A1152D mutation of the Na+ channel causes paramyotonia congenita and emphasizes the role of DIII/S4–S5 linker in fast inactivation

Missense mutations in the human skeletal muscle Na⁺ channel α subunit (hSkM1) are responsible for a number of muscle excitability disorders. Among them, paramyotonia congenita (PC) is characterized by episodes of muscle stiffness induced by cold and aggravated by exercise. We have identified a new PC-associated mutation, which substitutes aspartic acid for a conserved alanine in the S4–S5 linker of domain III (A1152D). This residue is of particular interest since its homologue in the rat brain type II Na⁺ channel has been suggested as an essential receptor site for the fast inactivation particle. To identify the biophysical changes induced by the A1152D mutation, we stably expressed hSkM1 mutant or wild-type (WT) channels in HEK293 (human embryonic kidney) cells, and recorded whole-cell Na⁺ currents with the patch-clamp technique. Experiments were performed both at 21 and 11°C to better understand the sensitivity to cold of paramyotonia. The A1152D mutation disrupted channel fast inactivation. In comparison to the WT, mutant channels inactivated with slower kinetics and displayed a 5 mV depolarizing shift in the voltage dependence of the steady-state. The other noticeable defect of A1152D mutant channels was an accelerated rate of deactivation from the inactivated state. Decreasing temperature by 10°C amplified the differences in channel gating kinetics between mutant and WT, and unveiled differences in both the sustained current and channel deactivation from the open state. Overall, cold-exacerbated mutant defects may result in a sufficient excess of Na⁺ influx to produce repetitive firing and myotonia. In the light of previous reports, our data point to functional as well as phenotypic differences between mutations of conserved S4–S5 residues in domains II and III of the human skeletal muscle Na⁺ channel.     

Cold-induced disruption of Na+ channel slow inactivation underlies paralysis in highly thermosensitive paramyotonia

The Q270K mutation of the skeletal muscle Na⁺ channel α subunit (Nav1.4) causes atypical paramyotonia with a striking sensitivity to cold. Attacks of paralysis and a drop in the compound muscle action potential (CMAP) are exclusively observed at cold. To understand the pathogenic process, we studied the consequences of this mutation on channel gating at different temperatures. WT or Q270K recombinant Nav1.4 channels fused at their C-terminal end to the enhanced green fluorescent protein (EGFP) were expressed in HEK-293 cells. Whole-cell Na⁺ currents were recorded using the patch clamp technique to examine channel gating at 30°C and after cooling the bathing solution to 20°C. Mutant channel fast inactivation was impaired at both temperatures. Cooling slowed the kinetics and enhanced steady-state fast inactivation of both mutant and WT channels. Mutant channel slow inactivation was fairly comparable to that of the WT at 30°C, but became clearly abnormal at 20°C. Cooling enhanced slow inactivation in the WT by shifting the voltage dependence toward hyperpolarization, but induced the opposite effect in the mutant. Destabilization of mutant channel slow inactivation in combination with defective fast inactivation is expected to increase the susceptibility to prolonged membrane depolarization, and can ultimately lead to membrane inexcitability and paralysis at cold. Thus, abnormal temperature sensitivity of slow inactivation can be a determinant pathogenic factor, and should therefore be more widely considered in thermosensitive Na⁺ channelopathies.     

Single channel properties of hyperpolarization-activated cation currents in acutely dissociated rat hippocampal neurones

Missense mutations in the skeletal muscle sodium channel α-subunit gene ( SCN4A ) are associated with a group of clinically overlapping diseases caused by alterations in the excitability of the sarcolemma. Sodium channel defects may increase excitability and cause myotonic stiffness or may render fibres transiently inexcitable to produce periodic paralysis. A patient with cold-aggravated myotonia did not harbour any of the common SCN4A mutations. We therefore screened all 24 exons by denaturing high-performance liquid chromatography, followed by direct sequencing. Two novel missense changes were found with predicted amino acid substitutions: T323M in the DIS5-S6 loop and F1705I in the intracellular C-terminus. The functional impact of these substitutions was assessed by recording whole-cell Na⁺ currents from transiently transfected HEK293 cells. T323M currents were indistinguishable from wild-type (WT). Fast inactivation was impaired for F1705I channels, as demonstrated by an 8.6-mV rightwards shift in voltage dependence and a two-fold slowing in the rate of inactivation. Recovery from fast inactivation was not altered, nor was there an increase in the persistent current after a 50- ms depolarization. Activation and slow inactivation were not appreciably affected. These data suggest that T323M is a benign polymorphism, whereas F1705I results in fast inactivation defects, which are often observed for myotonia. This is the first example of a C-terminal mutation in SCN4A associated with human disease. Like the cardiac disorders (long QT syndrome type 3 or Brugada syndrome) and generalized epilepsy with febrile seizures plus (GEFS+) associated with C-terminal mutations in other Na_V channels, the primary effect of F1705I was a partial disruption of fast inactivation.     

