Abstract
The ability of glycogen, the depot into which excess glucose is stored in mammals, to act as a source of rapidly available energy substrate, has been exploited by several organs for both general and local advantage. The liver, expressing the highest concentration of glycogen maintains systemic normoglycemia ensuring the brain receives a supply of glucose in excess of demand. However the brain also contains glycogen, although its role is more specialized. Brain glycogen is located exclusively in astrocytes in the adult, with the exception of pathological conditions, thus in order to benefit neurons, and energy conduit (lactate) is trafficked inter-cellularly. Such a complex scheme requires cell type specific expression of a variety of metabolic enzymes and transporters. Glycogen supports neural elements during withdrawal of glucose, but once the limited buffer of glycogen is exhausted neural function fails and irreversible injury ensues. Under physiological conditions glycogen acts to provide supplemental substrates when ambient glucose is unable to support function during increased energy demand. Glycogen also supports learning and memory where it provides lactate to neurons during the conditioning phase of in vitro long-term potentiation (LTP), an experimental correlate of learning. Inhibiting the breakdown of glycogen or intercellular transport of lactate in in vivo rat models inhibits the retention of memory. Our current understanding of the importance of brain glycogen is expanding to encompass roles that are fundamental to higher brain function.
Introduction
The lack of appreciation for the role(s) that brain glycogen contributes to brain function cannot be attributed to its recent discovery, as its presence, detected by both biochemical assay (Koizumi, ) and electron microscopy (Koizumi and Shiraishi, ), has been known for decades. Unlike skeletal muscle or liver, where glycogen is expressed uniformly throughout a homogenous cell population (Stryer, 1995), the cellular (and sub-cellular) location of glycogen within the brain provides clues to its function (Cataldo and Broadwell, ; Oe et al., ), but detailed information regarding the intricacies of metabolic cell-to-cell signaling within the brain (Dringen et al., ; Magistretti and Pellerin, ; Dienel, ) were required before potential roles for glycogen could be proposed and experimentally tested (Brown et al., ; Suzuki et al., 2011). This disregard for brain glycogen was compounded by the low concentration with which glycogen is expressed in the brain; up to 100 times lower than liver and skeletal muscle (Stryer, 1995). Although never consigned as a vestigial entity glycogen was quietly ignored, and in a neurocentric world there were few advocates proposing it warranted detailed investigation.
Systemic Hypoglycemia
The presence of glycogen in the brain may be viewed as at odds with established facts regarding whole body metabolism. Given the brains exclusive reliance on glucose as its sole energy support, and the complex endocrine machinery that secures blood glucose levels within a narrow concentration range (Frier and Fisher, ), any need for glycogen within the brain initially seems superfluous. The liver breaks down glycogen in response to falling systemic glucose levels ensuring adequate delivery of glucose to the brain for up to 24 h (Stryer, 1995). Skeletal muscle glycogen provides a localized energy reserve for muscle (Champe and Harvey, ; although even this is a simplification, with recent studies suggesting a highly complex and coordinated reciprocal metabolism of glucose and lactate between brain and muscle, dependent upon immediate localized requirements; Dalsgaard et al., ; Dalsgaard, ). What is not in doubt is the exquisite sensitivity that the brain displays when confronted with a shortfall in glucose delivery (Frier and Fisher, ). Consistent with the homeostatic hormonal response that maintains normoglycemia, in event of decreased systemic glucose (hypoglycemia) the brain responds via the autonomic nervous system, with a series of signals (sweating, tremor, decreased temperature, decreased intraocular pressure, increased gastric emptying) that warn the sufferer of an impending hypoglycemic attack (Frier and Fisher, ). The critical aspect of this autonomic response is that its threshold lies above that of the glycopenic symptoms (confusion, drowsiness, odd behavior, speech difficulty, lack of co-ordination) of hypoglycemia characterized by confusion. However repeated hypoglycemic episodes compromise the threshold for the autonomic symptoms, a process called hypoglycemia unawareness (Cryer, ), such that they dip below those of the glycopenic effects rendering the sufferer incapable of responding appropriately to the hypoglycemia, with potentially fatal consequences (Figure 1).
