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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell. Neurosci.</journal-id>
<journal-title>Frontiers in Cellular Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell. Neurosci.</abbrev-journal-title>
<issn pub-type="epub">1662-5102</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fncel.2024.1389335</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neuroscience</subject>
<subj-group>
<subject>Mini Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>GABAergic interneuron diversity and organization are crucial for the generation of human-specific functional neural networks in cerebral organoids</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Heesen</surname> <given-names>Sebastian H.</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/2681082/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/software/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>K&#x00F6;hr</surname> <given-names>Georg</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1845/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
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<aff id="aff1"><sup>1</sup><institution>Molecular and Behavioural Neurobiology, Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich</institution>, <addr-line>Munich</addr-line>, <country>Germany</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Neurophysiology, Mannheim Center for Translational Neurosciences, Heidelberg University</institution>, <addr-line>Mannheim</addr-line>, <country>Germany</country></aff>
<aff id="aff3"><sup>3</sup><institution>Physiology of Neural Networks, Central Institute of Mental Health, Heidelberg University</institution>, <addr-line>Mannheim</addr-line>, <country>Germany</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Dirk M. Hermann, University of Duisburg-Essen, Germany</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Jason Wester, The Ohio State University, United States</p><p>Gonzalo Le&#x00F3;n-Espinosa, CEU San Pablo University, Spain</p></fn>
<corresp id="c001">&#x002A;Correspondence: Georg K&#x00F6;hr, <email>georg.koehr@medma.uni-heidelberg.de</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>11</day>
<month>04</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>18</volume>
<elocation-id>1389335</elocation-id>
<history>
<date date-type="received">
<day>21</day>
<month>02</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>29</day>
<month>03</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Heesen and K&#x00F6;hr.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Heesen and K&#x00F6;hr</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>This mini review investigates the importance of GABAergic interneurons for the network function of human-induced pluripotent stem cells (hiPSC)-derived brain organoids. The presented evidence suggests that the abundance, diversity and three-dimensional cortical organization of GABAergic interneurons are the primary elements responsible for the creation of synchronous neuronal firing patterns. Without intricate inhibition, coupled oscillatory patterns cannot reach a sufficient complexity to transfer spatiotemporal information constituting physiological network function. Furthermore, human-specific brain network function seems to be mediated by a more complex and interconnected inhibitory structure that remains developmentally flexible for a longer period when compared to rodents. This suggests that several characteristics of human brain networks cannot be captured by rodent models, emphasizing the need for model systems like organoids that adequately mimic physiological human brain function <italic>in vitro</italic>.</p>
</abstract>
<kwd-group>
<kwd>human-specific inhibition</kwd>
<kwd>GABAergic interneurons</kwd>
<kwd>E-I balance</kwd>
<kwd>phase-amplitude-coupling</kwd>
<kwd>functional neural networks</kwd>
<kwd>2D/3D neuronal cell culture</kwd>
<kwd>cerebral organoids</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="58"/>
<page-count count="7"/>
<word-count count="5433"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Cellular Neuropathology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="S1" sec-type="intro">
<title>1 Introduction</title>
