Multiple components of cortical γ-aminobutyric acid (GABA) neurotransmission appear to be altered in schizophrenia. Presynaptic markers of both GABA synthesis and reuptake are decreased in the cerebral cortex of schizophrenic subjects
(1–
3), while the density of postsynaptic GABA
A receptors is increased in the prefrontal cortex
(4,
5). At least some of these findings reflect alterations at the level of gene expression. For example, in the prefrontal cortex of schizophrenic subjects, studies have reported reduced expression of the mRNA encoding the 67-kilodalton isoform of the synthesizing enzyme for GABA, glutamate decarboxylase (GAD
67)
(6,
7), and one reported a shift in the ratio of the mRNAs encoding the two splice variants of the γ
2 subunit of the GABA
A receptor
(8).
Furthermore, alterations in prefrontal cortex GABA neurotransmission may be most prominent in a subset of inhibitory neurons, including the chandelier neuron subpopulation. The axons of chandelier neurons furnish linear arrays of terminals, termed “cartridges,” which synapse at the axon initial segment of pyramidal neurons
(9). These cartridges can be readily identified by their immunoreactivity for an isoform of the GABA membrane transporter (GAT-1) that is responsible for terminating the synaptic activity of GABA by reuptake into nerve terminals
(10). It is interesting to note that the density of GAT-1-immunoreactive axon cartridges is reduced in the prefrontal cortex of schizophrenic subjects
(11,
12), whereas the relative density of other GAT-1-immunoreactive varicosities is unchanged
(11). However, these results do not reveal whether the decrease in GAT-1-immunoreactive axon cartridges could be attributed to alterations in GAT-1 mRNA expression.
Consequently, in this study, we examined cellular levels of GAT-1 mRNA in the prefrontal cortex of subjects with schizophrenia. Since we had previously observed a decrease in GAD67 mRNA expression in a subset of GABA neurons in prefrontal cortex layers 1–5, we predicted 1) that GAT-1 mRNA expression would be relatively unchanged in the majority of GABA neurons but decreased in a subset, 2) that this subset would be distributed across layers 1–5, but not layer 6, of the prefrontal cortex; and 3) that chronic treatment with haloperidol would not account for the decrease in GAT-1 mRNA expression.
Results
The specificity of the oligonucleotide probes for GAT-1 mRNA was demonstrated by the similarities of the GAT-1 mRNA+ neurons to the known morphological characteristics and laminar distribution of GABA neurons. First, a specific hybridization signal—the clustering of silver grains over Nissl-stained cell bodies—was clearly present for small- and medium-sized neurons but was noticeably absent for pyramidal neurons (
Figure 1). Second, as shown in
Figure 2, the relative laminar densities of GAT-1 mRNA+ neurons, greatest in layers 2 and 4 and lowest in layer 6, matched previous reports of the laminar distribution of GAD
67 mRNA+ neurons in human prefrontal cortex
(6,
7).
As illustrated in
Figure 3, the density of grain clusters, which represent GAT-1 mRNA+ neurons, appears to be less in schizophrenic subjects. Indeed, the mean density of GAT-1 mRNA+ neurons in layers 1–5 was decreased by 21%–33% in the subjects with schizophrenia, but was unchanged in layer 6 (
Figure 4, top). The overall MANCOVA for layers 1–5 demonstrated a significant effect of diagnosis (F=5.32, df=1, 8, p=0.05), and analyses within layers revealed that GAT-1 mRNA+ neuron density in the schizophrenic subjects was significantly lower in layer 1 (t=4.03, df=8, p=0.002), layer 2 (t=2.28, df=8, p<0.03), superficial layer 3 (t=2.07, df=8, p<0.04), and at the layer 3–4 border (t=3.29, df=8, p=0.006); the difference in layer 5 did not achieve significance (t=1.64, df=8, p=0.07). Furthermore, in each of layers 1 through 4, between six and nine of the 10 subjects with schizophrenia showed a lower GAT-1 mRNA+ neuron density relative to their matched comparison subject (
Figure 5, top half). In addition, the differences between subject groups in layers 1–4 could not be attributed to the effects of postmortem brain pH (F<3.02, df=1, 8, p>0.12).
In contrast, grain density of GAT-1 mRNA+ neurons (bottom halves of Figures 4 and 5), a relative measure of the cellular level of GAT-1 mRNA expression, did not differ between subjects with schizophrenia and the comparison group in layer 2, superficial layer 3, layer 5, or layer 6 (F<1.57, df=1, 8, p>0.24). Mean grain density per neuron was 11% lower in the subjects with schizophrenia at the layer 3–4 border (F=11.73, df=1, 8, p=0.009) and was 8% lower in layer 1 (F=4.54, df=1, 8, p<0.07).
