Abstract-NO is involved in the neural control of heart rate, and NO synthase expressing neurons and terminals have been localized in the nucleus ambiguus where parasympathetic cardiac vagal preganglionic neurons are located; however, little is known about the mechanisms by which NO alters the activity of premotor cardiac vagal neurons. This study examines whether the NO donor sodium nitroprusside ([SNP] 100 mol/L) and precursor, L-arginine (10 mmol/L), modulate excitatory and inhibitory synaptic neurotransmission to cardiac vagal preganglionic neurons. Glutamatergic, GABAergic, and glycinergic activity to cardiac vagal neurons was examined using whole-cell patch-clamp recordings in an in vitro brain slice preparation in rats. Both SNP, as well as L-arginine, increased the frequency of GABAergic neurotransmission to cardiac vagal preganglionic neurons but decreased the amplitude of GABAergic inhibitory postsynaptic currents. In contrast, both L-arginine and SNP inhibited the frequency of glutamatergic and glycinergic synaptic events in cardiac vagal preganglionic neurons. SNP and L-arginine also decreased glycinergic inhibitory postsynaptic current amplitude, and this response persisted in the presence of tetrodotoxin. Inclusion of the NO synthase inhibitor 7-nitroindazole (100 mol/L) prevented the L-arginine-evoked responses. These results demonstrate that NO differentially regulates excitatory and inhibitory neurotransmission, facilitating GABAergic and diminishing glutamatergic and glycinergic neurotransmission to cardiac vagal neurons. Key Words: nitric oxide Ⅲ parasympathetic Ⅲ vagal Ⅲ ambiguus Ⅲ cardiac Ⅲ brain stem N O, a gaseous neuromodulator, plays an important role in the central nervous system control of blood pressure and heart rate. In the brain stem, NO is localized to several medullary nuclei involved in cardiorespiratory and gastrointestinal function. 1,2 Neurons that contain the NO synthesizing enzyme, NO synthase (NOS), have been observed in many critical sites of central cardiovascular regulation, including the dorsal motor nucleus of the vagus, rostral ventrolateral medulla, caudal ventrolateral medulla, nucleus of the tractus solitarius (NTS), and the nucleus ambiguus (NA). 3 In the NA, NO is present in many of the terminal fields that surround cardiac vagal preganglionic neurons (CVPNs), including synaptic terminals from neurons that originate in the NTS. 4 CVPNs are primarily located within the external formation of the NA. 5-9 The CVPNs provide parasympathetic innervation to the heart and dominate control of the heart rate. CVPNs are intrinsically silent, and their activity is dominated by synaptic activation from other neurons that use neurotransmitters, such as acetylcholine, glutamate, GABA, and glycine, among others. 5,8 -12 NOS immunoreactivity is not directly colocalized with cholinergic neurons in the brain stem but rather is in small neurons, suggesting that NO is present in interneurons. 13,14 This indicates that NO may exert its actions by modulating synaptic inputs to CVPNs. ...