<p>The necessity to understand the functional properties of neural networks beyond the mere characterization of their anatomical structure and existence of neural projections is rapidly rising. This surge is driven by the growing scientific desire to create accurate <italic>in vitro</italic> representations of human brain regions and pathologies. Current hiPSC-derived two-dimensional (2D) cell cultures are argued to poorly imitate crucial functional characteristics of human brain networks (<xref ref-type="bibr" rid="B8">Centeno et al., 2018</xref>). Over the past few decades, the balance between inhibition and excitation (E-I balance) has been linked to many neurological diseases (<xref ref-type="bibr" rid="B38">Rubenstein and Merzenich, 2003</xref>; <xref ref-type="bibr" rid="B45">Spencer et al., 2003</xref>; <xref ref-type="bibr" rid="B42">Scharfman, 2007</xref>; <xref ref-type="bibr" rid="B15">Ferguson and Gao, 2018</xref>). Evolutionarily speaking the diversity in inhibitory signaling appears to strongly determine the cerebral and cognitive complexity of an organism. This review will examine evidence suggesting that an inaccurate representation of the inhibitory and excitatory network components is the main culprit of unsatisfactory network modeling. Moreover, it aims to identify whether diversity of inhibition might be the defining property that could render brain organoids functional model systems to mimic human brain function, thereby shedding light on the complex and species-specific effects that inhibition exerts onto physiological human brain networks.</p>
</sec>
<sec id="S2">
<title>2 Cerebral organoids</title>
<p>Typical human-derived neuronal 2D culture models have certain limitations such as a lack of glial cell support and their exclusively planar neurite outgrowth which deviates far from realistic growth behavior and potentially affects functionality to a great extent (<xref ref-type="bibr" rid="B34">Poli et al., 2019</xref>). Cerebral organoids represent three-dimensional (3D) neuronal tissue that strives to simulate the functional connectivity between brain regions. They are derived from pluripotent stem cells and self-organize into mini-organ-like structures in rotating bioreactors over several months (<xref ref-type="bibr" rid="B31">Passaro and Stice, 2021</xref>; <xref ref-type="bibr" rid="B47">Sun et al., 2021</xref>). Brain organoids aim to recapitulate defined developmental stages and replicate existing circuits. Consequently, brain organoids are often reasoned to represent the missing link between 2D cell cultures and <italic>in vivo</italic> models (<xref ref-type="bibr" rid="B8">Centeno et al., 2018</xref>). Translational and basic research as well as the field of personalized medicine hope to benefit from physiologically relevant 3D models for an improved understanding of many neurological disorders, risk factors and possible cures.</p>
</sec>
<sec id="S3">
<title>3 Functional neural networks</title>
<p>The functionality of a neural network can be defined as its ability to successfully process information that is specific to the corresponding network. The precise timing of synchronized action potentials in the correct locations is regarded as the underlying mechanism of this spatiotemporal encoding (<xref ref-type="bibr" rid="B44">Singer, 1993</xref>; <xref ref-type="bibr" rid="B9">Cobb et al., 1995</xref>). When assessing a neural network, a first indicator for its functionality is a healthy morphological appearance. This includes dendritic density and outgrowth as well as the presence of short- and long-distance cross-linkages (<xref ref-type="bibr" rid="B46">Stam and van Straaten, 2012</xref>; <xref ref-type="bibr" rid="B26">Lee et al., 2015</xref>). However, a defined morphological appearance does not prove the capacity of the network to propagate electrical signals mirroring physiological functionality. Hence, the most common analysis tools to investigate the functionality of neural networks of brain organoids are based on electrophysiology (<xref ref-type="bibr" rid="B31">Passaro and Stice, 2021</xref>). The functionality of individual neurons can be elucidated comparatively easily using whole-cell patch clamping in acute brain slices, even from human 3D cultures (<xref ref-type="bibr" rid="B30">Pa&#x015F;ca et al., 2015</xref>). However, information about whole-network connectivity or global functionality can thereby not be obtained. Therefore, indirect approaches for the quantification of whole-network dynamics have been developed such as all-optical electrophysiology whereby fluorescent markers indicate ionic fluxes during depolarization events (<xref ref-type="bibr" rid="B21">Kiskinis et al., 2018</xref>) or imaging of synchronized transient calcium currents (<xref ref-type="bibr" rid="B25">Lancaster et al., 2013</xref>; <xref ref-type="bibr" rid="B40">Sakaguchi et al., 2019</xref>).</p>
