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During a randomized Phase 1 clinical trial the drug candidate, PF‐04895162 (ICA‐105665), caused transaminase elevations (≥grade 1) in six of eight healthy subjects treated at 300 mg twice daily for 2‐weeks (NCT01691274). This was unexpected since studies in rats (

ICA-105665, identified by Icagen, Inc. (Durham, NC, U.S.A.), is a novel small molecule that opens Kv7.2/7.3 and Kv7.3/7.5 potassium channels (Roeloffs et al., 12), also known as KCNQ2/3 and KCNQ3/5 channels. The compound has demonstrated broad spectrum antiseizure activity in multiple animal models including maximal electroshock, 6 Hz seizures, pentylenetetrazole, and electrical kindling at doses from

Openers or activators of neuronal KCNQ2/Q3 potassium channels decrease neuronal excitability and may provide benefit in the treatment of disorders of neuronal excitability such as epilepsy. In the present study, we evaluate the effects of ICA-27243 [N-(6-chloro-pyridin-3-yl)-3,4-difluoro-benzamide], an orally bioavailable, potent, and selective KCNQ2/Q3 opener, in a broad range of rodent seizure models. ICA-27243 was effective against maximal electroshock (MES) and pentylenetetrazole (PTZ)-induced seizures in both rats (MES, ED(50) = 1.5 mg/kg p.o.; PTZ, ED(50) = 2.2 mg/kg p.o.) and mice (MES, ED(50) = 8.6 mg/kg p.o.; PTZ, ED(50) = 3.9 mg/kg p.o.) in the rat amygdala kindling model of partial seizures (full protection from seizure at 9 mg/kg p.o.) and in the 6-Hz model of psychomotor seizures in mice (active at 10 mg/kg i.p.). Antiseizure efficacy in all models was observed at doses significantly less than those shown to effect open-field locomotor activity (rat ED(50) = 40 mg/kg p.o.) or ability to remain on a Rotorod (no effect in rat at doses up to 100 mg/kg p.o.). There was no evidence of cognition impairment as measured in the Morris water maze in the rat (10 and 30 mg/kg p.o.), nor was there evidence of the development of tolerance after multiple doses of ICA-27243. Our findings suggest that selective KCNQ2/Q3 opening activity in the absence of effects on KCNQ3/Q5 or GABA-activated channels may be sufficient for broad-spectrum antiepileptic activity in rodents.

Senicapoc, a novel Gardos channel inhibitor, limits solute and water loss, thereby preserving sickle red blood cell (RBC) hydration. Because hemoglobin S polymerization is profoundly influenced by intracellular hemoglobin concentration, senicapoc could improve sickle RBC survival. In a 12-week, multicenter, phase 2, randomized, double-blind, dose-finding study, we evaluated senicapoc's safety and its effect on hemoglobin level and markers of RBC hemolysis in sickle cell anemia patients. The patients were randomized into 3 treatment arms: placebo; low-dose (6 mg/day) senicapoc; and high-dose (10 mg/day) senicapoc. For the primary efficacy end point (change in hemoglobin level from baseline), the mean response to high-dose senicapoc treatment exceeded placebo (6.8 g/L [0.68 g/dL] vs 0.1 g/L [0.01 g/dL], P < .001). Treatment with high-dose senicapoc also produced significant decreases in such secondary end points as percentage of dense RBCs (−2.41 vs −0.08, P < .001); reticulocytes (−4.12 vs −0.46, P < .001); lactate dehydrogenase (−121 U/L vs −15 U/L, P = .002); and indirect bilirubin (−1.18 mg/dL vs 0.12 mg/dL, P < .001). Finally, senicapoc was safe and well tolerated. The increased hemoglobin concentration and concomitant decrease in the total number of reticulocytes and various markers of RBC destruction following senicapoc administration suggests a possible increase in the survival of sickle RBCs. This study is registered at http://clinicaltrials.gov as NCT00040677.

Epilepsy and neuropathic pain are disorders characterised by excessive neuronal activity. These disorders are currently managed by drugs that are capable of dampening neuronal excitability, including voltage-gated sodium channel blockers, voltage-operated calcium channel modulators and modulators of inhibitory GABAergic neurotransmission. However, these drugs are rarely 100% efficacious and their use is often associated with limiting side effects. Thus, there is a clear medical need for novel agents to treat these diseases. One potential mechanism that has not yet been exploited is potassium (K+) channel opening. A significant (and growing) body of genetic, molecular, physiological and pharmacological evidence now exists to indicate that KCNQ-based currents represent particularly interesting targets for the treatment of diseases such as epilepsy and neuropathic pain. Evidence supporting these K+ channels as novel drug targets will be reviewed in the following article. Worldwide patent activity relating to...