The mean cross-sectional somal area (in μm
2) of GAT-1 mRNA+ neurons did not significantly differ (df=1, 8 for all analyses) between the schizophrenic and comparison groups in any layer (layer 1: mean=65.4 [SD=4.4] and 65.4 [SD=6.4], respectively, F=0.26, p>0.62; layer 2: mean=67.0 [SD=2.3] and 69.4 [SD=6.7], F=0.97, p>0.35; superficial layer 3: mean=76.7 [SD=7.8] and 84.1 [SD=7.4], F=4.69, p>0.06; layer 3–4 border: mean=75.7 [SD=8.5] and 74.9 [SD=6.7], F=0.00, p>0.94; layer 5: mean=80.5 [SD=8.7] and 83.5 [SD=6.7], F=0.91, p>0.36; layer 6: mean=75.8 [SD=12.5] and 78.7 [SD=15.8], F=0.98, p>0.35). As previously reported, cortical thickness also did not differ between the subject groups
(7).
As shown in
Figure 6, the lower density of GAT-1 mRNA+ neurons in the subjects with schizophrenia paralleled lower GAD
67 mRNA+ neuron density in layers 1–5, whereas neither was decreased in layer 6. Furthermore, across layers 1–5, the differences in GAT-1 mRNA+ neuron density and GAD
67 mRNA+ neuron density within subject pairs were significantly correlated (r=0.47, df=8, p=0.001).
In both the haloperidol-treated and control monkeys, the morphological characteristics and laminar distribution of GAT-1 mRNA+ neurons were similar to the observations in humans and to previous studies of other markers of GABA neurons in monkeys
(7,
21). Specifically, clusters of silver grains were found exclusively over small- and medium-sized neurons, and the density of GAT-1 mRNA+ neurons was greatest in layers 2 and 4. However, neither density (t<2.14, df=3, p>0.12), grain density (t<1.27, df=3, p>0.29), nor somal size (t<1.60, df=3, p>0.20) of the GAT-1 mRNA+ neurons differed significantly between haloperidol-treated and control monkeys in any layer.
Discussion
In the prefrontal cortex of subjects with schizophrenia, the mean density of neurons expressing a detectable level of GAT-1 mRNA was 21%–33% lower in layers 1–5 but was unchanged in layer 6 relative to matched comparison subjects. In contrast, the mean grain density per GAT-1 mRNA+ neuron, a relative measure of the cellular level of GAT-1 mRNA expression, did not differ between schizophrenic and comparison subjects by more than 11% in any cortical layer. These results indicate that GAT-1 mRNA expression is relatively unaltered or only slightly reduced in the majority of prefrontal cortex GABA neurons in schizophrenia but is reduced below a detectable level in a subset of GABA neurons (
Figure 7, left panel).
These findings do not appear to be attributable to treatment with antipsychotic medications. For example, although seven of the schizophrenic subjects in this study had received haloperidol at some point (
Table 1), long-term exposure of monkeys to therapeutic serum levels of haloperidol did not produce detectable changes in GAT-1 mRNA expression. Consistent with this finding, previous studies did not show a decrease in GAT-1 protein in association with antipsychotic medications
(11,
12).
Of the four subjects with schizophrenia who met criteria for substance abuse disorder, two subjects (587 and 625) actually showed an increase in GAT-1 mRNA+ neuron density in layer 2, superficial layer 3, and layer 5 (
Figure 5, top half), which suggests that substance abuse does not consistently decrease GAT-1 mRNA expression. mRNA instability in postmortem tissue also did not appear to be a confound because 1) the cellular levels of GAT-1 mRNA, GAD
67 mRNA
(7), and synaptophysin mRNA
(22) were relatively unaltered in the majority of neurons in the present cohort of subjects, and 2) brain pH was in the range associated with mRNA stability
(20) and did not differ between the two subject groups. Finally, the procedures used to assess relative neuron density employed, by necessity, a profile counting method. However, this approach was not confounded by differences in somal size between the diagnostic groups, and use of an Abercrombie correction would not have changed the relative differences in neuron density across subject groups
(7).
The decrease in density of GAT-1 mRNA+ neurons does not appear to be due to a decrease in the number of prefrontal cortex neurons in the subjects with schizophrenia because most, although not all
(23), previous studies have reported no change
(6), an increase in neuron density
(24), or no change in total neuron number
(25), in the prefrontal cortex of subjects with schizophrenia. Consistent with these observations, in the same cortical region of the same subjects with schizophrenia used in the present study, we found no differences in the density of neurons expressing synaptophysin mRNA
(22), which is found in virtually every cortical neuron. However, GABA neurons represent only approximately 25% of the total number of neurons in the prefrontal cortex, and studies of total prefrontal cortex cell number or density may not be sensitive enough to detect a reduction in number of a subset of GABA neurons.