Figure 1
Glucose Is the Main Energy Support for Brain Function
In the last 20 years attempts to deduce the role(s) of brain glycogen have been played out against a background of confusion, dead ends and polarized opinion, which stems from the simple fact that we know little about critical aspects of metabolism in the brain at the cellular level (Ames,
Sub-Cellular Location of Glycogen
Since the advent of the electron microscope it has been known that in the adult rodent brain glycogen is stored almost exclusively in astrocytes (Cataldo and Broadwell,
Until recently the regional expression of brain glycogen was unclear. This was primarily because the technique used to assess glycogen expression (biochemical glycogen assay) was incapable of the resolution required to accurately measure the glycogen concentration in small areas of brain (Passonneau et al.,
The dogmatic view of an exclusively astrocytic domain for glycogen must be considered against the evidence of neuronally located glycogen. Such a location was associated with pathological conditions such as Lafora’s disease, a form of epilepsy, where such an over-abundance of neuronal glycogen is considered a side effect of the disease and has no physiological function (Vilchez et al., 2007). In the sciatic nerve glycogen related enzymes are shown to be present in axons (Pfeiffer-Guglielmi et al.,
Astrocytic Support of Cultured Neurons
Initial studies that investigated the role of neuronal cells were carried out in tissue culture conditions. This reductionist approach was justified in the light of the difficulty of gaining meaningful data from in situ tissue (Kettenmann and Grantyn,
Whereas the behavior of neurones may have been compromised in tissue culture conditions, it was a serendipitous approach that yielded preliminary information on the metabolic support afforded neurones by astrocytes (Swanson and Choi, 1993). Neurones that were co-cultured with astrocytes displayed increased viability compared to neurones that were cultured in isolation. However it was discovered that it was the presence of glycogen in the astrocytes that was the critical factor in promoting neuronal survival, as astrocytes with depleted glycogen did not significantly prolong neuronal survival (Swanson and Choi, 1993). This was an intriguing result that posed more questions than it answered, most notably, what was the form in which glycogen provided support?
The Role of Glycogen during Aglycemia
From studies of glycogen in the liver and skeletal muscle the nature of the glycogen molecule and its regulation are well established (Stryer, 1995), information that can reasonably be applied to brain glycogen. In the periphery glycogen acts as a storage depot for excess glucose during periods of plenty, to be liberated in time of need. In the liver glycogen is liberated in the form of glucose to maintain normoglycemic blood glucose levels (Stryer, 1995), whereas in the muscle glycogen is glycolytically metabolized (Stryer, 1995), with the apparent waste product lactate liberated into the bloodstream. The nature of the support offered by astrocytic glycogen to neurons was presumably metabolic, thus how this was achieved was a prime focus of investigation. The simplest explanation was that glycogen supported solely astrocytes, relieving the metabolic burden from neurones, i.e., astrocytes are fueled exclusively be glycogen sparing interstitial glucose for exclusive use by neurons (DiNuzzo et al.,
Given the complexity of metabolic interactions in gray matter the Ransom lab chose to use a simple white matter model, the rodent optic nerve, to investigate the role of glycogen (Ransom et al., 1994). These studies were prompted by comparison of the effects of anoxia or aglycemia on the stimulus evoked compound action potential (CAP). The tissue is accessible to recordings of the stimulus evoked CAP, a monitor of axon conduction, whose area is proportional to the number of conducting axons (Cummins et al.,
Figure 2

Glycogen storage in the astrocyte. Glucose is taken up by astrocytes via the GLUT-1 glucose transporter, where it is phosphorylated by hexokinase (HK) to glucose-6-phosphate (G-6-P). The G-6-P can either proceed along the glycolytic pathway, or be added to the glycogen molecule by glycogen synthase (GS). The glycogen is broken down by glycogen phosphorylase (GP), ultimately to lactate, which crosses the astrocyte membrane by monocarboxylate transporter (MCT). Adapted from Figure 1 (Fryer and Brown,