Dear Editor: The Gardos channel inhibitor senicapoc is proven to diminish haemolytic anaemia in a Phase II study conducted in adults with sickle cell anaemia (Ataga, et al 2008), and later confirmed in a Phase III study in sickle cell disease subjects as reported in a recent article in the British Journal of Haematology (Ataga, et al 2011). Brain natriuretic peptide is a hormone secreted by ventricular cardiomyocytes in response to stretch (Levin, et al 1998). The plasma level of its propeptide (NT-proBNP) provides a convenient biomarker of cardiac stress, correlating in sickle cell subjects with pulmonary hypertension proven by pulmonary artery catheterization, or estimated by noninvasive Doppler echocardiography (Machado, et al 2006). Increased NT-proBNP in sickle cell adults is associated with lower haemoglobin, high serum lactate dehydrogenase (LDH) and other laboratory variables (Machado, et al 2006, Mekontso Dessap, et al 2008, Mokhtar, et al 2010, van Beers, et al 2008, Voskaridou, et al 2007). Because senicapoc is proven to increase haemoglobin and decrease LDH in sickle cell anaemia (Ataga, et al 2008), we hypothesized that NT-proBNP levels would fall in sickle cell anaemia subjects who respond to senicapoc treatment with increased haemoglobin level. We obtained local regulatory approval to study coded plasma samples from the 2008 Phase II senicapoc trial (Ataga, et al 2008). We procured archived plasma samples from that trial, and measured NT-proBNP by the same standard clinical laboratory assay we have previously reported in sickle cell anaemia (Machado, et al 2006). In the 53 treated subjects, NT-proBNP levels declined by a nonsignificant degree. However, when the analysis was restricted to the 35 subjects (66%) who responded to senicapoc with a rise in total Hb of at least 5 gm/L, significant changes were observed in NT-proBNP and other markers. Subjects who responded to 6mg daily or 10mg daily were analyzed together as a single group. Among these 35 senicapoc responders, baseline NT-proBNP fell by 26% (geometric mean 97 vs. 72 ng/l, p

2614W94 [3-(1-trifluoromethyl)ethoxyphenoxathiin 10,10-dioxide] is a selective, reversible inhibitor of monoamine oxidase-A with a competitive mechanism of inhibition and a Ki value of 1.6 nM with serotonin as substrate. In pretreated rats, the ED50 value after single oral dosing was 1.7 mg/kg, similar to an ED50 value of 1.1 mg/kg estimated in the 5-hydroxytryptophan potentiation test. Maximal inhibition of monoamine oxidase-A (MAO-A) was observed by 0.5 h after dosing, suggesting rapid transport to brain. Inhibition in brain was maintained for several hours, followed by a gradual reversal with a half-time of 7.2 h. Brain levels of parent compound were higher than plasma levels at all times after dosing. No significant inhibition of MAO-B was observed. After preincubation of MAO with 2614W94 at 37°C, the inhibition was reversed by dialysis. Concentrations of serotonin, norepinephrine, and dopamine were clearly elevated in brains of rats after single oral doses, whereas levels of MAO metabolites were decreased. In a rat model designed to show blood pressure elevations in response to a threshold dose of orally administered tyramine, 2614W94 compared well with moclobemide, an MAO-A selective inhibitor that has not been associated with problems relating to dietary tyramine. The two stereoisomers of 2614W94 were both potent MAO-A inhibitors. In vitro and in vivo properties of 2614W94 suggest that this compound and its close analogs are among the most potent MAO-A inhibitors known and that they may have therapeutic potential as safe new antidepressant/anxiolytic agents. Drug Dev. Res. 45:1–9, 1998. © 1998 Wiley-Liss, Inc.

