAP-25 (Lau et al., 2010). It is possible that activity-induced NMDA receptor trafficking is mediated by SNAP-25, while baseline maintenance of NMDA receptor levels relies on SNAP-23. Other evidence to suggest a strictly regulatory role for SNAP-23 in neuronal NMDA insertion is the finding that activity-dependent receptor insertion from early endosomes has previously been reported to be restricted to AMPA-type glutamate receptors (Park et al., 2004). However, it is possible that activity-induced insertion of AMPA receptors occurs via a distinct endosome pool than NMDA receptors; AMPA and NMDA receptor trafficking has been reported to proceed by distinct vesicle trafficking pathways (Jeyifous et al., 2009).

Although SNAP-23 may not be involved in activity-dependent early endosome receptor trafficking, it is possible that SNAP-23 operates in other pathways linked to activity-induced NMDA receptor trafficking. For instance, SNAP-23 may be the SNARE protein by which lipid raft shuttling of NMDA receptors occurs. SNAP-23 has been found to preferentially associate with lipid rafts over SNAP-25 in PC12 cells (Salaün et al., 2005). As well, NMDA receptors have been found to associate with lipid raft associated proteins flotilin-1 and -2 in neurons (Swanwick et al., 2009). Lipid raft trafficking of NMDA receptors to post-synaptic densities has been reported to follow global ischemia (Besshoh et al., 2005), and the possibility remains that under certain circumstances, NMDA trafficking occurs by lipid raft association to SNAP-23.

Taken together, the discovery of post-synaptic SNARE proteins offers several avenues of research to determine their roles and functions in glutamatergic synapse organization. Further, investigating disruption of synaptic receptor organization presents several possibilities for potential etiologies of disorders linked to compromised glutamate signaling like schizophrenia.

References:

Besshoh, S., Bawa, D., Teves, L., Wallace, M.C. and Gurd, J.W. (2005). Increased phosphorylation and redistribution of NMDA receptors between synaptic lipid rafts and post-synaptic densities following transient global ischemia in the rat brain. Journal of Neurochemistry, 93: 186-194. Abstract

Jeyifous, O., Waites, C.L., Specht, C.G., Fujisawa, S., Schubert, M., Lin, E.I., Marshall, J., Aoki, C., de Silva, T., Montgomery, J.M., Garner, C.C. and Green, W.N. (2009). SAP97 and CASK mediate sorting of NMDA receptors through a previously unknown secretory pathway. Nature Neuroscience, 12: 1011-1019. Abstract

Lau, C.G., Takayasu, Y., Rodenas-Ruano, A., Paternain, A.V., Lerma, J., Bennet, M.V.L. and Zukin, R.S. (2010). SNAP-25 is a target of protein kinase C phosphorylation critical to NMDA receptor trafficking. Journal of Neuroscience, 30: 242-254. Abstract

Lavezzari, G., McCallum, J., Dewey, C.M. and Roche, K.W. (2004). Subunit-specific regulation of NMDA receptor endocytosis. Journal of Neuroscience, 24: 6383-6391. Abstract

Park, M., Penick, E.C., Edward, J.G., Kauer, J.A. and Ehlers, M.D. (2004). Recycling endosomes supply AMPA receptors for LTP. Science, 305: 1972-1975. Abstract

Rodriguez-Boulan, E., Kreitzer, G. and Müsch, A. (2005) Organization of vesicular trafficking in epithelia. Nature Reviews: Molecular Cell Biology, 6: 233-247. Abstract

Salaün, C., Gould, G.W. and Chamberlain, L.H. (2005). The SNARE proteins SNAP-25 and SNAP-23 display different affinities for lipid rafts in PC12 cells. Journal of Biological Chemistry, 280: 1236-1240. Abstract

Suh, Y.H., Terashima, A., Petralia, R.S., Wenthold, R.J., Isaac, J.T.R., Roche, K.W. and Roche, P.A. (2010). A neuronal role for SNAP-23 in postsynaptic glutamate receptor trafficking. Nat Neurosci. 2010 Mar;13(3):338-43. Abstract

Swanwick, C.C., Shapiro, M.E., Chang, Y.Z. and Wenthold, R.J. (2009). NMDA receptors interact with flotillin-1 and -2, lipid raft-associated proteins. FEBS Letters, 583: 1226-1230. Abstract

Common or rare genetic variation in NRG3 influences risk for schizophrenia?
Emerging evidence implicating NRG3 as a likely susceptibility gene in population samples as diverse as the Ashkenazi Jews, Han Chinese, Australians of Anglo-Irish ancestry, and white Americans is certainly a “noteworthy” occurrence in schizophrenia genetics. The latest addition to the evidence (Kao et al., 2010) provides considerable support to earlier (Fallin et al., 2003; Wang et al., 2008) and recent findings of association of several polymorphisms (rs10883866, rs6584400, rs10748842) within a conserved linkage disequilibrium (LD) block in intron 1 of the NRG3 gene with a delusion-laden factor and a neurocognitive quantitative trait in the schizophrenia phenotype (Chen et al., 2009; Morar et al., 2010).

