Meera P, Wallner M, Otis TS. Molecular basis for the high THIP/gaboxadol sensitivity of extrasynaptic GABA A receptors. J Neurophysiol 106: 2057-2064, 2011. First published July 27, 2011 doi:10.1152/jn.00450.2011.-Extrasynaptic GABA A receptors (eGABARs) allow ambient GABA to tonically regulate neuronal excitability and are implicated as targets for ethanol and anesthetics. These receptors are thought to be heteropentameric proteins made up of two ␣ subunits-either ␣4 or ␣6 -two 2 or 3 subunits, and one ␦ subunit. The GABA analog 4,5,6,7-tetrahydroisoxazolo (5,4-c)pyridin-3(-ol) (THIP) has been proposed as a selective ligand for eGABARs. Behavioral and in vitro studies suggest that eGABARs have nanomolar affinity for THIP; however, all published studies on recombinant versions of eGABARs report micromolar affinities. Here, we examine THIP sensitivity of native eGABARs on cerebellar neurons and on reconstituted GABARs in heterologous systems. Concentrationresponse data for THIP, obtained from cerebellar granule cells and molecular layer interneurons in wild-type and ␦ subunit knockout slices, confirm that submicromolar THIP sensitivity requires ␦ subunits. In recombinant experiments, we find that ␦ subunit coexpression leads to receptors activated by nanomolar THIP concentrations (EC 50 of 30 -50 nM for ␣43␦ and ␣63␦), a sensitivity almost 1,000-fold higher than receptors formed by ␣4/6 and 3 subunits. In contrast, ␥2 subunit expression significantly reduces THIP sensitivity. Even when ␦ subunit cDNA or cRNA was supplied in excess, highand low-sensitivity THIP responses were often apparent, indicative of variable mixtures of low-affinity ␣ and high-affinity ␣␦ receptors. We conclude that ␦ subunit incorporation into GABARs leads to a dramatic increase in THIP sensitivity, a defining feature that accounts for the unique behavioral and neurophysiological properties of THIP.