1192U90 was developed on the assumption that antagonism of 5-HT2 receptors efficacy yields more potently than D2 receptors against positive and negative symptoms of schizophrenia with minimal liability for extrapyramidal side effects (EPSs), and that 5-HT1A agonism further reduces EPSs and provides anxiolytic and antidepressant activity. 1192U90 was submitted to four tests that predict antipsychotic efficacy (antagonism of apomorphine-induced climbing in mouse, antagonism of apomorphine-induced circling in rats with unilateral 6-OHDA lesions, antagonism of amphetamine-induced hyperlocomotion in rat, and inhibition of conditioned avoidance in rat), two tests of 5-HT2 function (antagonism of 5-MeODMT-induced head twitches in mouse and antagonism of 5-HTP-induced wet dog shakes in rat), and three tests that predict EPS liability (antagonism of apomorphine-induced stereotypy in mouse and rat and induction of catalepsy in mouse). ED50s (mg/kg PO) were as follows: climbing 10.1, circling 7.9, hyperlocomotion 6.6, and avoidance 5.7; head twitches 5 and wet dog shakes 4.6; stereotypy in mouse 91.1, stereotypy in rat 133.4, and catalepsy 192.4. The ratio of ED50 for stereotypy antagonism to ED50 for climbing antagonism was 9 (compared to 4, 3, and 4 for clozapine, risperidone, and haloperidol). The ratio of ED50 for catalepsy induction to ED50 for climbing antagonism was 19 (compared to 7, 2, and 17 for clozapine, risperidone, and haloperidol). 1192U90 was also submitted to three tests that predict anxiolysis: It produced only a small increase in punished lever pressing for food in rat (Geller-Seifter conflict test), which is specific for rapid-onset efficacy, but produced large increases in punished key pecking for food in pigeon and cork gnawing in rat, which identify the delayed onset 5-HT1A agonists such as buspirone. The results suggest that 1192U90 would be effective for positive and negative symptoms of schizophrenia, with minimal liability for EPSs, and may also have anxiolytic properties.

Binding of 3H-spiperone and 3H-raclopride to membranes of cells stably-transfected with a human dopamine D2 receptor clone was investigated, as was that of 3H-spiperone to those stably-transfected with a human D4 receptor clone. 3H-spiperone and 3H-raclopride labeled the same number of sites in the D2 receptor preparation. The inhibition of binding by clozapine, spiperone, (-) eticlopride, haloperidol and the novel substituted benzamide 1192U90 was also investigated. Clozapine and 1192U90 showed greater inhibition of 3H-raclopride binding than 3H-spiperone binding to the D2 receptor. Comparison with inhibition of 3H-spiperone binding to the D4 receptor revealed that clozapine and 1192U90 displayed apparent selectivity (as assessed by Ki ratios) for the D4 receptor when compared with binding of 3H-spiperone, but not 3H-raclopride, to the D2 receptor.

A series of novel 4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl) cyclic amides was prepared and evaluated as potential antipsychotic agents. The target compounds were examined in vitro for their binding affinities to the dopamine D2, serotonin 5-HT2, and serotonin 5-HT1a receptors and in vivo for their ability to antagonize the apomorphine-induced climbing response in mice. Derivatives that exhibited good D2/5-HT2 selectivity in vitro and good potency in vivo were selected for further evaluation in tests designed to assess their potential extrapyramidal side effect liability. Structural modifications discussed herein focus on the bicyclic amide subunit leading to the preparation of a variety of heterocyclic ring systems (i.e., phthalimide, isoindolinone, isoquinolinone, benzazepinone, indazolone, phthalazinone, 4-methyl phthalazinone, benzisothiazolone 1,1-dioxide, benzotriazinone, homophthalimide, benzisothiazolone, phthalazinedione, quinazoline, and saturated phthalazinones). The potency and selectivity within this series was found to be dependent on ring size, nature of the covalent linking unit, relative position of the functional groups, degree of unsaturation, and relative stereochemistry. In general, the cyclic benzamides examined in this investigation exhibited receptor binding activities indicative of potential atypical antipsychotic agents. Several of these derivatives possessed in vivo activities that suggest they would be useful in the treatment of schizophrenia and would have a low propensity to induce extrapyramidal side effects. Two potent analogues were identified and selected for further evaluation: 2-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl)-1-isoind olinone (31) and (+-)-cis-2-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)-butyl)- 4a,5,6,7,8,8a-hexahydro-1(2H)-phthalazinone hydrochloride (52).