Selectivity and interactions of Ba2+ and Cs+ with wild-type and mutant TASK1 K+ channels expressed in Xenopus oocytes

The acid-sensitive K⁺ channel, TASK1 is a member of the K⁺-selective tandem-pore domain (K2P) channel family. Like many of the K2P channels, TASK1 is relatively insensitive to conventional channel blockers such as Ba²⁺. In this paper we report the impact of mutating the pore-neighbouring histidine residues, which are involved in pH sensing, on the sensitivity to blockade by Ba²⁺ and Cs⁺; additionally we compare the selectivity of these channels to extracellular K⁺, Na⁺ and Rb⁺. H98D and H98N mutants showed reduced selectivity for K⁺ over both Na⁺ and Rb⁺, and significant permeation of Rb⁺. This enhanced permeability must reflect changes in the structure or flexibility of the selectivity filter. Blockade by Ba²⁺ and Cs⁺ was voltage-dependent, indicating that both ions block within the pore. In 100 m m K⁺, the K _D at 0 mV for Ba²⁺ was 36 ± 10 m m  ( n = 6)  , whilst for Cs⁺ it was 20 ± 6.0 m m  ( n = 5)  . H98D was more sensitive to Ba²⁺ than the wild-type (WT); in addition, the site at which Ba²⁺ appears to bind was altered (WT: δ, 0.64 ± 0.16, n = 6; H98D: δ, 0.16 ± 0.03, n = 5, statistically different from WT; H98N: δ, 0.58 ± 0.09, not statistically different from WT). Thus, the pore-neighbouring residue H98 contributes not only to the pH sensitivity of TASK1, but also to the structure of the conduction pathway.     

Descending vasa recta pericytes express voltage operated Na+ conductance in the rat

We studied the properties of a voltage-operated Na⁺ conductance in descending vasa recta (DVR) pericytes isolated from the renal outer medulla. Whole-cell patch-clamp recordings revealed a depolarization-induced, rapidly activating and rapidly inactivating inward current that was abolished by removal of Na⁺ but not Ca⁺ from the extracellular buffer. The Na⁺ current ( I _Na) is highly sensitive to tetrodotoxin  (TTX, K _d= 2.2 n m )  . At high concentrations, mibefradil (10 μ m ) and Ni⁺ (1 m m ) blocked I _Na. I _Na was insensitive to nifedipine (10 μ m ). The L-type Ca⁺ channel activator FPL-64176 induced a slowly activating/inactivating inward current that was abolished by nifedipine. Depolarization to membrane potentials between 0 and 30 mV induced inactivation with a time constant of ∼1 ms. Repolarization to membrane potentials between −90 and −120 mV induced recovery from inactivation with a time constant of ∼11 ms. Half-maximal activation and inactivation occurred at −23.9 and −66.1 mV, respectively, with slope factors of 4.8 and 9.5 mV, respectively. The Na⁺ channel activator, veratridine (100 μ m ), reduced peak inward I _Na and prevented inactivation. We conclude that a TTX-sensitive voltage-operated Na⁺ conductance, with properties similar to that in other smooth muscle cells, is expressed by DVR pericytes.     

