Glutamate mediates an inhibitory postsynaptic potential in dopamine neurons

Rapid information transfer within the brain depends on chemical signalling between neurons that is mediated primarily by glutamate and GABA (gamma-aminobutyric acid), acting at ionotropic receptors to cause excitatory or inhibitory postsynaptic potentials (EPSPs or IPSPs), respectively. In addition, synaptically released glutamate acts on metabotropic receptors to excite neurons on a slower timescale through second-messenger cascades, including phosphoinositide hydrolysisl. We now report a unique IPSP mediated by the activation of metabotropic glutamate receptors. In ventral midbrain dopamine neurons, activation of metabotropic glutamate receptors (mGluR1) mobilized calcium from caffeine/ryanodine-sensitive stores and increased an apamin-sensitive potassium conductance. The underlying potassium conductance and dependence on calcium stores set this IPSP apart from the slow IPSPs described so far. The mGluR-induced hyperpolarization was dependent on brief exposure to agonist, because prolonged application of exogenous agonist desensitized the hyperpolarization and caused the more commonly reported depolarization. The rapid rise and brief duration of synaptically released glutamate in the extracellular space can therefore mediate a rapid excitation through activation of ionotropic receptors, followed by inhibition through the mGluR1 receptor. Thus the idea that glutamate is solely an excitatory neurotransmitter must be replaced with a more complex view of its dual function in synaptic transmission.     

Mechanisms underlying the enhancement of excitatory synaptic transmission in basolateral amygdala neurons of the kindling rat

To elucidate the mechanism underlying epileptiform discharges in kindled rats, synaptic responses in kindled basolateral amygdala neurons in vitro were compared with those from control rats by using intracellular and whole cell patch-clamp recordings. In kindled neurons, electrical stimulation of the stria terminalis induced epileptiform discharges. The resting potential, apparent input resistance, current-voltage relationship of the membrane, and the threshold, amplitude, and duration of action potentials in kindled neurons were not different from those in control neurons. The electrical stimulation of stria terminalis elicited excitatory postsynaptic potentials (EPSPs) and DL-2-amino-5-phosphonopentanoic acid (AP5)-sensitive and 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX)-sensitive excitatory postsynaptic currents (EPSCs). The amplitude of evoked EPSPs and of evoked AP5-sensitive and CNQX-sensitive EPSCs were enhanced markedly, whereas fast and slow inhibitory postsynaptic potentials (IPSPs) induced by electrical stimulation of lateral amygdaloid nucleus were not significantly different. The rise time and the decay time constant of the evoked CNQX-sensitive EPSCs were shortened, whereas the rise time of the evoked AP5-sensitive EPSCs was shortened, but the decay time constants were not significantly different. In both tetrodotoxin (TTX)-containing medium and low Ca2+ and TTX-containing medium, the frequency and amplitude of spontaneous EPSCs were increased in kindled neurons. These increases are presumably due to nearly synchronous multiquantal events resulted from the increased probability of Glu release at the nerve terminals. The rise time of evoked CNQX- and AP5-sensitive EPSCs and the decay time constant of evoked CNQX-sensitive EPSCs were shortened, suggesting that excitatory synapses at the proximal dendrite and/or the soma in kindled neurons may contribute more effectively to generate evoked EPSCs than those at distal dendrites. In conclusion, the increases in the amplitudes of spontaneous and evoked EPSCs and in the frequency of spontaneous EPSCs may contribute to the epileptiform discharges in kindled neurons.     

Epileptogenesis in vivo enhances the sensitivity of inhibitory presynaptic metabotropic glutamate receptors in basolateral amygdala neurons in vitro