A series of N-pyridyl benzamide KCNQ2/Q3 potassium channel openers were identified and found to be active in animal models of epilepsy and pain. The best compound 12 [ICA-027243, N-(6-chloro-pyridin-3-yl)-3,4-difluoro-benzamide] has an EC50 of 0.38 μM and is selective for KCNQ2/Q3 channels. This compound was active in several rodent models of epilepsy and pain but upon repeated dosing had a number of unacceptable toxicities that prevented further development. On the basis of the structure−activity relationships developed around 12, a second compound, 51, [N-(2-chloro-pyrimidin-5-yl)-3,4-difluoro-benzamide, ICA-069673], was prepared and advanced into a phase 1 clinical study. Herein, we describe the structure−activity relationships that led to the identification of compound 12 and to the corresponding pyrimidine 51.

Heterocyclic analogues of 1192U90, 2-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)-butyl) benzamide hydrochloride (1), were prepared and evaluated as potential antipsychotic agents. These analogues were evaluated in vitro for their binding to the dopamine D2, serotonin 5-HT2, and serotonin 5-HT1a receptors and in vivo for their ability to antagonize the apomorphine-induced climbing response in mice. Nine different types of heterocyclic carboxamides were studied in this investigation (i.e., pyridine-, thiophene-, benzothiophene-, quinoline-, 1,2,3,4-tetrahydroquinoline-, 2,3-dihydroindole-, indole-, benzimidazole-, and indazolecarboxamides). Two derivatives exhibited potent in vivo activities comparable to 1: 3-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl)-2 -pyridinecarboxamide (16) and 3-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl) -2-thiophenecarboxamide (29). Furthermore, these derivatives were found to be much less active in behavioral models predictive of extrapyramidal side effects than in the mouse climbing assay, which predicts antipsychotic activity. Carboxamides 16 and 29 were selected for further evaluation as potential backup compounds to 1.

BW 1370U87, a novel, selective, reversible monoamine oxidase-A inhibitor, was tested in the 5-HTP (5-hydroxytryptophan) potentiation test in mice and rats to establish its activity following systemic administration, to determine its duration of action and to determine if its effects were reversible in vivo. The behavioral effects of a threshold dose of 5-HTP were potentiated by BW 1370U87 in mice with ED50s of 3.4 mg/kg i.p. and 18.4 mg/kg p.o. 5-HTP potentiation occurred in rats with an ED50 of 10.4 mg/kg p.o. BW 1370U87 (20 mg/kg) was active 9 hr, but not 16 hr following oral administration, consistent with reversible enzyme inhibition.

BW 1370U87 is a potent, reversible, selective inhibitor of rat and human brain MAO-A with a competitive mechanism of action. The ED50 of BW 1370U87 for inhibition of MAO-A in rat brain is 8 mg/kg after oral administration, and the duration of action exceeds 7 hr. The ED80 dose for inhibition of MAO-A (20 mg/kg) elevates NE, DA, and 5-HT levels in brains of rats without significantly potentiating the blood pressure effects of a 15 mg/kg oral dose of tyramine. This dose of tyramine, extrapolated to man, exceeds the amount that could be consumed at one time from dietary sources. No inhibition of MAO-B has been observed with BW 1370U87 either in vitro or ex vivo. BW 1370U87 was effective in the 5-hydroxytryptophan potentiation test over the dose range that produced MAO-A inhibition in brain in both rats and mice, and it reduced swim stress induced immobility in the Porsolt test. The compound has positive effects on abnormal social behavior produced by early social deprivation in the rhesus monkey. BW 1370U87 had no adverse cardiovascular effects in dogs or rats. It also had no significant pharmacological effects on various isolated tissue preparations and did not cause changes in the neuronal transport or the receptor systems which mediate the antidepressant effects or side effects of the tricyclic antidepressants. An acute oral dose 100 times that which produced an 80% inhibition of brain MAO-A exhibited no signs of toxicity. BW 137OU87 appears to be a safe reversible MAO-A inhibitor with potential for treating depression, anxiety conditions, panic, phobias, obsessive compulsive behaviors, and borderline personality disorders.

Startle response amplitude is greatly reduced by a low intensity pulse presented 100 msec prior to the startle stimulus. The magnitude of this prepulse inhibition (PPI) is reduced in schizophrenic patients. In rats, apomorphine disrupts PPI; haloperidol antagonizes apomorphine's effects. We tested the antipsychotic drugs haloperidol, chlorpromazine, clozapine, and risperidone, and the non-antipsychotic psychopharmacological agents diazepam, buspirone, and imipramine for their ability to antagonize apomorphine's effects on PPI of the acoustic startle reflex. Haloperidol, chlorpromazine, and risperidone antagonized apomorphine's blockade of PPI. Clozapine antagonized apomorphine's effect only at a dose that decreased startle amplitude by 82%. Imipramine and diazepam did not antagonize apomorphine's effect at behaviorally relevant doses. Buspirone weakly antagonized apomorphine blockade of PPI, but, like apomorphine, disrupted PPI when given alone. These results suggest that this PPI test may provide a useful screening procedure for compounds wtih antipsychotic activity. However, the lack of a robust clozapine effect needs to be investigated.