A fundamental contribution of the present study is...  Read more

Common or rare genetic variation in NRG3 influences risk for schizophrenia?
Emerging evidence implicating NRG3 as a likely susceptibility gene in population samples as diverse as the Ashkenazi Jews, Han Chinese, Australians of Anglo-Irish ancestry, and white Americans is certainly a “noteworthy” occurrence in schizophrenia genetics. The latest addition to the evidence (Kao et al., 2010) provides considerable support to earlier (Fallin et al., 2003; Wang et al., 2008) and recent findings of association of several polymorphisms (rs10883866, rs6584400, rs10748842) within a conserved linkage disequilibrium (LD) block in intron 1 of the NRG3 gene with a delusion-laden factor and a neurocognitive quantitative trait in the schizophrenia phenotype (Chen et al., 2009; Morar et al., 2010).

A fundamental contribution of the present study is the cloning and detailed characterization of full-length NRG3 transcripts from postmortem fetal, child, adolescent, and adult brain samples (whole brain, hippocampus, and dorsolateral prefrontal cortex). Sequencing of the cDNA clones and expression analysis revealed a complex picture of alternative splicing, abundance of developmentally regulated transcripts in schizophrenia brains, and, notably, increased expression of a fetal brain-derived clone (hFBNRG3), which introduces a premature stop codon resulting in a truncated protein and a possibly destabilized NRG3-ErbB4 signalling pathway. In their clinical collections (a family-based sample and a partially independent case-control sample), the authors report significant associations of rs10748842 (representing 12 SNPs located in the LD block within intron 1) with schizophrenia, with the PANSS (Positive and Negative Syndrome Scale) subscale score on delusion severity, as well as with the PANSS negative symptom load.

Overall, the findings from this investigation and the earlier studies appear to be in a broad agreement, converging on a plausible role of NRG3 in schizophrenia pathogenesis. However, there is a fly in the ointment: The associations found in the present study exhibit a risk allele reversal compared to previously reported results; namely, all significant associations are with the major, common alleles, rather than with the minor alleles, as in Chen et al. (2009) and Morar et al. (2010). While many reasons for genuine allele flipping can be invoked (multi-locus interactions, variation in local patterns of LD, environmental exposures, ethnic background differences—see Clarke and Cardon, 2010), the explanation for the flip in this particular context is not obvious, and NRG3 should remain on the examination bench. Even in the GWAS era, studies proceeding from biologically and clinically anchored hypotheses remain rewarding and potentially productive.

References:

Chen PL, Avramopoulos D, Lasseter VK, McGrath JA, Fallin MD, Liang K-Y, Nestadt G, Feng N, Steel G, Cutting AS, Wolyniec P, Pulver AE, Valle D. Fine mapping on chromosome 10q22-q23 implicates Neuregulin 3 in schizophrenia. Am J Hum Genet. 2009;84:21-34. Abstract

Clarke GM, Cardon LR. Aspects of observing and claiming allele flips in association studies. Genet Epidemiol. 2010;34:266-74. Abstract

Fallin MD, Lasseter VK, Wolyniec PS, McGrath JA, Nestadt G, Valle D, Liang KY, Pulver AE. Genomewide linkage scan for schizophrenia susceptibility loci among Ashkenazi Jewish families shows evidence of linkage on chromosome 10q22. Am J Hum Genet. 2003;73:601-11. Abstract

Kao WT, Wang Y, Kleinman JE, Lipska BK, Hyde TM, Weinberger DR, Law AJ. Common genetic variation in Neuregulin 3 (NRG3) influences risk for schizophrenia and impacts NRG3 expression in human brain. Proc Natl Acad Sci U S A. 2010 Aug 31;107(35):15619-24. Abstract

Morar B, Dragovic M, Waters FAV, Chandler D, Kalaydjieva L, Jablensky A. Neuregulin 3 (NRG3) as a susceptibility gene in a schizophrenia subtype with florid delusions and relatively spared cognition. Mol Psychiatry. 2010 June 15. Abstract

Wang YC, Chen JY, Chen ML, Chen CH, Lai IC, Chen TT, Hong CJ, Tsai SJ, Liou YL. Neuregulin 3 genetic variations and susceptibility to schizophrenia in a Chinese population. Biol Psychiatry. 2008;64:1093-6. Abstract