Role of extracellular Ca2+ in gating of CaV1.2 channels

We examined changes in ionic and gating currents in Ca_V1.2 channels when extracellular Ca²⁺ was reduced from 10 m m to 0.1 μ m . Saturating gating currents decreased by two-thirds ( K _D≈ 40 μ m ) and ionic currents increased 5-fold ( K _D≈ 0.5 μ m ) due to increasing Na⁺ conductance. A biphasic time dependence for the activation of ionic currents was observed at low [Ca²⁺], which appeared to reflect the rapid activation of channels that were not blocked by Ca²⁺ and a slower reversal of Ca²⁺ blockade of the remaining channels. Removal of Ca²⁺ following inactivation of Ca²⁺ currents showed that Na⁺ currents were not affected by Ca²⁺-dependent inactivation. Ca²⁺-dependent inactivation also induced a negative shift of the reversal potential for ionic currents suggesting that inactivation alters channel selectivity. Our findings suggest that activation of Ca²⁺ conductance and Ca²⁺-dependent inactivation depend on extracellular Ca²⁺ and are linked to changes in selectivity.     

Slow removal of Na+ channel inactivation underlies the temporal filtering property in the teleost thalamic neurons

It has been previously shown that the 'large cell' in the corpus glomerulosum (CG) of a teleost brain has a low-pass temporal filtering property. It fires a single spike only in response to temporally sparse synaptic inputs and thus extracts temporal aspects of afferent activities. To explore the ionic mechanisms underlying this property, we quantitatively studied voltage-gated Na⁺ channels of the large cell in the CG slice preparation of the marine filefish by means of whole-cell patch clamp recordings in the voltage-clamp mode. Recorded Na⁺ current was well described using the Hodgkin-Huxley ' m³h ' model. It was revealed that the Na⁺ channels have a novel feature: remarkably slow recovery from inactivation. In other words, the time constant for the ' h ' gate was extremely large (∼100 ms at −80 to −50 mV). In order to test whether the analysed Na⁺ current serves as a mechanism for filtering, the behaviour of the membrane model incorporating the Na⁺ channel was simulated using a computer program called NEURON. In response to current injections, the membrane model displayed low-pass filtering and firing properties similar to those reported in real cells. The present results suggest that slow removal of Na⁺ channel inactivation serves as a crucial mechanism for the low-pass temporal filtering property of the large cell. The simulation study also suggested that velocity and/or amplitude of a spike propagating though an axon expressing Na⁺ channels of this type could potentially be modulated depending on the preceding activities of the cells.     

Separation of P/C- and U-type inactivation pathways in Kv1.5 potassium channels

P/C-type inactivation of Kv channels is thought to involve conformational changes in the outer pore of the channel, culminating in a partial constriction of the selectivity filter. Recent studies have identified a number of phenotypic differences in the inactivation properties of different Kv channels, including different sensitivities to elevation of extracellular K⁺ concentration, and different state dependencies of inactivation. We have demonstrated that an alternatively spliced short form of Kv1.5, resulting in disruption of the T1 domain, exhibits a shift in the state dependence of inactivation in this channel, and in the current study we have examined this further to contrast the properties of inactivation from open versus closed states. In a TEA⁺-sensitive mutant of Kv1.5 (Kv1.5 R487T), 10 m m extracellular TEA⁺ inhibits inactivation in both full-length and T1-deleted channels, but does not inhibit closed-state inactivation in T1-deleted channel forms. Similarly, substitution of K⁺ and Na⁺ with Cs⁺ ions in the recording medium inhibits inactivation of both full-length and T1-deleted channel forms, but fails to inhibit closed-state inactivation of T1-deleted channels. Collectively, these data distinguish between open-state and closed-state inactivation, and suggest the presence of multiple possible mechanisms of inactivation coexisting in Kv1 channels.     

Charge at the lidocaine binding site residue Phe-1759 affects permeation in human cardiac voltage-gated sodium channels

