The Dlx homeobox transcription factors are broadly expressed prenatally in progenitors of forebrain GABAergic neurons, as well as postnatally in subsets of mature GABAergic neurons, such as in cortical interneurons (
Cobos et al., 2005a,
2006). Mutations that simultaneously block the function of pairs of mouse Dlx genes (Dlx1&2) disrupt development (particularly migration and differentiation) of most forebrain GABAergic neurons (including cortical interneurons, projection neurons of the striatum, pallidum, central nucleus of the amygdala, and the reticular nucleus of the thalamus) (
Anderson et al., 1997a,
b; Long et al., 2008). Such mutations have the potential to disrupt function within these regions in addition to the communication between the neocortex, basal ganglia and thalamus with obvious detrimental affects on cognitive and emotional functions (
Fanselow and Poulos 2005;
Yin and Knowlton, 2006;
LeDoux, 2007).
While mice lacking pairs of Dlx genes die neonatally, mice lacking Dlx1 are viable. However, after ~1 month, there is a selective degeneration of a subset of cortical interneurons, that results in epilepsy (
Cobos et al., 2005a). Thus, Dlx1
−/− mutants have an age-dependent onset of seizures analogous to a subset of ASD patients who have late onset of epilepsy (
Levisohn, 2007). Furthermore, Dlx genes regulate craniofacial morphogenesis, including the ossicles (
Qiu et al., 1995;
Jeong et al., 2008); as a result, Dlx1 mutants have reduced hearing acuity (
Polley et al., 2006), which has obvious implications for auditory comprehension. This result also brings up an important point. Many transcription factors that control brain development also have important roles in regulating craniofacial development, suggesting that analysis of craniofacial morphology may provide insights into the etiologies of ASD.
While mutations in the Dlx2 and Dlx5 genes have been detected in some autistic individuals, it is unknown whether these contribute to the development of ASD (
Hamilton et al., 2005), or co-morbid symptoms such as epilepsy. Despite the lack of firm evidence implicating Dlx mutations genes in ASD susceptibility, examining the function of the Dlx genes is illustrative of a genetic pathway, whose dysfunction, could predispose to ASD, through defects in forebrain inhibitory neurons (
Rubenstein and Merzenich, 2003). This could be through Dlx function in the neocortex and/or basal ganglia (including the amygdala). For instance, in the cortex, reduced Dlx dosage (function) would weaken inhibitory tone in the cortex, thereby increasing the ratio of excitation/inhibition, which would decrease the signal/noise ratio, altering neural processing and predisposing to epilepsy. In the basal ganglia, Dlx mutations could alter development of the striatum and pallidum – key components of the cortico-basal ganglia-thalamic circuit that is important in controlling Pavlovian (appetitve) learning, habit learning, and goal directed behaviors (
Yin and Knowlton, 2006). Thus, understanding the genetic circuits downstream of the Dlx genes will identify genes required for forebrain inhibitory neuronal function – perhaps many of these, alone or in combination with other genes – are susceptibility factors for ASD.
Currently, the Dlx genes are known to (directly or indirectly) regulate the expression of large numbers of genes that are implicated in GABAergic neuronal development. For example, the Arx transcription factor is downstream of Dlx (
Cobos et al., 2005b;
Colasante et al., 2008;
Long et al., 2009a,
b). Mutation of Human Arx can cause epilepsy and autism, and in mice results in defects in cortical interneuron development (
Colombo et al., 2007). Dlx genes also promote the expression of glutamic acid decarboxylase and vesicular GABA transporter (
Stuhmer et al., 2002; Long et al., 2007,
2009a,
b), and thereby can regulate inhibitory tone. Furthermore, reduced Dlx dosage is associated with reduced synapse formation and reduced expression of neurexin3, a neuroligin ligand (Cobos, Long and Rubenstein, unpublished). Dlx repression of the Pak3 kinase expression is implicated in regulating neurite growth (
Cobos et al., 2007); Human Pak3 mutants have mental retardation (
van Galen and Ramakers, 2005). Finally, Dlx genes promote the balance of neuronal vs oligodendrocyte production; reduced Dlx function can reduce the number of GABAergic neurons while perhaps altering the extent of myelination (
Petryniak et al., 2007).
In sum, the Dlx genes can regulate the development and function of a single generic class of neurons: forebrain inhibitory neurons (e.g. interneurons in the cortex, and projection neurons in the basal ganglia). As such, alterations in the function of the Dlx genes, or of genes downstream of them, can weaken forebrain inhibitory tone, and thereby impact neural systems that underlie cognition.