title: Defects in Neuromuscular Transmission May Underlie Motor Dysfunction in Spinal and Bulbar Muscular Atrophy.
abstract: Spinal and bulbar muscular atrophy (SBMA) in men is an androgen-dependent neuromuscular disease caused by expanded CAG repeats in the androgen receptor (AR). Whether muscle or motor neuron dysfunction or both underlies motor impairment in SBMA is unknown. Muscles of SBMA mice show significant contractile dysfunction, implicating them as a likely source of motor dysfunction, but whether disease also impairs neuromuscular transmission is an open question. Thus, we examined synaptic function in three well-studied SBMA mouse models-the AR97Q, knock-in (KI), and myogenic141 models-by recording in vitro miniature and evoked end-plate potentials (MEPPs and EPPs, respectively) intracellularly from adult muscle fibers. We found striking defects in neuromuscular transmission suggesting that toxic AR in SBMA impairs both presynaptic and postsynaptic mechanisms. Notably, SBMA causes neuromuscular synapses to become weak and muscles to become hyperexcitable in all three models. Presynaptic defects included deficits in quantal content, reduced size of the readily releasable pool, and impaired short-term facilitation. Postsynaptic defects included prolonged decay times for both MEPPs and EPPs, marked resistance to μ-conotoxin (a sodium channel blocker), and enhanced membrane excitability. Quantitative PCR revealed robust upregulation of mRNAs encoding neonatal isoforms of the AChR (γ-subunit) and the voltage-gated sodium channel (NaV1.5) in diseased adult muscles of all three models, consistent with the observed slowing of synaptic potentials and resistance to μ-conotoxin. These findings suggest that muscles of SBMA patients regress to an immature state that impairs neuromuscular function.
  
  
  
  We have discovered that SBMA is accompanied by marked defects in neuromuscular synaptic transmission involving both presynaptic and postsynaptic mechanisms. For three different mouse models, we find that diseased synapses are weak, having reduced quantal content due to reductions in the size of the readily releasable pool and/or probability of release. Synaptic potentials in diseased adult fibers are slowed, explained by an aberrant upregulation of the neonatal isoform of the acetylcholine receptor. Diseased fibers also show marked resistance to μ-conotoxin, explained by an aberrant upregulation in the neonatal isoform of the sodium channel, and are hyperexcitable, reminiscent of myotonic dystrophy, showing anode-break action potentials. This work identifies several new molecular targets for recovering function in SBMA.
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824.
authors.forename: Youfen
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824.
authors.forename: Katherine
authors.initials: K
authors.lastname: Halievski
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824.
authors.forename: Casey
authors.identifier: 0000-0001-9632-6184
authors.initials: C
authors.lastname: Henley
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824.
authors.forename: William D
authors.initials: WD
authors.lastname: Atchison
authors.affiliation: Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Katsuno
authors.affiliation: Department of Neurology, University of Occupational and Environment Health School of Medicine, Fukuoka 807-8555, Japan.
authors.forename: Hiroaki
authors.identifier: 0000-0002-9302-4663
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824.
authors.forename: S Marc
authors.initials: SM
authors.lastname: Breedlove
authors.affiliation: Neuroscience Program, Michigan State University, East Lansing, Michigan 48824, jordancy@msu.edu.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Jordan
mesh_terms: D000818:Animals; D020916:Conotoxins / Q000494:pharmacology; D019054:Evoked Potentials, Motor; D015870:Gene Expression / Q000235:genetics; D055879:Gene Knock-In Techniques; D008297:Male; D051379:Mice; D008822:Mice, Transgenic; D009045:Motor Endplate / Q000187:drug effects; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D020966:Muscular Disorders, Atrophic / Q000150:complications / Q000503:physiopathology*; D009469:Neuromuscular Junction; D026941:Sodium Channel Blockers / Q000494:pharmacology; D009435:Synaptic Transmission
chemical_list: D020916:Conotoxins; D026941:Sodium Channel Blockers
keywords: acetylcholine receptor; motor dysfunction; muscle excitability; neuromuscular transmission; spinal and bulbar muscular atrophy; synaptic vesicle