Distinctive molecular mechanisms in higher cortical circuits confer vulnerability to mental disorders

This paper reviews the molecular differences across the cortical hierarchy in primates that expand in dorsolateral prefrontal cortex (dlPFC) to generate working memory and top-down control, but which confer vulnerability in mental disorders. Research on molecular mechanisms early in the primate cortical hierarchy, e.g. in primary visual cortex (V1), are often in concert with rodent, e.g. neurotransmission relies greatly on AMPAR, while modulation with attention involves NMDAR and cholinergic mechanisms. However, there are also significant differences in cortical specializations and cholinergic receptor localization between rodent and primate V1. In contrast to V1, the recurrent excitatory microcircuits in layer III of primate dlPFC that generate working memory express many distinct mechanisms: neurotransmission depends on NMDAR and acetylcholine (and thus arousal state), not AMPAR; extended neuronal firing underlying working memory depends on magnified calcium signaling in spines; however, excessive cytosolic calcium reduces firing, with powerful mechanisms to take the dlPFC "off-line" during uncontrollable stress and/or inflammation, e.g. opening potassium channels on spines to rapidly weaken connections. Regulation of these powerful mechanisms is lost due to inflammation and/or genetic insults (e.g. gain-of-function mutations in CACNA1C, loss of function in GRM3), which may interact to induce loss of dendritic spines and/or tau pathology, cognitive impairments and reduced top-down control. Many of the genetic risks for schizophrenia weaken layer III dlPFC spine connections, suggesting that multiple genotypes would produce a shared phenotype. The review also suggests new therapeutic targets that can act to reduce inflammation, regulate calcium and strengthen synaptic efficacy in the primate dlPFC.