<p>Direct electrical measurements of entire networks can be conducted using devices known as microelectrode arrays (MEAs) which contain a grid of a large number of microscopic electrodes that enable the capture of network activity in real-time over large regions of two-dimensional cell cultures (<xref ref-type="bibr" rid="B31">Passaro and Stice, 2021</xref>). However, the planar electrode arrays can only touch limited areas of the surface of a 3D organoid, thus the accessibility of inner neurons is greatly decreased. <xref ref-type="bibr" rid="B31">Passaro and Stice (2021)</xref> have outlined multiple solutions to address this issue, including inner regional recordings either by inserting probes or neuron-like electronics, or by placing mesh nanoelectronics into the center of developing organoids. Other similar strategies to overcome the issue entail e.g., pit-shaped arrays or 3D MEA systems where a large number of microelectrodes is integrated on different height levels of thin needle-like tools which were successfully inserted into a small engineered human iPSC-derived organoids (<xref ref-type="bibr" rid="B43">Shin et al., 2021</xref>). Recently, a kirigami-inspired electrophysiology platform was created that eliminates the need to plate suspended organoids, thereby preserving their self-organized 3D structure (<xref ref-type="bibr" rid="B55">Yang et al., 2024</xref>).</p>
<sec id="S3.SS1">
<title>3.1 Brain waves and synchronous neuronal activity</title>
<p>The described electrophysiology-based whole-network approaches seek to determine whether a large neural network is healthy and functional by analyzing the emerging brain waves. Brain waves are oscillatory neural activity patterns that arise from synchronized activity of functional neuronal units. A fundamental trait of functional networks appears to be the capacity to embed small regional oscillations into the framework of global brain communication, thereby transferring different types of information across distant brain networks via oscillations. At the network level, this cross-frequency coupling is commonly achieved through the amplitude modulation of fast local oscillations by the phase of slow large-scale rhythms, e.g., coupling of slow global &#x03B8;- or respiration-entrained rhythms to different specific fast &#x03B3;-subbands (<xref ref-type="bibr" rid="B58">Zhong et al., 2017</xref>). This interaction is known as phase-amplitude-coupling (<xref ref-type="bibr" rid="B49">Tort et al., 2010</xref>).</p>
<p>Two mechanisms are thought to govern the entrainment of these synchronized brain rhythms: electrical coupling of neighboring cells via gap junctions is one of these mechanisms. The removal of functional gap junctions via genetic knockout of Connexin-36 in an investigated neuronal population has shown that sub-threshold neuronal oscillations ceased to be synchronized in the absence of gap junctions (<xref ref-type="bibr" rid="B27">Leznik and Llin&#x00E1;s, 2005</xref>). Apart from gap junction-mediated cell-to-cell current fluxes, synaptic coupling between excitatory and inhibitory neurons leading to feedback inhibition is thought to be the major mechanism of synchronization. Many GABAergic cortical interneurons such as chandelier cells innervate numerous cortical pyramidal cells in a local area (<xref ref-type="bibr" rid="B28">Li et al., 1992</xref>). The discharge of a single interneuron can consequently hyperpolarize a population of pyramidal cells of over a thousand neurons at the same time and give rise to the synchronized oscillations that play a paramount role in defining a functional network (<xref ref-type="bibr" rid="B9">Cobb et al., 1995</xref>; <xref ref-type="bibr" rid="B42">Scharfman, 2007</xref>). A delicate E-I balance in a locally and temporally precisely regulated framework is therefore crucial for neural networks to be functional.</p>