Some antidepressant drugs are potent inhibitors of neuronal uptake of serotonin. In vivo, these compounds inhibit serotonergic dorsal raphe neuronal firing rates, presumably through increased stimulation of 5-HT1a autoreceptors. We recorded from electrophysiologically identified serotonergic dorsal raphe neurons in rat brain slices and determined the effects of five serotonin uptake blockers on the firing rates of these units in vitro. Each drug decreased the neuronal firing rates in a concentration-dependent manner. IC50 values derived from concentration-response curves are: fluvoxamine, 0.8 μM; sertraline, 1.1 μM; imipramine, 2.7 μM; chlorimipramine, 2.8 μM; and fluoxetine, 4.2 μM. Exposure of brain slices to 10 μM tetrabenazine, a serotonin depleting agent, prior to treatment with serotonin uptake blockers resulted in a rightward shift of the concentration-response curve. In vitro single unit recording allows: (1) direct comparison with neurochemical data obtained in vitro; (2) access to tissue bypassing blood brain barrier and liver enzymes; (3) quick wash out of drug from tissue; and (4) ability to record from single unitsover long periods (hours). This in vitro test provides a fast, simple means of determining neurophysiological effects of potential antidepressant drugs on the serotonin system.

The design of rigid cyclic analogues derived from cinnamamide 1, (E)-N-cyclopropyl-3-(3-fluorophenyl)prop-2-enamide, and beta-methylcinnamamide 2, (E)-N-cyclopropyl-3-(3-fluorophenyl)but-2-enamide, has led to the discovery of the potent, centrally acting muscle relaxant (E)-2-(4,6-difluoro-1-indanylidene)acetamide, 17. Compound 17 also possesses potent antiinflammatory and analgesic activity. This paper describes the synthesis and the muscle relaxant, antiinflammatory, and analgesic structure-activity relationships of 17 and 67 of its analogues. Compound 17 has been taken into phase I clinical trials.

Extension of the structure-activity relationship studies that led to the discovery of the nonsedating potent muscle relaxant, antiinflammatory, and analgesic agent (E)-2-(4,6-difluoro-1-indanylidene)acetamide, 1, has given rise to (E)-2-(4-chloro-6-fluoro-1-indanylidene)-N-methylacetamide, 2. Compound 2 is a potent antiinflammatory and analgesic agent without centrally acting muscle relaxant activity.

Heterocyclic analogues of 1192U90, 2-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)-butyl) benzamide hydrochloride (1), were prepared and evaluated as potential antipsychotic agents. These analogues were evaluated in vitro for their binding to the dopamine D2, serotonin 5-HT2, and serotonin 5-HT1a receptors and in vivo for their ability to antagonize the apomorphine-induced climbing response in mice. Nine different types of heterocyclic carboxamides were studied in this investigation (i.e., pyridine-, thiophene-, benzothiophene-, quinoline-, 1,2,3,4-tetrahydroquinoline-, 2,3-dihydroindole-, indole-, benzimidazole-, and indazolecarboxamides). Two derivatives exhibited potent in vivo activities comparable to 1: 3-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl)-2 -pyridinecarboxamide (16) and 3-amino-N-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl) -2-thiophenecarboxamide (29). Furthermore, these derivatives were found to be much less active in behavioral models predictive of extrapyramidal side effects than in the mouse climbing assay, which predicts antipsychotic activity. Carboxamides 16 and 29 were selected for further evaluation as potential backup compounds to 1.

A series of phthalimide and isoindolinone derivatives bridged to 4-(1,2-benzisothiazol-3-yl)-1-piperazinyl was prepared. The compounds were evaluated in vitro at dopamine D2 and serotonin 5-HT1a and 5-HT2 receptors and in vivo for their ability to antagonize the apomorphine-induced climbing response in mice. The effects of bridge length and conformation on the biological activity of these potential antipsychotic agents are discussed. A four-carbon spacer provided optimal activity within the two homologous series. Conformational investigations of the lead compound, isoindolinone 2, were conducted in an attempt to account for the superior activity observed for the butyl derivatives. On the basis of NMR and molecular modeling studies, two types of folded structures were proposed and several conformationally restrained analogues were synthesized. In general, restrictions incorporated within the linking bridge were detrimental to activity.

