Reviewer #1:
This is an interesting study of the effects of intracellularly-applied amyloid beta (Ab) in primary hippocampal cultures of embryonic rats or in area CA1 of hippocampal slices or anesthetized rats that are less than 35 days old (therefore prepubertal). In vivo, whole cell recordings were made of CA1 neurons which is difficult and therefore a strength. Both synthetic Ab and human-derived Ab were applied by adding them to the internal solution of a patch electrode. Several interesting effects were documented, such as increased evoked and miniature EPSCs (mEPSCs) as well as some effects on IPSCs and neuronal properties. A major question is whether these effects were pharmacological or physiological.
An intriguing finding was that the increased EPSCs was reduced by inhibiting a PKC-mediated effect of nitric oxide (NO). Furthermore, the effect of intracellular Ab on the recorded cell had effects on neighboring cells. Whether those were due to diffusion of NO, synaptic inputs from the recorded cell on neighboring cells, or release of Ab from the recorded cell was not clear. The authors suggested this is 'functional spreading of hyperexcitabiliity' similar to the way prions are spread transynaptically (actually this has been suggested for Ab too; see work by Karen Duff or Brad Hyman's groups) although this seems premature because the work that has been done with prions and Ab involves spread over a long time and a long distance relative to the results of the present study. Still the results are interesting and could be relevant in some way to the development of the disease or hyperexcitability.
MAJOR CONCERNS
One major issue is whether the results are relevant to Alzheimer's disease (AD) or represent interesting pharmacological data about what Ab can potentially do in some of its forms in normal tissue. The cultures are from embryonic rats and it is not clear how well they can predict what occurs in aged humans with AD. This issue is not only a question related to the preparation of tissue but the use of Ab intracellularly. It is not clear that synthetic or human Ab that is prepared outside the animal and used to fill electrodes to dialyze a cell is similar to the Ab generated in a cell of a person with AD. Independent of the methods to determine whether it is oligomeric outside the cell, once dialyzed it is not clear how it may change and where it would go. In AD Ab has a particular location and precursor where it forms and how it travels to the external milieu. As a product of its precursor APP, several peptides are produced besides Ab and many labs think they are as important as Ab in the disease. Although a strength to use atomic force microscopy to attempt to verify the form of Ab being used, it is not clear what form was actually in the dialyzed cell and how that compared to the form in AD.
How this work relates to other studies that are similar is important. It seems that few other studies that have applied Ab are mentioned because few have studied it intracellularly. However, they are relevant because adding Ab has been shown to cause an increase in hippocampal neurons of excitatory activity at low concentration but at higher concentrations synaptic transmission is weakened. Many studies of mouse models of AD pathology suggest reduced synaptic transmission and plasticity, although many others show hyperexcitability, often without adding Ab at all.
PKC and NO do a lot of things throughout the brain and body. How do the effects the authors have identified relate to all these other effects. For example, if PKC is activated by another mechanism, would it occlude the effects of Ab? What are the changes in PKC and NO in AD?
ADDITIONAL CONCERNS
I am not sure of the validation of Ab using the anti amyloid or 6E10 antibodies. The western blot shows a large region that both antibodies detect and the 6E10 antibody shows an even greater band. It is not clear what the large range of bands that are shown imply except nonspecificity. The antigen that the antibodies recognize should be stated exactly.
Clarifying sample sizes throughout the study is needed.
Do the cultures include interneurons? Are the excitatory and inhibitory neurons interconnected? This information will help interpret the results.
The external solution for cultures contains 5.4 mM K+ which is quite high, and can induce hyperexcitability. Therefore it is important to be sure controls did not show hyperexcitability even after persistent recordings. Similarly, the use of 100uM AMPA and GABA seem very high. Justifying these high concentrations is important. They should lead to hyperexcitability and toxicity (AMPA) over time. Another point of concern is that the concentration of K+ for the slice work is 3 mM, much different than cultures. There are also differences in Mg2+ and Ca2+, making data hard to compare in the two preparations.
Line 295 mentions 2 min recording periods were used to acquire sufficient events. One wants to know if this was done throughout the paper and if so, how many events per 2 min was considered sufficient?
Terms related to intrinsic membrane properties and firing need to be explained much more because each lab has a slightly different method.
In the statistics part of the Methods, why is Welch's ANOVA (followed by Games-Howell) used when variance was unequal. Usually the test to determine inequality is provided, so it is clear it was done objectively and with a reasonable test. Then if the data are unequal there is often a choice for a non parametric test, which is common. Some groups transform the data such as taking the log of all data values. If this reduces the variance between groups, sufficient to pass the test to determine inequality, it leads to a parametric test like a one-way ANOVA followed by Tukey's posthoc test.