</sec>
</sec>
<sec id="S4">
<title>4 GABA-mediated network inhibition</title>
<p>Excitatory action in the mammalian central nervous system (CNS) is primarily mediated by the neurotransmitter glutamate (<xref ref-type="bibr" rid="B13">Dingledine et al., 1999</xref>). In the mature mammalian CNS, glutamate is opposed by &#x03B3;-aminobutyric acid (GABA) which acts as the main inhibitory neurotransmitter (<xref ref-type="bibr" rid="B10">Costa, 1998</xref>). The recycling of these neurotransmitters is largely dependent on the presence and proper arrangement of presynaptic neurons and surrounding astrocytes. By removing most of the synaptic GABA and glutamate, converting both to glutamine and shuffling it back to the presynaptic neuron (glutamate/GABA-glutamine cycle), astrocytes are fundamental to maintaining the homeostasis of excitation and inhibition (<xref ref-type="bibr" rid="B19">Hertz, 2013</xref>; <xref ref-type="bibr" rid="B1">Andersen and Schousboe, 2023</xref>).</p>
<sec id="S4.SS1">
<title>4.1 GABA receptor subtypes and the GABAergic polarity switch</title>
<p>GABA interacts with two major receptor subtypes: GABA<sub>A</sub> receptors, ionotropic and selectively permeable to chloride ions (Cl<sup>&#x2013;</sup>) and GABA<sub>B</sub> receptors which are metabotropic, mediating a slow and sustained suppression of neuronal excitability.</p>
<p>The study of developing network inhibition is complicated by a phenomenon known as the GABAergic polarity switch. The first described hyperpolarizing (inhibitory) effects that GABA exerts onto mature neurons are contrasted by depolarizing (excitatory) effects on immature neurons (<xref ref-type="bibr" rid="B5">Ben-Ari et al., 2007</xref>). Mechanistically, the excitatory action of GABA is primarily explained by high intracellular Cl<sup>&#x2013;</sup> levels established by the prevailing expression of the Cl<sup>&#x2013;</sup> loader NKCC1 and the low expression of the Cl<sup>&#x2013;</sup> extruder KCC2. This GABAergic polarity switch persists in rodents 14&#x2013;15 days after birth and is of particular interest for the modeling of developmental brain disorders (<xref ref-type="bibr" rid="B20">Kang et al., 2019</xref>). The switch has been observed in bioengineered neuronal organoids at a later time point, at day 40 (<xref ref-type="bibr" rid="B56">Zafeiriou et al., 2020</xref>), and could be especially relevant to the growth stages of brain organoids which are supposed to undergo a maturation process similar to neurons in a physiological environment.</p>
</sec>
<sec id="S4.SS2">
<title>4.2 Diversity of interneuron types</title>
<p>A great diversity of interneurons has been observed and is described to link different oscillatory patterns to each other in a timed and locally confined manner. This flexibly shapes neural activity into temporal patterns (<xref ref-type="bibr" rid="B7">Cardin, 2018</xref>; <xref ref-type="bibr" rid="B23">Kullander and Topolnik, 2021</xref>). Interneuron classifications remain a subject of ongoing discussion and vary depending on whether they are based on neurochemicals, function, morphology or developmental origin within the ganglionic eminences which lay out a path for the migration of glial and neuronal progenitor cells (<xref ref-type="bibr" rid="B2">Anderson et al., 2001</xref>; <xref ref-type="bibr" rid="B14">Encha-Razavi and Sonigo, 2003</xref>; <xref ref-type="bibr" rid="B17">Ghashghaei et al., 2007</xref>). A compelling framework segregates interneurons into three groups based on a combination of developmental origins and neurochemical occurrence: parvalbumin (PV), somatostatin (SST) and ionotropic serotonin receptor (5HT3aR)-expressing (<xref ref-type="bibr" rid="B39">Rudy et al., 2011</xref>; <xref ref-type="bibr" rid="B32">Pelkey et al., 2017</xref>; <xref ref-type="bibr" rid="B51">Tzilivaki et al., 2023</xref>).</p>
<list list-type="simple">
<list-item>
<label>(i)</label>
