关键词: de novo SCN2A mutation dynamic action potential clamp epilepsy modeling voltage clamp

Mesh : Action Potentials / genetics Adolescent Adult Brain Diseases / genetics Child Child, Preschool Epilepsy / genetics Female Genetic Association Studies / methods Genetic Variation / genetics Genotype Humans Infant Infant, Newborn Male NAV1.2 Voltage-Gated Sodium Channel / genetics Phenotype Seizures / genetics Spasms, Infantile / genetics Young Adult

来  源:   DOI:10.1073/pnas.1800077115   PDF(Pubmed)

Abstract:
De novo variants in SCN2A developmental and epileptic encephalopathy (DEE) show distinctive genotype-phenotype correlations. The two most recurrent SCN2A variants in DEE, R1882Q and R853Q, are associated with different ages and seizure types at onset. R1882Q presents on day 1 of life with focal seizures, while infantile spasms is the dominant seizure type seen in R853Q cases, presenting at a median age of 8 months. Voltage clamp, which characterizes the functional properties of ion channels, predicted gain-of-function for R1882Q and loss-of-function for R853Q. Dynamic action potential clamp, that we implement here as a method for modeling neurophysiological consequences of a given epilepsy variant, predicted that the R1882Q variant would cause a dramatic increase in firing, whereas the R853Q variant would cause a marked reduction in action potential firing. Dynamic clamp was also able to functionally separate the L1563V variant, seen in benign familial neonatal-infantile seizures from R1882Q, seen in DEE, suggesting a diagnostic potential for this type of analysis. Overall, the study shows a strong correlation between clinical phenotype, SCN2A genotype, and functional modeling. Dynamic clamp is well positioned to impact our understanding of pathomechanisms and for development of disease mechanism-targeted therapies in genetic epilepsy.
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