Several investigators have found that basal forebrain neurons in the area of the nucleus basalis and substantia innominata respond to cues that signal the availability of reinforcement (DeLong, 1971; Mitchell et al., 1987; Richardson and DeLong, 1986, 1988; Rolls et al., 1979; Travis and Sparks, 1968; Wilson and Rolls, 1990a, 1990b). The reinforcement-related or conditioning-related responses of such basal forebrain neurons do not depend upon the sensory modality of the signal cue (Wilson and Rolls, 1990a). It is also known that cortical neurons respond to conditioned stimuli applied during similar behavioral paradigms (Aou et al., 1983; Boyd et al., 1982; Fuster et al., 1982; Kojima and Goldman-Rakic, 1982; Mauritz and Wise, 1986; Peterson, 1986; Watanabe, 1990), suggesting a possible relationship between cortical neuron responses and activity of basal forebrain neurons.

Apomorphine disruption of prepulse inhibition (PPI) has been proposed as an animal model of sensorimotor gating deficits exhibited by schizophrenics. The effects of apomorphine on PPI of the acoustic startle reflex in male rats of Wistar and CD (Sprague-Dawley derived) strains were compared under identical test conditions. In Wistar rats, subcutaneous administration of 0.25–1.0 mg/kg apomorphine blocked PPI without affecting startle amplitude. In CD rats, apomorphine (0.3–3.0 mg/kg, SC) had no effect on PPI, but increased startle amplitude. Therefore, choice of rat strain is an important factor in the design of experiments studying apomorphine effects on PPI.

The Stroke Prevention Trial in Sickle Cell Anemia (STOP I) demonstrated a 90% risk reduction of first stroke in high-risk pediatric patients with sickle cell disease (SCD) receiving chronic transfusion therapy (CTT) (Adams RJ et al. N Engl J Med1998;339:5–11). Transcranial Doppler (TCD) is key in assessing the need for CTT in children with SCD. A survey of the American Society of Pediatric Hematology/Oncology found wide variation in how hematologists are managing children with SCD (Lane PA et al. Blood2001;98:784a). Recent recommendations by the National Heart, Lung and Blood Institute (NHLBI) suggest TCD and CTT for stroke prevention in high-risk children with SCD; however, there are no data on the utilization of these guidelines in clinical practice. Therefore, we conducted a telephone survey of Sickle Cell Centers to assess the clinical use of TCD and CTT for stroke prevention in pediatric patients with SCD. Invitations to participate were mailed to Directors of 70 centers; interviews were conducted between December 7, 2005 and February 10, 2006. Results from 25 participating centers were analyzed for trends related to use of TCD and CTT in the care of children with SCD. Questions included frequency of TCD based on velocity: 200 cm/sec (Table). Because some participants could not provide an accurate response, responses are not available for all 25 centers in some cases. Frequency of TCD Sickle Cell Centers N = 25 TCD 200 cm/sec Repeat every mo 14 Repeat every 2 mo 1 Repeat every 3 mo 3 Based on clinical observations, participants estimated the percentage of patients with eventual worsening of TCD velocity to >200 cm/sec and the approximate number of months to reach that endpoint. Responses indicated an average of 23% and 11.3 months, respectively. Of the 25 centers, all but one indicated that patients with an abnormal TCD (>200 cm/sec) were typically placed on CTT. Four participants stated that results from the STOP trial were the basis for their decision. Fifteen centers indicated that the youngest age they would initiate CTT was 1–2 years. Only 2 directors would consider CTT in children

Urethane is an anesthetic which is commonly used in neurophysiological studies because it is presumed to have minimal effects upon neuronal activity. This study investigated the influence of urethane anesthesia upon flash evoked potentials (FEPs) recorded from hooded rats. Subanesthetic dosages (25 g/kg and 0.5 g/kg) and an anesthetic dosage (1.0 g/kg) were administered, and subsequently recorded FEPs were compared to vehicle-injected controls. Urethane produced profound qualitative and quantitative effects upon the FEP. At 0.5 g/kg, the P1 (normal latency = 20 msec) and N1 (normal latency = 30 msec) peaks became unrecognizable. Peak N1 disappeared and peak P1 merged with P2 (normal latency = 45 msec). Peak P2 increased in amplitude by about 100%. The results indicate that in the visual system, urethane has a significant influence upon neuronal activity. Caution should be used in interpreting data obtained from urethane-anesthetized rats.