<p>PV-expressing interneurons (including chandelier cells) are fast-spiking basket cells and the most abundant species (<xref ref-type="bibr" rid="B16">Galarreta and Hestrin, 2002</xref>; <xref ref-type="bibr" rid="B35">Puig et al., 2008</xref>; <xref ref-type="bibr" rid="B39">Rudy et al., 2011</xref>). Targeting cell somata, they regulate spiking probability of excitatory neurons through strong feedback inhibition on a short and precise timescale (<xref ref-type="bibr" rid="B11">Cruikshank et al., 2007</xref>; <xref ref-type="bibr" rid="B7">Cardin, 2018</xref>).</p>
</list-item>
<list-item>
<label>(ii)</label>
<p>SST-expressing interneurons (including Martinotti cells) are dendrite-targeting and induce slight depression of synaptic inputs over an extended timescale upon repeated activation (<xref ref-type="bibr" rid="B48">Tan et al., 2008</xref>; <xref ref-type="bibr" rid="B7">Cardin, 2018</xref>).</p>
</list-item>
<list-item>
<label>(iii)</label>
<p>5HT3aR-expressing interneurons target dendrites of pyramidal neuron and SST-expressing interneurons (<xref ref-type="bibr" rid="B7">Cardin, 2018</xref>). Their functional role is the least understood among the three groups (<xref ref-type="bibr" rid="B39">Rudy et al., 2011</xref>). However, by regulating inhibitory neurons through disinhibition (<xref ref-type="bibr" rid="B23">Kullander and Topolnik, 2021</xref>), they present a potential direct mechanism of timing slow rhythms to superimposed fast local oscillations.</p>
</list-item>
</list>
<p>The three classes of interneurons have been shown to reciprocally interact with each other (<xref ref-type="bibr" rid="B7">Cardin, 2018</xref>; <xref ref-type="bibr" rid="B51">Tzilivaki et al., 2023</xref>) which creates timed neural-activity loops and gives rise to the complex coupling patterns of fast nested oscillations that occur inside large-scale rhythms. Notably, fast timescale nested oscillation inside slower rhythms have not been observed in 3D neurospheres suggesting that the necessary structure and diversity of glial and in particular inhibitory cell types might currently only be achieved in organoid models (<xref ref-type="bibr" rid="B50">Trujillo et al., 2019</xref>). The three groups of interneurons are present in varying distributions across the six layers of the neocortex. In rodents, layer 1 is almost exclusively populated by 5HT3aR-expressing interneurons, layers 4/5 are dominated by PV and layer 6 by SST (<xref ref-type="bibr" rid="B39">Rudy et al., 2011</xref>). This heterogenous physiological organization emphasizes the need for proper distribution of interneuron types to replicate the functional properties of specific cortical circuits. Cerebral organoids have been shown to form the six cortical layers <italic>in vitro</italic>. These layers also contain astrocytes, oligodendrocytes and other types of glial cells (<xref ref-type="bibr" rid="B36">Qian et al., 2020</xref>; <xref ref-type="bibr" rid="B54">Yang et al., 2022</xref>). Because of their involvement in neurotransmitter recycling, astrocytes are likely to influence strength and precision of synaptic transmission. Despite these general structural homologies of organoids to physiological networks, their lack of functional vascularization impedes efficient nutrient and oxygen distribution, typically resulting in a necrotic core (<xref ref-type="bibr" rid="B24">LaMontagne et al., 2022</xref>). Observed elevated metabolic stress that leads to constrained cell-type specification further exemplifies the limitations faced by current organoid technologies (<xref ref-type="bibr" rid="B6">Bhaduri et al., 2020</xref>).</p>
</sec>
<sec id="S4.SS3">
<title>4.3 GABAergic inhibition facilitates complex network function in organoids</title>
<p>Electrophysiological analysis of young organoids further revealed that the contained inner neural circuitry shows synchronized activity (<xref ref-type="bibr" rid="B43">Shin et al., 2021</xref>). Moreover, a small initial proportion of inhibitory neurons in the neuronal population after 6 months of cortical organoid development reached around 15% after 10 months (<xref ref-type="bibr" rid="B50">Trujillo et al., 2019</xref>). This increase in the fraction of inhibitory neurons correlated with an observed increase in network complexity, emphasizing the crucial role inhibitory neurons seem to play in the latter (<xref ref-type="fig" rid="F1">Figure 1</xref>). Electrophysiological findings support the hypothesis that inhibitory interneurons are necessary and responsible for the creation of complex coupled oscillatory patterns that transfer the spatiotemporal information constituting physiological network function. To prove this, <xref ref-type="bibr" rid="B41">Samarasinghe et al. (2021)</xref> developed a fusion organoid platform in which ventral ganglionic eminence organoids were fused with cerebral cortical organoids. This approach introduced interneurons in addition to the excitatory connections, resulting in complex oscillatory patterns that were not observed in purely cortical organoids. This showed that the functional integration of interneurons is the determining factor for network complexity.