Scheme illustrating the network effect of soman and galantamine. The
pyramidal neuron (P) in the CA1 hippocampal region receives inhibitory inputs
from various interneurons. The SRI provides the feed-forward inhibition,
whereas both SOI and SPI provide feedback inhibition to the pyramidal neurons.
Soman suppresses feedback inhibition (i.e., causes disinhibition) via
inhibition of type IA currents in SOI and SPI. Soman enhances feed-forward
inhibition via enhancement of ACh-induced type IA currents and via increase in
the number of SRI with type II currents. Soman-induced imbalance in
feed-forward and feedback inhibition results in increased pyramidal neuron
firing leading to excitotoxicity, neuronal damage, and altered rhythm. The
loss of pyramidal neurons partly contributes to a decrease in type III nAChR
activity after exposure to soman. Galantamine opposes the action of soman by
preventing irreversible inhibition of AChE, leading to preservation of nAChR
activity, and/or by inducing changes in the expression of nAChRs in the
interneurons, thereby restoring the balance of nAChR-dependent feed-forward
and feedback inhibition in the hippocampal neurocircuitry.