Modulation of excitatory synaptic transmission by presynaptic metabotropic glutamate receptors (mGluRs) was examined in brain slices from control rats and rats with amygdala-kindled seizures. Using whole-cell voltage-clamp and current-clamp recordings, this study shows for the first time that in control and kindled basolateral amygdala neurons, two pharmacologically distinct presynaptic mGluRs mediate depression of synaptic transmission. Moreover, in kindled neurons, agonists at either group II- or group III-like mGluRs exhibit a 28- to 30-fold increase in potency and suppress synaptically evoked bursting. The group II mGluR agonist (2S,3S,4S)-2-(carboxycyclopropyl)glycine (L-CCG) dose-dependently depressed monosynaptic EPSCs evoked by stimulation in the lateral amygdala with EC50 values of 36 nM (control) and 1.2 nM (kindled neurons). The group III mGluR agonist L-2-amino-4-phosphonobutyrate (L-AP4) was less potent, with EC50 values of 297 nM (control) and 10.8 nM (kindled neurons). The effects of L-CCG and L-AP4 were fully reversible. Neither L-CCG (0.0001-10 microM) nor L-AP4 (0.001-50 microM) caused membrane currents or changes in the current-voltage relationship. The novel mGluR antagonists (2S,3S,4S)-2-methyl-2-(carboxycyclopropyl)-glycine (MCCG; 100 microM) and (S)-2-methyl-2-amino-4-phosphonobutyrate (MAP4; 100 microM) selectively reversed the inhibition by L-CCG and L-AP4 to 81.3 +/- 12% and 65.3 +/- 6.6% of predrug, respectively. MCCG and MAP4 (100-300 microM) themselves did not significantly affect synaptic transmission. The exquisite sensitivity of agonists in the kindling model of epilepsy and the lack of evidence for endogenous receptor activation suggest that presynaptic group II- and group III-like mGluRs might be useful targets for suppression of excessive synaptic activation in neurological disorders such as epilepsy.     

A loss of functional spinal alpha motor neurons in amyotrophic lateral sclerosis

We obtained motor unit number estimates (MUNEs) of the hypothenar and the extensor digitorum brevis muscles in ALS patients by our new technique. One year after symptom onset, the MUNEs had decreased to +/-30% of normal. Accordingly, we suggest that 70% of functional spinal alpha motor neurons are lost in the first post-onset year in ALS.     

Neurotrophins induce formation of functional excitatory and inhibitory synapses between cultured hippocampal neurons

Cell cultures were used to analyze the role of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in the development of synaptic transmission. Neurons obtained from embryonic day 18 (E18) rat hippocampus and cultured for 2 weeks exhibited extensive spontaneous synaptic activity. By comparison, neurons obtained from E16 hippocampus expressed very low levels of spontaneous or evoked synaptic activity. Neurotrophin treatment produced a sevenfold increase in the number of functional synaptic connections in the E16 cultures. BDNF induced formation of both excitatory and inhibitory synapses, whereas NT-3 induced formation of only excitatory synapses. These effects were independent of serum or the age of the glia bed used for the culture. They were not accompanied by significant changes in synaptic-vesicle-associated proteins or glutamate receptors. Treatment of the cultures with the neurotrophins for 3 d was sufficient to establish the maximal level of functional synapses. During this period, neurotrophins did not affect the viability or the morphology of the excitatory neurons, although they did produce an increase in the number and length of dendrites of the GABAergic neurons. Remarkably, only BDNF caused an increase in the number of axonal branches and in the total length of the axons of the GABAergic neurons. These results support a unique and differential role for neurotrophins in the formation of excitatory and inhibitory synapses in the developing hippocampus.     

Somatosensory and auditory convergence in the lateral nucleus of the amygdala.

Previous studies have shown that the lateral nucleus of the amygdala (AL) is essential in auditory fear conditioning and that neurons in the AL respond to auditory stimuli. The goals of the present study were to determine whether neurons in the AL are also responsive to somatosensory stimuli and, if so, whether single neurons in the AL respond to both auditory and somatosensory stimulation. Single-unit activity was recorded in the AL in anesthetized rats during the presentation of acoustic (clicks) and somatosensory (footshock) stimuli. Neurons in the dorsal subdivision of the AL responded to both somatosensory and auditory stimuli, whereas neurons in the ventrolateral AL responded only to somatosensory stimuli and neurons in the ventromedial AL did not respond to either stimuli. These findings indicate that the dorsal AL is a site of auditory and somatosensory convergence and may therefore be a focus of convergence of conditioned and unconditioned stimuli (CS and UCS) in auditory fear conditioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrinsic GABAergic neurons in the rat central extended amygdala