For both the human and monkey studies, a unique threshold of grain density per neuron relative to the background grain density in the white matter was created to exclude nonspecifically labeled neurons from the analysis. The appropriateness of each threshold was confirmed 1) by the laminar distribution of GAT-1 mRNA+ neurons, which paralleled the known distribution of GABA neurons, and 2) by the similarities between the densities of GAT-1 mRNA+ neurons and GAD67 mRNA+ neurons in each layer. Furthermore, applying a more stringent threshold (i.e., 5× background grain density) to the human GAT-1 mRNA study resulted in a similar laminar specificity of differences between subject groups and did not increase the magnitude of the differences, which suggests that the entire affected subset of GABA neurons expressed levels of GAT-1 mRNA beneath the 2× background threshold of detectability. In addition, eliminating the somal size cutoff of 50 μm2 resulted in the same magnitude of differences in both neuron density and grain density of GAT-1 mRNA+ neurons between subject groups.
Altered gene expression of presynaptic components of GABA neurotransmission appears to be common in schizophrenia. In the prefrontal cortex, studies that have used different cohorts of subjects have found decreased expression of GAD
67 mRNA
(6,
7,
26) and GAT-1 mRNA
(27), although in the latter study, the specificity of the probes for GAT-1 mRNA was not clearly demonstrated, since primarily pyramidal neurons were labeled. Furthermore, in the same cohort of subjects, both GAD
67 mRNA+ and GAT-1 mRNA+ neurons showed similar reductions in density that were restricted to layers 1–5 (
Figure 6). These similarities suggest that these two markers may be affected to the same extent in individual subjects with schizophrenia, and thus, may be altered within the same subset of GABA neurons.
One specific subpopulation of cortical GABA neurons, the chandelier subclass, has been previously implicated in the pathophysiology of schizophrenia. GAT-1 protein has been reported to be selectively altered in the axon cartridges of chandelier neurons
(11,
12). However, it was unclear whether the decrease in GAT-1 immunoreactive axon cartridges resulted from alterations in gene transcription. It is interesting to note that our results suggest that decreased GAT-1 mRNA expression in chandelier neurons may account for the decreased density of GAT-1-immunoreactive axon cartridges in schizophrenia (
Figure 7, right side). First, the density of GAT-1 mRNA+ neurons was decreased in the same layers in which chandelier neurons are found, prefrontal cortex layers 2–5, which suggests that chandelier neurons may be included in the subset of GABA neurons expressing an undetectable level of GAT-1 mRNA. Furthermore, Pearson correlation analyses conducted on the nine subjects with schizophrenia included in both this GAT-1 mRNA study and the previous study of GAT-1-immunoreactive axon cartridges
(12) revealed positive associations between the densities of GAT-1 mRNA+ neurons and GAT-1-labeled cartridges in the superficial (r=0.61, df=7, p=0.08), middle (r=0.44, df=7, p=0.23), and deep (r=0.64, df=7, p=0.07) cortical layers, even though the GAT-1-labeled cartridges and GAT-1 mRNA+ neurons were quantified in the left and right prefrontal cortex, respectively. Although these comparisons have the aforementioned limitations, they are consistent with the idea that lower density of GAT-1-immunoreactive axon cartridges reflects decreased GAT-1 protein secondary to decreased GAT-1 mRNA expression in chandelier neurons. However, the magnitude of the decrease in GAT-1 mRNA+ neuron density suggests that other subpopulations of GABA neurons, in addition to chandelier neurons, may also be affected.
Alterations in gene expression restricted to a subset of GABA neurons in prefrontal cortex layers 1–5 might reflect the developmental origin of this subset of neurons. For example, although the majority of neurons in the primate neocortex migrate radially from the subventricular zone during the second trimester of gestation
(28), many GABA neurons appear to find their final location in the cortex following a tangential migration from the ganglionic eminences
(29). Although it is not known what proportion of GABA neurons originate from each of these two sources, and to which cortical layers these neurons migrate, it is possible that the site of embryonic origin may be associated with a greater susceptibility to altered gene expression in schizophrenia. Alternatively, the subset of GABA neurons affected in schizophrenia could include those that are a product of postnatal neurogenesis. It is interesting to note that in monkeys, cortical neurons that originate during adulthood appear to migrate selectively to layers 1–5, but not to layer 6, of association regions
(30). Although speculative, these comparisons may provide novel clues as to links between either pre- or postnatal developmental events and the specific types of cortical circuitry abnormalities observed in schizophrenia.
Alternatively, an abnormality in afferents from another brain region may be the pathophysiological mechanism behind alterations in GABA markers in the prefrontal cortex in schizophrenia. For example, the number of neurons in the mediodorsal nucleus of the thalamus, which projects to the prefrontal cortex
(31), has been reported to be lower in schizophrenia
(32,
33). Furthermore, a decrease in thalamic relay input to the cortex can produce a decreased expression of the gene products regulating GABA neurotransmission in layer 4 and adjacent layers, at least in the visual cortex of monkeys
(34,
35). However, additional studies are needed to determine whether a loss of input from the mediodorsal nucleus accounts for the decreased expression of GAD
67 and GAT-1 mRNA in a subset of prefrontal cortex neurons in schizophrenia.