Our homology molecular model of the open/inactivated state of the Na⁺ channel pore predicts, based on extensive mutagenesis data, that the local anaesthetic lidocaine docks eccentrically below the selectivity filter, such that physical occlusion is incomplete. Electrostatic field calculations suggest that the drug's positively charged amine produces an electrostatic barrier to permeation. To test the effect of charge at this pore level on permeation in hNa_V1.5 we replaced Phe-1759 of domain IVS6, the putative binding site for lidocaine's alkylamino end, with positively and negatively charged residues as well as the neutral cysteine and alanine. These mutations eliminated use-dependent lidocaine block with no effect on tonic/rested state block. Mutant whole cell currents were kinetically similar to wild type (WT). Single channel conductance (γ) was reduced from WT in both F1759K (by 38%) and F1759R (by 18%). The negatively charged mutant F1759E increased γ by 14%, as expected if the charge effect were electrostatic, although F1759D was like WT. None of the charged mutations affected Na⁺/K⁺ selectivity. Calculation of difference electrostatic fields in the pore model predicted that lidocaine produced the largest positive electrostatic barrier, followed by lysine and arginine, respectively. Negatively charged glutamate and aspartate both lowered the barrier, with glutamate being more effective. Experimental data were in rank order agreement with the predicted changes in the energy profile. These results demonstrate that permeation rate is sensitive to the inner pore electrostatic field, and they are consistent with creation of an electrostatic barrier to ion permeation by lidocaine's charge.     

Compound-specific Na+ channel pore conformational changes induced by local anaesthetics

Upon prolonged depolarizations, voltage-dependent Na⁺ channels open and subsequently inactivate, occupying fast and slow inactivated conformational states. Like C-type inactivation in K⁺ channels, slow inactivation is thought to be accompanied by rearrangement of the channel pore. Cysteine-labelling studies have shown that lidocaine, a local anaesthetic (LA) that elicits depolarization-dependent ('use-dependent') Na⁺ channel block, does not slow recovery from fast inactivation, but modulates the kinetics of slow inactivated states. While these observations suggest LA-induced stabilization of slow inactivation could be partly responsible for use dependence, a more stringent test would require that slow inactivation gating track the distinct use-dependent kinetic properties of diverse LA compounds, such as lidocaine and bupivacaine. For this purpose, we assayed the slow inactivation-dependent accessibility of cysteines engineered into domain III, P-segment (μ1: F1236C, K1237C) to sulfhydryl (MTSEA) modification using a high-speed solution exchange system. As expected, we found that bupivacaine, like lidocaine, protected cysteine residues from MTSEA modification in a depolarization-dependent manner. However, under pulse-train conditions where bupivacaine block of Na⁺ channels was extensive (due to ultra-slow recovery), but lidocaine block of Na⁺ channels was not, P-segment cysteines were protected from MTSEA modification. Here we show that conformational changes associated with slow inactivation track the vastly different rates of recovery from use-dependent block for bupivacaine and lidocaine. Our findings suggest that LA compounds may produce their kinetically distinct voltage-dependent behaviour by modulating slow inactivation gating to varying degrees.     

A novel alteration of muscle chloride channel gating in myotonia levior

Mutations in the voltage-dependent skeletal muscle chloride channel, ClC-1, result in dominant or recessive myotonia congenita. The Q552R mutation causes a variant of dominant myotonia with a milder phenotype, myotonia levior. To characterise the functional properties of this mutation, homodimeric mutant and heterodimeric wild-type (WT) mutant channels were expressed in tsA201 cells and studied using the whole-cell recording technique. Q552R ClC-1 mutants formed functional channels with normal ion conduction but altered gating properties. Mutant channels were activated by membrane depolarisation, with a voltage dependence of activation that was shifted by more than +90 mV compared to WT channels. Q552R channels were also activated by hyperpolarisation, and this process was dependent upon the intracellular chloride concentration ([  Cl⁻  ]_i). Together, these alterations resulted in a substantial reduction in the open probability at −85 mV at a physiological [  Cl⁻  ]_i. Heterodimeric WT-Q552R channels did not exhibit hyperpolarisation-activated gating transitions. As was the case for WT channels, activation occurred upon depolarisation, but the activation curve was shifted by 28 mV to more positive potentials. The functional properties of heterodimeric channels suggest a weakly dominant effect, a finding that correlates with the inheritance pattern and symptom profile of myotonia levior.     