The present study examined the distribution, morphology, and connections of gamma-aminobutyric acid-immunoreactive (GABA-IR) neurons in the three principal components of the central extended amygdala: the central amygdaloid nucleus, the bed nucleus of the stria terminalis (BNST) and the sublenticular substantia innominata. In the central nucleus, large numbers of GABA-IR neurons were identified in the lateral, lateral capsular, and ventral subdivisions, though in the medial subdivision, GABA-IR neurons were only present at very caudal levels. Combined immunocytochemistry-Golgi impregnation revealed that GABA-IR neurons in the lateral central nucleus were medium-sized spiny neurons that were morphologically similar to GABAergic neurons in the striatum. Injections of horseradish peroxidase into the bed nucleus of the stria terminalis labeled a major proportion of the GABA-IR neurons in the central nucleus. In the bed nucleus, the majority of GABA-IR neurons were located in the anterolateral subdivision, ventral part of the posterolateral subdivision and the parastrial subdivision. GABA-IR neurons in the anterolateral bed nucleus were of the typical medium-sized spiny type. Injections of horseradish peroxidase into the central nucleus labeled a few GABA-IR neurons in the posterior part of the anterolateral bed nucleus. GABA-IR neurons were identified in the sublenticular substantia innominata and medial shell of the nucleus accumbens and contributed to the continuum of GABA-IR extending from the central nucleus to the bed nucleus. Injections of horseradish peroxidase (HRP) into the central nucleus, but not the BNST, labeled a few GABA-IR neurons in the substantia innominata. The data point to GABA-IR neurons being a characteristic feature of the central extended amygdala and that GABA-IR neurons participate in the long intrinsic connections linking the major components of this structure. Since lesions of the stria terminalis and basolateral amygdaloid nucleus failed to deplete GABA-IR terminals in the central nucleus, the role of GABA in local and short intrinsic connections in the central extended amygdala is discussed. Further, physiological findings implicating the intrinsic GABAergic system of the central extended amygdala in the tonic inhibition of brainstem efferents are reviewed.     

Sensorimotor syndrome produced by lesions of the amygdala and lateral hypothalamus.

Experimented with 7 male Long-Evans hooded rats. Small unilateral lesions of the amygdala, lateral hypothalamus, or nearby structures resulted in an inability to orient and localize, by an appropriate movement of the head, stimuli in the contralateral visual and somatosensory fields. This is neither a primary sensory nor motor deficit. Conditioning experiments revealed that the linkage between contralateral sensory and motor fields has been disrupted, possibly reflecting damage to fibers which connect sensory and motor areas within a hemisphere. This sensorimotor syndrome can account for the placidity and decreased aggressive, social, and feeding behaviors commonly observed following lesions of these areas. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of medial and lateral lesions in the amygdala on fixed-ratio performance.

Trained 18 male albino Wistar rats with medial or lateral lesions in the amygdala to respond on progressively increasing fixed-ratio schedules of reinforcement. Results indicate that medial lesions produced an earlier breakdown of responding, and lateral lesions produced perseveration of response. Interpretations of the data in terms of motivational effects and excitatory and inhibitory functions are discussed. (French summary) (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional and ionic properties of a slow afterhyperpolarization in ferret perigeniculate neurons in vitro

Intracellular recordings from spontaneously spindling GABAergic neurons of the ferret perigeniculate nucleus in vitro revealed a fast afterhyperpolarization after each action potential, a medium-duration afterhyperpolarization after each low-threshold Ca2+ spike, and a slow afterhyperpolarization after the cessation of spindle waves. The slow afterhyperpolarization was associated with an increase in membrane conductance, and the reversal potential was sensitive to extracellular [K+]o, indicating that it is mediated at least in part by the activation of a K+ conductance. However, the block of Ca2+ channels did not block the slow afterhyperpolarization, whereas the block of Na+ channels did block this event, even after the generation of repetitive Ca2+ spikes, indicating that it is mediated by a Na+-activated K+ current. Application of apamin reduced the afterhyperpolarization and enhanced a plateau potential after each low-threshold Ca2+ spike. This plateau potential could result in a prolonged depolarization of perigeniculate neurons, even before the application of apamin, resulting in the generation of tonic discharge. The plateau potential was blocked by the local application of tetrodotoxin, indicating that it is mediated by a persistent Na+ current. The activation and interaction of these slowly developing and persistent currents contributes significantly to low-frequency components of spindle wave generation. In particular, we suggest that the activation of the slow afterhyperpolarization may contribute to the generation of the spindle wave refractory period in vitro.     