The sciatic nerve was studied in order to determine whether there was an equivalent metabolic cell-to-cell signaling pathway in the peripheral nervous system (PNS). Electron microscopic images revealed that Schwann cells did express glycogen, which was measured by biochemical assay at a concentration about twice that in the optic nerve (Brown et al.,
Figure 3

Glycogen content determines latency to failure in optic nerve axons and Schwann cell A fibers but not C fibers. (A) In mouse optic nerve (MON) glycogen content determines latency to failure during subsequent period of aglycemia (Δ). (B) In Schwann cells elevated glycogen content benefits A fibers (□) but not C fibers (Δ). Note elevated (glycogen) does not prolong C fiber latency to failure. Adapted from Figure 2 (Brown et al.,
The Role of Glycogen during High Frequency Stimulus
Imposing a short period of high intensity stimulus was very effective at revealing key information. At frequencies between 10 Hz and 100 Hz, i.e., an action potential was evoked between every 100 ms and 10 ms, the increasing metabolic demand imposed on the tissue exceeded its ability to support conduction, in the presence of 10 mM glucose aCSF (Brown et al.,
A key issue that was missing from these studies was identification of the signaling mechanism whereby neurones inform astrocytes of their metabolic requirements. Such a mechanism would have to adhere to the following requirements: (1) it must be localized; (2) it must be capable of invoking rapid glycogen breakdown; (3) the intensity of the signal must be proportionate to the stimulus intensity; (4) the intensity of the signal must dissipate as the stimulus intensity declines; and (5) if the signal is not universal, then comparable localized equivalent systems must exist across the nervous system. A potential mechanism was revealed via studies investigating the neurotransmitter modulation of glycogen content.
The Astrocyte Neuron Lactate Shuttle Hypothesis
One important aspect of glycogen’s metabolism in the brain is the means by which it is modified. Whereas in the periphery glycogen is modulated by the hormones insulin and glucagon, in the brain parenchyma the influence of these hormones appear to be attenuated and neurotransmitters contribute regulatory roles. Pierre Magistretti’s group started investigating this phenomenon in the early 1990’s. Their goal was to identify physiologically relevant modulators, and these initial studies identified VIP, nor-epinephrine and adenosine as well as K+ (see later) as controlling glycogen levels (Hof et al.,
Elevated Interstitial K+ Promotes Glycogenolysis
A recent study has linked elevations in extracellular K+, as would occur during increased neuronal activity, to promotion of astrocytic glycogenolysis (Choi et al.,
Figure 4

Interstitial K+ stimulates astrocytic glycogenolysis. Increased neural activity promotes elevated interstitial K+, which activates the Na+-HCO3− coupled transporter leading to alkalization of the astrocyte cytoplasm. This activates soluble adenylyl cyclase (sAC), which in turn elevates cytoplasmic cAMP leading to glycogenolysis and transfer of lactate out of the astrocyte for neuronal oxidative metabolism. Adapted from Figure 7 (Choi et al.,
In a complementary study interstitial K+ elevations were shown to have a separate but related effect, activating a channel on the astrocyte membrane through which pools of astrocytic lactate could flow into the interstitium, in parallel with the established route of MCTs (Sotelo-Hitschfeld et al., 2015). This is a very important route for astrocytic lactate release, since it is coupled to the membrane potential and allows lactate release against a concentration gradient, whereas the MCT is electro-neutral and net flux is governed by the trans-membrane concentrations of H+ and lactate (Figure 5).
Figure 5

Interstitial K+ promotes astrocytic lactate release via the lactate channel. As described in Figure 4, neural activity results in elevated interstitial K+. This activates a channel leading to release of the cytoplasmic lactate pool into the interstitium, which, via a positive feedback loop, causes further lactate release. Adapted from Figure 8 (Sotelo-Hitschfeld et al., 2015).
