eLife (Nov 2024)

NE contribution to rebooting unconsciousness caused by midazolam

  • LeYuan Gu,
  • WeiHui Shao,
  • Lu Liu,
  • Qing Xu,
  • YuLing Wang,
  • JiaXuan Gu,
  • Yue Yang,
  • ZhuoYue Zhang,
  • YaXuan Wu,
  • Yue Shen,
  • Qian Yu,
  • XiTing Lian,
  • HaiXiang Ma,
  • YuanLi Zhang,
  • HongHai Zhang

DOI
https://doi.org/10.7554/eLife.97954
Journal volume & issue
Vol. 13

Abstract

Read online

The advent of midazolam holds profound implications for modern clinical practice. The hypnotic and sedative effects of midazolam afford it broad clinical applicability. However, the specific mechanisms underlying the modulation of altered consciousness by midazolam remain elusive. Herein, using pharmacology, optogenetics, chemogenetics, fiber photometry, and gene knockdown, this in vivo research revealed the role of locus coeruleus (LC)-ventrolateral preoptic nucleus noradrenergic neural circuit in regulating midazolam-induced altered consciousness. This effect was mediated by α1 adrenergic receptors. Moreover, gamma-aminobutyric acid receptor type A (GABAA-R) represents a mechanistically crucial binding site in the LC for midazolam. These findings will provide novel insights into the neural circuit mechanisms underlying the recovery of consciousness after midazolam administration and will help guide the timing of clinical dosing and propose effective intervention targets for timely recovery from midazolam-induced loss of consciousness.

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