Kainate receptors mediate a slow postsynaptic current in hippocampal CA3 neurons

Glutamate, the neurotransmitter at most excitatory synapses in the brain, activates a variety of receptor subtypes that can broadly be divided into ionotropic (ligand-gated ion channels) and metabotropic (G-protein-coupled) receptors. Ionotropic receptors mediate fast excitatory synaptic transmission, and based on pharmacological and molecular biological studies are divided into NMDA and non-NMDA subtypes. The non-NMDA receptor group is further divided into AMPA and kainate subtypes. Virtually all fast excitatory postsynaptic currents studied so far in the central nervous system are mediated by the AMPA and NMDA subtypes of receptors. Surprisingly, despite extensive analysis of their structure, biophysical properties and anatomical distribution, a synaptic role for kainate receptors in the brain has not been found. Here we report that repetitive activation of the hippocampal mossy fibre pathway, which is associated with high-affinity kainate binding and many of the kainate receptor subtypes, generates a slow excitatory synaptic current with all of the properties expected of a kainate receptor. This activity-dependent synaptic current greatly augments the excitatory drive of CA3 pyramidal cells.     

Recurrent inhibitory interneurons of the Rabbit's lateral posterior-pulvinar complex

We recorded from 118 neurons in the visual sector of the thalamic reticular nucleus (TRN) in anesthetized rabbits. Cells were identified by their location and characteristic burst responses to stimulation of the primary visual cortex (Cx) and optic chiasm (OX) and were classified into two groups. Type I cells had relatively short latencies from both OX and Cx stimulation, and the latency from OX was always longer than from Cx. In contrast, type II cells had much longer latencies after OX and Cx stimulation, and the latency from OX was always shorter than from Cx. Type I cells were located in the dorsal part of TRN, whereas type II cells were located in the ventral part of TRN. The physiological properties and location of type I TRN cells indicate that they are recurrent inhibitory interneurons of the dorsal lateral geniculate nucleus (LGN). Type II TRN cells most likely function as recurrent inhibitory interneurons for the lateral posterior nucleus-pulvinar complex (LP) because they could be activated antidromically by LP stimulation and orthodromically activated via axonal collaterals of LP cells. Type II TRN cells exhibited a prolonged depression after Cx or OX stimulation. Intracellular recordings showed that a prolonged inhibitory postsynaptic potential was evoked by Cx or OX stimulation. Therefore, these recurrent interneurons of LP, type II cells form mutual inhibitory connections just like those recurrent interneurons of LGN, type I cells. Our data suggest that the geniculocortical and extrageniculate visual pathways have similar recurrent inhibitory circuits.     

P3, positive slow wave and working memory load: a study on the functional correlates of slow wave activity

Parietal positivities of the 'slow wave' type are known to emerge after the P300 whenever target detection leads to a complex subsidiary task. Although the functional correlates of these 'positive slow waves' (PSW) are not known, it has been suggested that they may index (a) the selection or decision processes, (b) the preparation of the response or (c) the evaluation of its correctness. We investigated whether PSW could be dissociated from each of these putative steps of information processing by means of a paradigm devoid of motor components and needing very long reaction times. In our protocol, target stimuli acted as the triggering signal to perform silently one of 4 different tasks, namely (a) simple updating of a target count; (b) counting backward in threes; (c) simultaneous updating of two items (day of the week and ordinal of the month) and (d) updating of 3 items (the two above plus the month of the year). Reaction times to the same stimuli were obtained in 5 subjects during separate sessions. The different tasks did not modify the latencies of N2 or P3b components, but attenuated the amplitude of P3 as a mirror image of the subjective difficulty scores. A conspicuous parietal PSW appeared in conditions where two or 3 items had to be updated. This PSW developed 1-2 s earlier than the reaction times to the same experiments and could be therefore dissociated from the selection and decision processes. PSW latency was correlated with the number of items to be updated, but not with subjective difficulty. In the present paradigm PSW appeared to index the retrieval of information from working memory; however, in more general terms our results suggest that PSW is a non-specific activity that signals the completion of any synchronized operation immediately following target detection. Our data suggest a functional link between P3 and PSW, also supported by the similarity of their respective scalp topographies. The present paradigm proved to be easy to implement and suitable to study the 'executive' functions governing attentional and working-memory control during the performance of multiple tasks.     