Glycogen and Memory
It is germane at this point to reflect upon the properties of glycogen and how these can confer certain metabolic advantages. Glycogen is an energy buffer, present in astrocytes that can be mobilized rapidly, without the need to expend ATP, as is the case with glucose. As such glycogen stands as a readily metabilizable energy source that would rapidly provide energy substrate. Compare this to glucose, which is delivered via the blood stream implying delivery of excess glucose would require delivery of excess blood, a process called functional hyperemia. This is a comparatively slow process (Gordon et al.,
In studies dating back two decades the role of glycogen in supporting one of the most important brain functions, learning and memory commenced. Learning and memory are functions that can be tested in live animals via a series of standard tests (Kandel et al.,
The main findings of these chick experiments were extended in studies on rodents to encompass not only live animal studies on learning and memory, but investigation of the cellular mechanism underlying these processes using in vitro techniques. Rats were placed in a white chamber, separated from another chamber by a door. The experimenter opened the door, and when the rat entered the new chamber it received an electric footshock, and was then placed back in the white chamber. The time taken for the rat to re-enter the second chamber was taken as an index of memory, with increased latency signifying that the rat had learned to avoid the chamber (Taubenfeld et al., 2001). The rats were tested daily after the conditioning shock, and the latency to re-enter the second chamber was stable at about 300 s for up to 7 days. Injection of the GP inhibitor DAB into the rat’s brain decreased the latency indicating that memory was impaired. Exogenously dialyzed lactate into the hippocampus circumvented the inhibitory effects of DAB and augmented the latency. Electrophysiological recordings of LTP in hippocampal slices showed that in the presence of DAB the synaptic efficacy was initially enhanced, but this rapidly fell, indicative of no long-term enhancement of synaptic efficacy occurring (Suzuki et al., 2011). These data confirm a role for glycogen in the process of memory. This data appears to suggest there is a metabolic aspect to LTP, that glycogen-derived lactate is an integral component of the process (Suzuki et al., 2011). The speed with which glycogen can be metabolized makes it an ideal energy buffer, capable of rapid delivery of lactate to the neuronal elements that exhibit very rapid augmentation of synaptic efficacy in response to high frequency conditioning pulses.
This conclusion was further complemented by a study on mice where brain glycogen synthase (GS) was knocked out. Biochemical assay revealed that liver and muscle glycogen were unaffected. In these knockout animals learning and memory was impaired compared to control animals (Duran et al.,
Glycogen and Exercise
A role for glycogen during exercise is emerging. Its role as an energy reserve has important consequences during exercise with skeletal muscle glycogen used to provide energy. The effects, if any, of exercise on brain glycogen were unknown. Initial studies demonstrated that in rats exercising on a treadmill, the skeletal muscle glycogen fell by up to 90%, but super-compensated to ~45% after 24 h recovery. A similar scenario occurred in the brain, with a decrease of over 50%, with regional specific decreases, followed by super-compensation (Matsui et al.,
Conclusion
The role(s) of nervous system glycogen are slowly emerging. Far from being a mere metabolic curiosity, it appears to act as an energy buffer, capable of the rapid delivery of the energy substrate lactate, to fuel neural function. Established occasions when this occurs are during the absence of glucose, or during hypoglycemia where glycogen derived lactate acts as a supplemental energy substrate to fuel neuronal function. As such a balance appears to be struck between ambient glucose and glycogen-derived lactate, when the former, is insufficient to meet immediate energy requirements delivery of the latter is increased. Brain glycogen also plays a pivotal role in learning and memory, where it’s presence is an absolute requirement for the transformation of short term learning into storage as memories. As such glycogen is positioned to play the key role as a buffer to supply energy substrate for short term increases in energy demand as occurs during the cellular mechanisms underlying LTP.
Funding
The review was funded in part by the University of Nottingham.
Statements
Author contributions
AMB and BRR conceived the review; edited the final version of the manuscript. AEW, LR and AMB wrote the first draft of the manuscript. AMB and BRR edited the final version of the manuscript.
Conflict of interest
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.
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Summary
Keywords
glycogen, glucose, lactate, astrocyte, potassium, memory, aglycemia, exercise
Citation
Waitt AE, Reed L, Ransom BR and Brown AM (2017) Emerging Roles for Glycogen in the CNS. Front. Mol. Neurosci. 10:73. doi: 10.3389/fnmol.2017.00073
Received
16 January 2017
Accepted
03 March 2017
Published
16 March 2017
Volume
10 - 2017
Edited by
Susan A. Masino, Trinity College, USA
Reviewed by
Johannes Hirrlinger, Leipzig University, Germany; María Llorens-Martín, Consejo Superior de Investigaciones Científicas (CSIC), Spain; Lasse Kristoffer Bak, University of Copenhagen, Denmark
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Copyright
© 2017 Waitt, Reed, Ransom and Brown.
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*Correspondence: Angus M. Brown ambrown@nottingham.ac.uk
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