NMDA receptor 1 expression in the brainstem of human infants and its relevance to the sudden infant death syndrome (SIDS)

The N-methyl-D-aspartate (NMDA) glutamatergic receptor is widely expressed in the brain during the early postnatal period and, among other functions is involved in cardiorespiratory control and in cell death by excitotoxic mechanisms. This study examined NMDA receptor-1 (NR1) expression in the human infant brainstem and assessed whether expression differed between non-SIDS and SIDS infants. NRI mRNA was identified using non-radioactive in situ hybridization and quantified by optical density. NRI protein was identified by immunohistochemistry and quantified by cellular counting. Eight nuclei of the mid-medulla and 2 nuclei of the rostral pons were studied. NRI mRNA and protein were expressed in all nuclei studied, confirming that the NMDA receptor is widely distributed in the human infant brainstem. Compared to non-SIDS infants (n = 10). SIDS infants (n = 15) had increased mRNA in 6 nuclei of the mid-medulla (p < 0.05 for all) while protein was increased in the dorsal motor nucleus of the vagus (p = 0.04) and decreased in the nucleus of the spinal trigeminal tract (p = 0.03). No differences were observed in the rostral pons. This preliminary study suggests that abnormalities of the glutamatergic system are present in SIDS victims. Further studies will be required to delineate these abnormalities and to investigate potential underlying mechanisms and sequelae.