Serotonin modulation of sensory inputs to the lateral amygdala: dependency on corticosterone

The lateral nucleus of the amygdala (LA) receives excitatory (glutamatergic) inputs from thalamic and cortical sensory processing areas and is believed to be involved in evaluation of the affective significance of sensory events. We examined whether serotonin (5-HT) affects excitatory transmission in auditory afferents to the LA and, if so, whether this modulation of sensory transmission is regulated by the stress hormone corticosterone (CORT). Neuronal activity in the LA was elicited via iontophoretic ejection of L-glutamate or synaptically via electrical stimulation of auditory afferent pathways. In the intact rat, iontophoretically applied 5-HT inhibited both synaptically and glutamate-evoked action potentials in most neurons examined. However, after adrenalectomy (ADX), which eliminates endogenous CORT, 5-HT no longer inhibited evoked activity in the LA. High-CORT doses given to ADX animals reinstated the inhibition of excitatory transmission of 5-HT, whereas low-CORT doses had little effect. Immunocytochemical labeling of the glucocorticoid receptor in the intact rat demonstrated nuclear staining throughout several amygdala regions, including the LA. However, after ADX, no nuclear labeling was visible. With a high replacement dose of CORT (5 or 10 mg) after ADX, dense nuclear staining returned, but with a low replacement dose (1 mg/kg), there was only light nuclear staining. Thus, the ability of 5-HT to modulate glutamatergic activity in auditory pathways to the amygdala is dependent on the presence of CORT and possibly glucocorticoid activation. Via this mechanism, 5-HT modulates the processing of sensory information within the LA and thus may regulate amygdala-related functions.     

Cholinergic responses of morphologically and electrophysiologically characterized neurons of the basolateral complex in rat amygdala slices

The electrophysiological properties, the response to cholinergic agonists and the morphological characteristics of neurons of the basolateral complex were investigated in rat amygdala slices. We have defined three types of cells according to the morphological characteristics and the response to depolarizing pulses. Sixty-six of the recorded cells (71%) responded with two to three action potentials, the second onwards having less amplitude and longer duration (burst). In a second group, consisting of 21 cells (22%), the response to depolarization was a train of spikes, all with the same amplitude (multiple spike). Finally, seven neurons (7%) showed a single action potential (single spike). Burst response and multiple-spike neurons respond to the cholinergic agonist carbachol (10-20 microM) with a depolarization that usually attained the level of firing. This effect was accompanied by decreased or unchanged input membrane resistance and was blocked by atropine (1.5 microM). The depolarizing response to superfusion with carbachol occurred even when synaptic transmission was blocked by tetrodotoxin, indicating a direct effect of carbachol. Similarly, the depolarization by carbachol was still present when the M-type conductance was blocked by 2 mM Ba2+. The carbachol-induced depolarization was prevented by superfusion with tetraethylammonium (5 mM). Injection of biocytin into some of the recorded cells and subsequent morphological reconstruction showed that "burst" cells have piriform or oval cell bodies with four or five main dendritic trunks; spines are sparse or absent on primary dendrites but abundant on secondary and tertiary dendrites. This cellular type corresponds to a pyramidal morphology. The "multiple-spike" neurons have oval or fusiform somata with four or five thick primary dendritic trunks that leave the soma in opposite directions; they have spiny secondary and tertiary dendrites. Finally, neurons which discharge with a "single spike" to depolarizing pulses are round with four or five densely spiny dendrites, affording these neurons a mossy appearance. The results indicate that most of the amygdaloid neurons respond to carbachol with a depolarization. This effect was concomitant with either decrease or no change in the membrane input resistance and was not blocked by the addition of Ba2+, an M-current blocker, indicating that a conductance pathway other than K+ is involved in the response to carbachol.     