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption><p>Schematic increase of network functionality with increasing complexity of inhibitory components. (1) Human neural progenitor cell (NPC)-derived neuronal cell culture, co-cultured with glial cells, showing basic repetitive oscillatory activity in the form of plain theta waves. The presence of astrocytes in particular helps to maintain E-I balance. (2) Co-culture of human NPC-derived neuronal cells, separately differentiated into inhibitory and excitatory subpopulations, co-cultured with glial cells. Spiking activity is more synchronous and begins to exhibit coherent dynamics in more balanced excitatory-inhibitory neural networks. Both theta and gamma oscillations occur independently or with minimal coupling. Comparable activity can be observed in a 2D primary neuronal cell culture prepared from embryonic rodent tissue containing a physiological variety of neuronal and supporting cell types. (3) Human iPSC-derived brain organoid (after 6&#x2013;10 months of maturation) with multiple cortical layers and 3D structure mimicking authentic human brain regions that display higher order rhythms with cross-frequency coupling. These nested phase-amplitude-coupled oscillations are created by inhibitory feedback loops and are commonly part of local field potential (LFP) or EEG recordings <italic>in vivo</italic>. Faster local oscillations are encapsulated within broader global brain rhythms. This configuration facilitates the spatiotemporal encoding of information thus emulating genuine physiological brain function. In this example, gamma wave amplitude is controlled by the phase of the theta wave. Figure created using <ext-link ext-link-type="uri" xlink:href="https://Biorender.com">Biorender.com</ext-link> and Python.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fncel-18-1389335-g001.tif"/>
</fig>
<p>Comparison of patient electroencephalograms (EEGs) and patient-derived organoid readouts demonstrated a network complexity-functionality relationship. Minor interneuron composition variances in disease phenotype organoids may explain observed network irregularities and absence of specific oscillations in mutants.</p>
<p>These findings are strongly supported by a recent study that examined 3D horizontally bio-printed neuronal tissue (<xref ref-type="bibr" rid="B53">Yan et al., 2024</xref>). An increased synaptic density and frequency of spontaneous action potentials were found when GABAergic interneurons were included into the neuronal print compared to being omitted.</p>
</sec>
</sec>
<sec id="S5">
<title>5 Consequences of inhibitory dysfunction</title>
<p>Temporal network organization is likely to be lost when inhibitory mechanisms malfunction (<xref ref-type="bibr" rid="B7">Cardin, 2018</xref>). In healthy brain networks, GABAergic interneurons put brakes on excitatory signaling&#x2013;their loss has been linked to several neuropsychiatric disorders (<xref ref-type="bibr" rid="B38">Rubenstein and Merzenich, 2003</xref>; <xref ref-type="bibr" rid="B33">Petanjek et al., 2009</xref>; <xref ref-type="bibr" rid="B15">Ferguson and Gao, 2018</xref>). The most prominent example of inhibitory dysfunction is epilepsy. Epileptic seizures are thought to be the manifestation of hypersynchronous network activity in the absence of adequate inhibition. Excessive discharge alone can act as a major disruptor of E-I balance but tends to be insufficient to induce seizures. Consequently, epilepsy seems to only be fully characterized by uninhibited synchronous discharge across large brain regions (<xref ref-type="bibr" rid="B42">Scharfman, 2007</xref>). Forms of abnormal neural synchrony as