Sodium and calcium currents shape action potentials in immature mouse inner hair cells

Before the onset of hearing at postnatal day 12, mouse inner hair cells (IHCs) produce spontaneous and evoked action potentials. These spikes are likely to induce neurotransmitter release onto auditory nerve fibres. Since immature IHCs express both α1D (Ca_v1.3) Ca²⁺ and Na⁺ currents that activate near the resting potential, we examined whether these two conductances are involved in shaping the action potentials. Both had extremely rapid activation kinetics, followed by fast and complete voltage-dependent inactivation for the Na⁺ current, and slower, partially Ca²⁺-dependent inactivation for the Ca²⁺ current. Only the Ca²⁺ current is necessary for spontaneous and induced action potentials, and 29 % of cells lacked a Na⁺ current. The Na⁺ current does, however, shorten the time to reach the action-potential threshold, whereas the Ca²⁺ current is mainly involved, together with the K⁺ currents, in determining the speed and size of the spikes. Both currents increased in size up to the end of the first postnatal week. After this, the Ca²⁺ current reduced to about 30 % of its maximum size and persisted in mature IHCs. The Na⁺ current was downregulated around the onset of hearing, when the spiking is also known to disappear. Although the Na⁺ current was observed as early as embryonic day 16.5, its role in action-potential generation was only evident from just after birth, when the resting membrane potential became sufficiently negative to remove a sizeable fraction of the inactivation (half inactivation was at −71 mV). The size of both currents was positively correlated with the developmental change in action-potential frequency.     

Lucifer Yellow Slows Voltage-Gated Na+ Current Inactivation in a Light-Dependent Manner in Mice

Lucifer Yellow CH (LY), a membrane-impermeant fluorescent dye, has been used in electrophysiological studies to visualize cell morphology, with little concern about its pharmacological effects. We investigated its effects on TTX-sensitive voltage-gated Na⁺ channels in mouse taste bud cells and hippocampal neurons under voltage-clamp conditions. LY applied inside cells irreversibly slowed the inactivation of Na⁺ currents upon exposure to light of usual intensities. The inactivation time constant of Na⁺ currents elicited by a depolarization to −15 mV was increased by fourfold after a 5 min exposure to halogen light of 3200 lx at source (3200 lx light), and sevenfold after a 1-min exposure to 12 000 lx light. A fraction of the Na⁺ current became non-inactivating following the exposure. The non-inactivating current was ≈ 20 % of the peak total Na⁺ current after a 5 min exposure to 3200 lx light, and ≈ 30 % after a 1 min exposure to 12 000 lx light. Light-exposed LY shifted slightly the current-voltage relationship of the peak Na⁺ current and of the steady-state inactivation curve, in the depolarizing direction. A similar light-dependent decrease in kinetics occurred in whole-cell Na⁺ currents of cultured mouse hippocampal neurones. Single-channel recordings showed that exposure to 6500 lx light for 3 min increased the mean open time of Na⁺ channels from 1.4 ms to 2.4 ms without changing the elementary conductance. The pre-incubation of taste bud cells with 1 mM dithiothreitol, a scavenger of radical species, blocked these LY effects. These results suggest that light-exposed LY yields radical species that modify Na⁺ channels.     

Na+ channel inactivation: a comparative study between pancreatic islet β-cells and adrenal chromaffin cells in rat

A comparative study was carried out on the inactivation of Na⁺ channels in two types of endocrine cells in rats, β-cells and adrenal chromaffin cells (ACCs), using patch-clamp techniques. The β-cells were very sensitive to hyperpolarization; the Na⁺ currents increased ninefold when the holding potential was shifted from −70 mV to −120 mV. ACCs were not sensitive to hyperpolarization. The half-inactivation voltages were −90 mV (rat β-cells) and −62 mV (ACCs). The time constant for recovery from inactivation at −70 mV was 10.5 times slower in β-cells (60 ms) than in ACCs (5.7 ms). The rate of Na⁺-channel inactivation at physiological resting potential was more than three times slower in β-cells than in ACCs. Na⁺ influx through Na⁺ channels had no effect on the secretory machinery in rat β-cells. However, these 'silent Na⁺ channels' could contribute to the generation of action potentials in some conditions, such as when the cell is hyperpolarized. It is concluded that the fractional availability of Na⁺ channels in β-cells at a holding potential of −70 mV is about 15 % of that in ACCs. This value in rat β-cells is larger than that observed in mouse (0 %), but is smaller than those observed in human or dog (90 %).     