Gaze-related activity of putative inhibitory burst neurons in the head-free cat

1. Previous studies in the cat have demonstrated that output neurons of the superior collicular as well as brain stem omnipause neurons have discharges that are best correlated, not with the trajectory of the eye in the head but, with the trajectory of the visual axis in space (gaze = eye-in-head + head-in-space) during rapid orienting coordinated eye and head movements. In this study, we describe the gaze-related activity of cat premotor "inhibitory burst neurons" (IBNs) identified on the basis of their position relative to the abducens nucleus. 2. The firing behavior of IBNs was studied during 1) saccades made with the head stationary, 2) active orienting combined eye-head gaze shifts, and 3) passive movements of the head on the body. IBN discharges were well correlated with the duration and amplitude of saccades made when the head was stationary. In both head-free paradigms, the behavior of cat IBNs differed from that of previously described primate "saccade bursters". The duration of their burst was better correlated with gaze than saccade duration, and the total number of spikes in a burst was well correlated with gaze amplitude and generally poorly correlated with saccade amplitude. The behavior of cat IBNs also differed from that of previously described primate "gaze bursters". The slope of the relationship between the total number of spikes and gaze amplitude observed during head-free gaze shifts was significantly lower than that observed during head-fixed saccades. 3. These studies suggest that cat IBNs do not fit into the categories of gaze-bursters or saccade-bursters that have been described in primate studies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Mechanisms of afterhyperpolarization in lobster olfactory receptor neurons

In lobster olfactory receptor neurons (ORNs), depolarizing responses to odorants and current injection are accompanied by the development of an afterhyperpolarization (AHP) that likely contributes to spike-frequency adaptation and that persists for several seconds after termination of the response. A portion of the AHP can be blocked by extracellular application of 5 mM CsCl. At this concentration, CsCl specifically blocks the hyperpolarization-activated cation current (Ih) in lobster ORNs. This current is likely to be active at rest, where it provides a constant, depolarizing influence. Further depolarization deactivates Ih, thus allowing the cell to be briefly hyperpolarized when that depolarizing influence is removed, thus generating an AHP. Reactivation of Ih would terminate the AHP. The component of the AHP that could not be blocked by Cs+ (the Cs(+)-insensitive AHP) was accompanied by decreased input resistance, suggesting that this component is generated by increased conductance to an ion with an equilibrium potential more negative than the resting potential. The Cs(+)-insensitive AHP in current clamp and the underlying current in voltage clamp displayed a reversal potential of approximately -75 mV. Both EK and ECl are predicted to be in this range. Similar results were obtained with the use of a high Cl- pipette solution, although that shifted ECl from -72 mV to -13 mV. However, when EK was shifted to more positive or negative values, the reversal potential also shifted accordingly. A role for the Ca(2+)-mediated K+ current in generating the Cs(+)-independent AHP was explored by testing cells in current and voltage clamp while blocking IK(Ca) with Cs+/Co(2+)-saline. In some cells, the Cs(+)-independent AHP and its underlying current could be completely and reversibly blocked by Cs+/Co2+ saline, whereas in other cells some fraction of it remained. This indicates that the Cs(+)-independent AHP results from two K+ currents, one that requires an influx of extracellular Ca2+ and one that does not. Collectively, these findings indicate that AHPs result from three phenomena that occur when lobster ORNs are depolarized: 1) inactivation of the hyperpolarization-activated cation current, 2) activation of a Ca(2+)-mediated K+ current, and 3) activation of a K+ current that does not require influx of extracellular Ca2+. Roles of these processes in modulating the output of lobster ORNs are discussed.     

Gamma-aminobutyric acid-immunoreactive neurons in the amygdala of the rat - sex differences and effect of early postnatal castration

We report a case of angiolymphoid hyperplasia with eosinophilia (ALHE). Histologically, some vessels were lined with plump endothelial cells. Infiltration by lymphocytes, histiocytes and eosinophils was marked. An arteriovenous malformation and vessels occluded by endothelial cell hyperplasia were present. PCNA staining gave positive results for the nuclei of many of the plump endothelial cells. Electron-microscopic findings disclosed increased metabolic activity in the cells. These observations suggest that the plump endothelial cells, characteristic of ALHE, have high metabolic activity. These results suggest that blood flow is increased by arteriovenous malformations and that blood pressure is elevated by occlusion, resulting in hyperplasia of plump endothelial cells and accelerated neovascularization.