observed in schizophrenia are another important example of inhibitory dysfunction. Phase locking and phase coherence associated to the binding of visual features were found to strongly deviate in schizophrenic patients (<xref ref-type="bibr" rid="B45">Spencer et al., 2003</xref>). This characteristic has possible implications for altered perception of reality, a frequent positive symptom of schizophrenia. Extending these clinical findings to organoid systems, abnormal activity resembling epilepsy has been shown to arise in organoids derived from Rett syndrome patient iPSCs (<xref ref-type="bibr" rid="B41">Samarasinghe et al., 2021</xref>). Interestingly, functional properties were partially restored by pharmacological intervention. This manifests both the possibility of creating functional replicas of human pathologies <italic>in vitro</italic> and the option to test the efficacy of drugs for restoring brain function.</p>
</sec>
<sec id="S6">
<title>6 Species-specific formation of E-I balance</title>
<sec id="S6.SS1">
<title>6.1 Origins of neuronal progenitor cells</title>
<p>Prior investigations into the cortical neurodevelopment of rodents led to the establishment of a model in which excitatory and inhibitory cortical neurons exclusively originate from two distinct populations of progenitor cells (<xref ref-type="bibr" rid="B18">Gorski et al., 2002</xref>; <xref ref-type="bibr" rid="B33">Petanjek et al., 2009</xref>). According to this, excitatory glutamatergic neurons originate from progenitors located in the cortex (dorsal forebrain region) and inhibitory GABAergic interneurons originate exclusively from progenitors in the ganglionic eminences (ventral forebrain region) (<xref ref-type="bibr" rid="B4">Bandler et al., 2022</xref>). This observation in mice was assumed to hold true for humans as well. However, deviating from this, newer findings have unveiled that human cortical interneurons can additionally be formed from the same cortical progenitor cells which primarily generate excitatory neurons (<xref ref-type="bibr" rid="B12">Delgado et al., 2022</xref>). Human neuronal diversity and fate determination appear to remain modifiable deep into the developmental process. This can be speculated to enable more precise finetuning of inhibition demands for regional specifications and allow for developmental flexibility beyond the disappearance of the ganglionic eminences after around one year (<xref ref-type="bibr" rid="B14">Encha-Razavi and Sonigo, 2003</xref>). At this point the underlying molecular mechanisms that determine the cell fate and induce locally born inhibitory neurons are not understood (<xref ref-type="bibr" rid="B12">Delgado et al., 2022</xref>) which limits the possibility to recreate given mechanisms in organoid models.</p>
</sec>
<sec id="S6.SS2">
<title>6.2 Network complexity increases with increased number and diversity of GABAergic neurons</title>
<p>The location, number and diversity of GABAergic interneurons directly coordinate cortical function (<xref ref-type="bibr" rid="B33">Petanjek et al., 2009</xref>; <xref ref-type="bibr" rid="B23">Kullander and Topolnik, 2021</xref>). Looking at evolutionary evidence, a rise in network complexity has been observed to be accompanied by an increase in diversity of GABAergic neurons (<xref ref-type="bibr" rid="B37">Rakic, 2009</xref>; <xref ref-type="bibr" rid="B52">Vanderhaeghen and Polleux, 2023</xref>) suggesting an important role of inhibitory circuit diversity regulating functional complexity. Connectome and transcriptome analyses revealed a 2-3-fold higher proportion of interneurons in humans compared to rodents (<xref ref-type="bibr" rid="B22">Krienen et al., 2020</xref>; <xref ref-type="bibr" rid="B3">Bakken et al., 2021</xref>; <xref ref-type="bibr" rid="B29">Loomba et al., 2022</xref>). Surprisingly, despite this increase in inhibitory circuit elements, the synaptic input to pyramidal neurons and thereby the E-I balance only displays a very moderate shift toward increased inhibition. The human interneuron population was found to be primarily expanded toward bipolar-type interneurons (6&#x2013;8 times; <xref ref-type="bibr" rid="B29">Loomba et al., 2022</xref>), favoring interneuron-to-interneuron circuits. In contrast, multipolar neurons, receiving substantially lower levels of inhibitory input, constitute the large majority in mice (<xref ref-type="bibr" rid="B29">Loomba et al., 2022</xref>). Thus, elaborated disinhibitory circuits in humans appear to give rise to unique network properties and functional complexity distinct from rodent brains.</p>