Single-unit and slow potential responses were recorded from the frontal cortex of unanesthetized, restrained rats trained to associate an auditory cue (tone) with rewarding medial forebrain bundle stimulation. Slow potential responses to the unpaired tone were minimal whereas large negative slow potential responses developed to the paired tone. Units were selected which had large-amplitude action potentials and positive first deflections, characteristics suggesting that the recordings were derived from pyramidal neurons. Responses of excitation, inhibition, and no change were observed during tone presentation. Forty-five percent of the units responded to the unpaired tone; with pairing, 90% of the units demonstrated significant responses. Furthermore, the magnitude of the excitatory responses was enhanced by pairing and a distribution pattern developed in which the overall response of the more superficial units was activation whereas deeper units were inhibited. The results suggest that the conditioning-related negative slow potential responses recorded from the surface of the rat frontal cortex reflect excitatory processes which are associated with an enhanced firing rate of neurons in the upper layers.

1. 1. The effects of acute and chronic trazodone or desipramine treatment on the spontaneous firing rate of cortical neurons In chloral hydrate anesthetized rats were determined. 2. 2. Either trazodone (30 or 60 mg/kg, po) or desipramine (5 or 10 mg/kg, po) was administered daily for periods of up to 11 or 16 days respectively. 3. 3. A significant reduction in the firing rate of cortical neurons was observed after acute and chronic 10 mg/kg desipramine treatment. 4. 4. Chronic treatment with 5 mg/kg desipramine had no effect on activity. 5. 5. Neither acute nor chronic treatment with trazodone produced any significant alteration in cortical unit activity. 6. 6. The results suggest that the spontaneous activity of randomly encountered cortical neurons is not involved in the mechanism of the therapeutic action produced by chronic treatment with the two clinically effective antidepressants. 7. 7. The response of the cortical neurons to antidepressant treatment might help differentiate the relative effects of the drugs on monoaminergic receptors. 8. 8. Also, the depressant effect of desipramine on the spontaneous rate of cortical neurons does not appear to be a specific effect of chronic treatment since it occurred after a single dose.

Male rats were chronically implanted for recording of single units in the frontal cortex during a cue-event paradigm. The rats were sedated and restrained during the experiments. Units were selected which had large-amplitude, clearly isolated action potentials. The animals were first trained to associate a 2-s tone cue with rewarding medial forebrain bundle stimulation. After training, units responded to the cue by an increase or decrease in discharge rate. Cumulative histograms of the unit response to the cue were obtained and then either procaine hydrochloride or GABA was microinjected into the nucleus basalis magnocellularis (nBM). Immediately after drug administration another histogram was obtained to ascertain the drug effect. Procaine microinjections to the nBM suppressed the frontal cortex unit responses in 9 of 10 units that had previously responded with an increase in firing rate and 10 of 12 units that had decreased their firing rate before drug administration. GABA microinjections antagonized the response in 15 of 19 excited units and 2 of 2 inhibited units. Recovery was obtained in 23 units. Other units did not remain isolated long enough to obtain complete recovery. The nBM supplies the frontal cortex with as much as 70% of its cholinergic innervation. Lesions of the region do not significantly alter the amounts of neurotransmitters other than acetylcholine in the frontal cortex. These results indicate that neurons in the nucleus basalis magnocellularis are involved in the cue-elicited changes in the rate of discharge of units in the rat frontal cortex.

Administration of high doses of monosodium glutamate (MSG) to rats during the first postnatal week results in severe losses of retinal ganglion cells and interneurons in the retina. This study was conducted to determine what effect severe retinal damage would have upon the ontogeny of rat flash evoked potentials (FEPs) and the adult pattern reversal evoked potential (PREP). MSG (4 mg/g) or isotonic saline was administered to rat pups daily from postnatal day (PND) 2 until PND 9. FEPs were recorded following 2 stimulation frequencies from unanesthetized, unrestrained MSG treated and control rats on PND 15, PND 22, and PND 60 or older. PREPs were recorded from unanesthetized, restrained rats older than PND 60 from each treatment group. On PND 15, 9 of 12 control animals exhibited responses to light flashes, while only 4 of 13 MSG treated animals did so. All animals from both treatment groups exhibited FEPs on PND 22 and beyond. All FEP peak latencies were significantly increased in MSG treated animals with the magnitude of the effect being greater during development. Peak N1 amplitude was reduced in MSG treated animals by 50% or more at each age. Frequency x treatment interactions were observed on peak P2 and peak N3 latency, and a frequency x age x treatment interaction was observed on peak N3 amplitude. MSG treatment severely impaired the ability to generate PREPS. Only small responses to the pattern reversal stimulus could be detected and the normal PREP peaks could not be identified with confidence. Perinatal MSG treatment results in profound alterations in FEP ontogeny and the generation of PREPs.