In the Results, Line 331 suggests that the authors think they know what a low concentration is for Ab. I don't think it is known in AD what is low and what is high. In other studies of Ab, low concentrations were picomolar (Puzzo et al., listed in the references). So it is not clear the term low is justified for 50 nM.
The bursts of activity are not quantified. What was defined as a burst? What was the burst frequency and did it change over the recording period?
In the section about mPSCs in culture, starting on Line 348, were these events EPSCs or IPSCs? It is important because in the section starting on Line 383 there were changes in IPSCs but the authors conclude a major role of EPSCs only. For example, Line 400 suggests that the effects of Ab were on AMPA receptor-mediated activity but it seems from the data there were also some effects on IPSCs.
Line 434. Provide evidence that the fluorescent probe accurately measures NO.
At the top of page 19 there is a section that needs to be moved earlier because it relates to the work in cultures. That earlier section needs to be reinterpreted given changes in membrane properties occurred. Also, if there is increased synaptic activity in cells dialyzed with Ab, TTX needs to be added to be sure of intrinsic properties. The increase in excitability the authors discuss could be due to the synaptic activity or changes in properties, or both and this needs clarification.
The last paragraph on page 20 is not useful because DRG neurons are so different from hippocampal neurons. One could have effects in DRG but not hippocampus, and vice-versa.
The paragraph starting on Line 616 should be revised. It is not a series of compelling arguments in its present form. For example, saying that AMPAR are linked to epilepsy seems quite obvious, and does not mean that the work presented here is like epilepsy because AMPAR events increased in several assays. Increased AMPAR events also occur when there is a change in behavioral state, plasticity, etc.
In the conclusions, I don't think the data suggest a synaptic change in AMPAR alone. There are intrinsic changes and changes in GABAergic events. Many sites in the brain could have different effects but were not studied. It is not clear effects of NO were coordinated in the way they affected adjacent neurons to the recorded cell. NO simply could have diffused to an area around the recorded cell. I may have missed evidence to the contrary, but effects could have been mediated by axons of the recorded cell and not NO.
In Figure 1b, there is a representative example. Could the neurons be shown? Then one knows the relationship of the signal to the location of neurons.
Graphs should show points. This is one way to clarify sample size easily also.
MINOR POINTS
Line 169 mentions stable access resistance and one usually provides a number indicating how little it increased over time, such as 10-20%. Similarly the way synaptic events were discriminated by noise is not provided (line 291). Instead, a brief description is provided.
Line 292 mentions noise ~2 pA but it is much higher in the data shown in the figures.
Solvents of drugs are not listed at all, and controls that show no effect of vehicle need clarification in some cases.
On Line 371, Ab-mediated neurotransmission is used. I believe this needs to be modulated rather than mediated, or an explanation is needed.
On Line 381, how do the authors know that EPSCs are mediated primarily by AMPA receptors in this preparation?
On Line 393, what is the comparison of AMPA-mediated events to [where it is stated they are what is mostly changing]?
In all of the sections where drugs were applied, abbreviations need to be spelled out before the first use, concentrations need to be confirmed as specifically action on the intended receptor, and indirect effects on other cells need to be discussed if bath-applied.
The sentence starting on Line 417 is a repetition of a prior sentence on the previous page.
Line 433. Clarify what low concentrations mean here.
Line 444. mPSCs are referred to here. One needs to know what were the values for E and IPSCs.
In this section it is often stated that there is a decrease but actually the dialyzed cells are compared to controls so different language is needed.
Line 461. It is not clear that the hippocampus is the first site to be affected in AD. The entorhinal cortex is earlier in the studies of some, and in the mouse models it is usually the cortex that gets plaque first. In humans, the locus coeruleus may be earlier than the entorhinal cortex.
How the plots of current vs. spikes were done is important. If there were differences in membrane potential, that could affect the spike output. If there were differences in input resistance or threshold, that also could play a role. One can control for these potential confounds, so explanations are needed.
Line 472. Vm does not generate fluctuations in this case. Vm changes, and synaptic potentials get larger or smaller, add new components or lose them, etc.
Line 476. It is not clear why cells are firing at membrane potentials so hyperpolarized to threshold.
The streptavidin/calbindin labeling is good but the morphology of the cell is not like a pyramidal cell of area CA1 because there is a major branch of the dendrites at almost a right angle to the apical dendrites. The electrophysiology of this cell might be like an interneuron, and two of the figures show firing with a large afterhyperpolarization similar to an interneuron.
In Figure 3, what are EPSCs and what are spikes would be helpful to point out. The concentration, 500 nm, may never be reached in the brain of an individual with AD, or do the authors have evidence that concentration is relevant in vivo?
There are typos in figure headings, such as Contro instead of Control and in figure 4g, AMPAergic has the c below AMPAergi