<p>Recent findings emphasize that due to the differences in network development and resulting network complexity, rodent-based models seem to inadequately reflect various features that define functional neural network activity in human brains. This serves as an explanation for the short-comings of many clinical trials when trying to transfer insights from rodent pathologies over to human diseases without additional testing on functional human cell-based assays (<xref ref-type="bibr" rid="B41">Samarasinghe et al., 2021</xref>; <xref ref-type="bibr" rid="B57">Zhang et al., 2023</xref>). Thus, the interspecies differences in organization, diversity and circuit integration of GABAergic interneurons are very likely to be the main driving force behind this lack of resemblance and transferability.</p>
</sec>
</sec>
<sec id="S7" sec-type="conclusion">
<title>7 Conclusion</title>
<p>The electrophysiological analysis of brain organoids still poses a challenge to current research since most available assays are designed for 2D cultures. A number of new technologies are being developed and tested and will continue to make it more feasible to harness the full electrophysiological potential of organoid models. At present, 2D neuronal cell cultures are the most widely available, fastest and most robust environment <italic>in vitro</italic> to obtain data from functional brain networks. The 2D structure without cortical layers, however, is typically too limiting to allow for complex cross-frequency coupling of distinct oscillatory patterns. As replicated in brain organoids, the varying three-dimensional distribution of different GABAergic interneuron types across cortical layers and the arising inhibitory feedback loops can be hypothesized to play the primary role in giving rise to the complex nested brain waves that more closely characterize a physiological and truly functional network. Further limiting the transferability of primary neuronal rodent cell cultures to humans, structural differences in the number, diversity and interconnectivity of inhibitory network components between humans and rodents have been detected. Hence, to leverage insights into human-specific network activity patterns, the culturing of human-induced pluripotent stem cell-derived brain organoids will have to be refined and subsequent advances in electrophysiological measurement platforms will be necessary. In conclusion, the evidence strongly indicates that the number, diversity and organization of inhibitory network components are the main factors determining network complexity and functionality. Physiological replication of inhibitory components consequently renders organoid-based model systems extremely promising candidates for future drug screening assays and disease modeling. The potential to successfully bridge the gap from current human 2D cell cultures, that are often functionally limited or unspecific to humans, over to clinical trials is immense.</p>
</sec>
<sec id="S8" sec-type="author-contributions">
<title>Author contributions</title>
<p>SH: Data curation, Investigation, Software, Writing &#x2013; original draft. GK: Conceptualization, Funding acquisition, Supervision, Writing &#x2013; review &#x0026; editing.</p>
</sec>
</body>
<back>
<sec id="S9" sec-type="funding-information">
<title>Funding</title>
<p>The authors declare that financial support was received for the research, authorship, and/or publication of this article. The costs of publication were supported by Frontiers Fee Support and Heidelberg Library Publication Fund.</p>
</sec>
<ack><p>We thank Julia Ladewig (HITBR, Heidelberg University) for mentioning the Frontiers project on human brain organoids, and Stephen J. Haggarty (MGH, Harvard Medical School) for providing the scientific environment that encouraged the writing process.</p>
</ack>
<sec id="S10" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="S11" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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