Discovering the neurotransmitters involved in the generation of flash evoked potentials (FEPs) would enhance the use of FEPs in screening for and assessment of neurological damage. Recent evidence suggests that the excitatory amino acids, glutamate and aspartate, may be transmitters in the visual system. Ketamine selectively antagonizes the actions of excitatory amino acids on n-methyl-d-aspartate receptors and may be administered systemically. Two experiments were designed to test the effects of ketamine on rat FEPs. First, the effects of ketamine (37, 75, 150 mg/kg) on FEPs recorded in light and dark backgrounds were investigated at a single (10 min) posttreatment interval. Ketamine administration resulted in dose-dependent alterations in FEP peak amplitudes and latencies. Peak P1 amplitude increased by a factor of 4, in a dose-dependent manner. Peak N1 virtually disappeared at 150 mg/kg. Peak P2 amplitude increased by 50%, but only in the light background, and only at 150 mg/kg. Second, ketamine (150 mg/kg) effects on FEPs were investigated 5 min and 30 min following administration. The decrease in peak N1 amplitude was maximal 5 min after administration and the amplitude was recovering at 30 min. The effects on peak P1 and peak N3 amplitudes were maximal 5 min after ketamine administration, but were not recovering 30 min postinjection. The various peak latencies were also affected differently. The possible role of glutamate or aspartate in the generation of rat FEPs is discussed.

Responses of frontal cortex single units to a tone preceding medial forebrain bundle (MFB) stimulation were recorded in urethane anesthetized rats. The animals were implanted with mono-polar electrodes for MFB stimulation and, following recovery, stimulation parameters which supported self-stimulation were determined for each rat. Prior to the unit recording experiment, the animals were trained to associate a 2-sec tone with MFB stimulation. Trials were presented at variable intervals. Under urethane anesthesia, single units were isolated and the responses of units to paired and unpaired tones were determined. The results indicate that conditioning-related responses of frontal cortex single units can be recorded in urethane anesthetized rats.

These experiments were conducted to gather information regarding the role of cholinergic innervation to the cortex in the generation of event-related slow potentials. The effects of unilateral drug treatments or lesions on ipsilateral and contralateral frontal cortex slow potential (SP) responses were examined in rats. The SP responses were recorded with silver-silver chloride electrodes and were generated by a 2 sec light cue which preceded medial forebrain bundle stimulation. The following approaches were used: (1) microinjection of GABA, procaine or saline into the nucleus basalis magnocellularis; (2) microinjection of atropine or saline subdurally in the SP recording area; (3) electrolytic lesion of the nucleus basalis area; and (4) kainic acid lesion of the nucleus basalis area. The following bilateral measurements were obtained in the lesion studies: choline acetyltransferase (ChAT) in cortex and hippocampus; serotonin in cortex, hippocampus, striatum and nucleus accumbens; norepinephrine in cortex and hippocampus; dopamine in striatum and nucleus accumbens; and metabolites of serotonin, norepinephrine and dopamine in these areas. The cortical SP responses were reduced on the side ipsilateral to the injections of GABA and procaine into the nucleus basalis, and on the side of the subdural atropine injection. With either type of lesion, the SP responses on the lesioned side were significantly reduced as compared to the non-lesioned side. Reductions in cortical ChAT and other measures were observed ipsilateral to the electrolytic lesion, but only cortical ChAT activity was reduced in the kainic acid-lesioned animals. Thus, pharmacological depression of nucleus basalis neurons, blockade of cholinergic muscarinic receptors in the cortex, and nucleus basalis lesions that reduce cortical choline acetyltransferase activity depress event-related slow potentials in the rat frontal cortex. These results provide evidence that cortical slow potential responses in the rat are dependent upon cholinergic innervation from the nucleus basalis.