Circuit-based intervention corrects excessive dentate gyrus output in the Fragile X mouse model

Reviewer #1 (Public Review):

Summary:
In this work, the authors provide evidence to show that an increase in Kv7 channels in hilar mossy cells of Fmr1 knock out mice results in a marked decrease in their excitability. The reduction in excitatory drive onto local hilar interneurons produces an increased excitation/inhibition ratio in granule cells. Inhibiting Kv7 channels can help normalize the excitatory drive in this circuit, suggesting that they may represent a viable target for targeted therapeutics for fragile-x syndrome.

Strengths:
The work is supported by a compelling and thorough set of electrophysiological studies. The authors do an excellent job of analysing their data and present a very complete data set.

Weaknesses:
There are no significant weaknesses in the experimental work, however the complexity of the data presentation and the lack of a schematic showing the organizational framework of this circuit make the data less accessible to non-experts in the field. I highly encourage a graphical abstract and network diagram to help individuals understand the implications of this work.

The work is important as it identifies a unique regional and cell-specific abnormality in Fmr1 KO mice, showing how the loss of one gene can result in region-specific changes in brain circuits.

Reviewer #2 (Public Review):

Summary:
Deng et al. investigate, for the first time to my knowledge, the role that hippocampal dentate gyrus mossy cells play in Fragile X Syndrome. They provide strong evidence that, in slice preparations from Fmr1 knockout mice, mossy cells are hypoactive due to increased Kv7 function whereas granule cells are hyperactive compared to slices from wild-type mice. They provide indirect evidence that the weakness of mossy cell-interneuron connections contributes to granule cell hyperexcitability, despite converse adaptations to mossy cell inputs. The authors show that application of the Kv7 inhibitor XE991 is able to rescue granule cell hyperexcitability back to wild-type baseline, supporting the overall conclusion that inhibition of Kv7 in the dentate may be a potential therapeutic approach for Fragile X Syndrome. However, any claims regarding specific circuit-based intervention or analysis are limited by the exclusively pharmacological approach of the manipulations.

Strengths:
Thorough electrophysiological characterization of mossy cells in Fmr1 knockout mice, a novel finding.

Their electrophysiological approach is quite rigorous: patched different neuron types (GC, MC, INs) one at a time within the dentate gyrus in FMR1 KO and WT, with and without 'circuit blockade' by pharmacologically inhibiting neurotransmission. This allows the most detailed characterization possible of passive membrane/intrinsic cell differences in the dentate gyrus of Fmr1 knockout mice.

Provide several examples showing the use of Kv7 inhibitor XE991 is able to rescue excitability of granule cell circuit in Fmr1 knockout mice (AP firing in the intact circuit, postsynaptic current recordings, theta-gamma coupling stimulation).

Weaknesses:
The implications for these findings and the applicability of the potential treatment for the disorder in a whole animal are limited due to the fact that all experiments were done in slices.

The authors' interpretation of the word 'circuit-based' is problematic - there are no truly circuit-specific manipulations in this study due to the reliance on pharmacology for their manipulations. While the application of the Kv7 inhibitor may have a predominant effect on the circuit through changes to mossy cell excitability, this manipulation would affect many other cells within the dentate and adjacent brain regions that connect to the dentate that express Kv7 as well.

Reviewer #3 (Public Review):

The paper by Deng, Kumar, Cavalli, Klyachko describes that, unlike in other cell types, loss of Fmr1 decreases the excitability of hippocampal mossy cells due to up-regulation of Kv7 currents. They also show evidence that while muting mossy cells appears to be a compensatory mechanism, it contributes to the higher activity of the dentate gyrus, because the removal of mossy cell output alleviates the inhibition of dentate principal cells. This may be important for the patho-mechanism in Fragile X syndrome caused by the loss of Fmr1.

These experiments were carefully designed, and the results are presented ‎in a very logical, insightful, and self-explanatory way. Therefore, this paper represents strong evidence for the claims of the authors. In the current state of the manuscript, there are only a few points that need additional explanation.

One of the results, which is shown in the supplementary dataset, does not fit the main conclusions. Changes in the mEPSC frequency suggest that in addition to the proposed network effects, there are additional changes in the synaptic machinery or synapse number that are independent of the actual activity of the neurons. Since the differences of the mEPSC and sEPSC frequencies are similar and because only the latter can signal network effects, while the former is typically interpreted as a presynaptic change, it cannot be claimed that sEPSC frequency changes are due to the hypo-excitability of mossy cells.

An apparent technical issue may imply a second weak point in the interpretation of the results. Because the IPSCs in the PP stimulation experiments (Fig 8) start within a few milliseconds, it is unlikely that its first ‎components originate from the PP-GC-MC-IN feedforward inhibitory circuit. The involvement of this circuit and MCs in the Kv7-dependent excitability changes is the main implication of the results of this paper. But this feedforward inhibition requires three consecutive synaptic steps and EPSP-AP couplings, each of them lasting for at least 1ms + 2-5ms. Therefore, the inhibition via the PP-GC-MC-IN circuit can be only seen from 10-20ms after PP stimulation. The earlier components of the cPSCs should originate from other circuit elements that are not related to the rest of the paper. Therefore, more isolated measurements on the cPSC recordings are needed ‎which consider only the later phase of the IPSCs. This can be either a measurement of the decay phase or a pharmacological manipulation that selectively enhances/inhibits a specific component of the proposed circuit.

I suggest refraining from the conclusions saying "‎MCs provide at least ~51% of the excitatory drive onto interneurons in WT and ~41% in KO mice", because too many factors (eg. IN cell types, slice condition, synaptic reliability) are not accounted for in these actual numbers, and these values are not necessary for the general observation of the paper.

There are additional minor issues about the presentation of the results.