Roles of axonal sodium channels in precise auditory time coding at nucleus magnocellularis of the chick

How the axonal distribution of Na⁺ channels affects the precision of spike timing is not well understood. We addressed this question in auditory relay neurons of the avian nucleus magnocellularis. These neurons encode and convey information about the fine structure of sounds to which they are tuned by generating precisely timed action potentials in response to synaptic inputs. Patterns of synaptic inputs differ as a function of tuning. A small number of large inputs innervate high- and middle-frequency neurons, while a large number of small inputs innervate low-frequency neurons. We found that the distribution and density of Na⁺ channels in the axon initial segments varied with the synaptic inputs, and were distinct in the low-frequency neurons. Low-frequency neurons had a higher density of Na⁺ channels within a longer axonal stretch, and showed a larger spike amplitude and whole-cell Na⁺ current than high/middle-frequency neurons. Computer simulations revealed that for low-frequency neurons, a large number of Na⁺ channels were crucial for preserving spike timing because it overcame Na⁺ current inactivation and K⁺ current activation during compound EPSPs evoked by converging small inputs. In contrast, fewer channels were sufficient to generate a spike with high precision in response to an EPSP induced by a single massive input in the high/middle-frequency neurons. Thus the axonal Na⁺ channel distribution is effectively coupled with synaptic inputs, allowing these neurons to convey auditory information in the timing of firing.     

Role of the amiloride-sensitive epithelial Na+ channel in the pathogenesis and as a therapeutic target for cystic fibrosis lung disease

Increased airway Na⁺ absorption mediated by the amiloride-sensitive epithelial Na⁺ channel (ENaC) is a basic defect in cystic fibrosis (CF) lung disease. Cystic fibrosis is one of the most common lethal hereditary diseases and is caused by mutations in the cystic fibrosis transmembrane conductance regulator ( CFTR ) gene. The CFTR acts as a cAMP-dependent Cl⁻ channel and regulator of ENaC, and CFTR dysfunction causes impaired Cl⁻ secretion and increased Na⁺ absorption in the airways of CF patients. Evidence from in vitro studies suggested that increased Na⁺ absorption produces airway surface liquid (ASL) volume depletion and led to the generation of transgenic mice with airway-specific overexpression of ENaC to elucidate the role of this mechanism in the in vivo pathogenesis of lung disease. Studies of the pulmonary phenotype of βENaC-overexpressing mice demonstrated that increased airway Na⁺ absorption caused ASL depletion and reduced mucus transport, producing a CF-like lung disease with airway mucus plugging, chronic airway inflammation and pulmonary mortality. Further, recent pharmacological studies demonstrated that preventive, but not late, inhibition of increased airway Na⁺ absorption with the ENaC blocker amiloride reduced morbidity and mortality in this murine model of CF lung disease. These results support a critical role of ENaC in the in vivo pathogenesis of CF lung disease and suggest that amiloride may be an effective preventive therapy for CF patients.     

Mechanisms underlying the early phase of spike frequency adaptation in mouse spinal motoneurones

Spike frequency adaptation (SFA) is a fundamental property of repetitive firing in motoneurones (MNs). Early SFA (occurring over several hundred milliseconds) is thought to be important in the initiation of muscular contraction. To date the mechanisms underlying SFA in spinal MNs remain unclear. In the present study, we used both whole-cell patch-clamp recordings of MNs in lumbar spinal cord slices prepared from motor functionally mature mice and computer modelling of spinal MNs to investigate the mechanisms underlying SFA. Pharmacological blocking agents applied during whole-cell recordings in current-clamp mode demonstrated that the medium AHP conductance (apamin), BK-type Ca²⁺-dependent K⁺ channels (iberiotoxin), voltage-activated Ca²⁺ channels (CdCl₂), M-current (linopirdine) and persistent Na⁺ currents (riluzole) are all unnecessary for SFA. Measurements of Na⁺ channel availability including action potential amplitude, action potential threshold and maximum depolarization rate of the action potential were found to correlate with instantaneous firing frequency suggesting that the availability of fast, inactivating Na⁺ channels is involved in SFA. Characterization of this Na⁺ conductance in voltage-clamp mode demonstrated that it undergoes slow inactivation with a time course similar to that of SFA. When experimentally measured parameters for the fast, inactivating Na⁺ conductance (including slow inactivation) were incorporated into a MN model, SFA could be faithfully reproduced. The removal of slow inactivation from this model was sufficient to remove SFA. These data indicate that slow inactivation of the fast, inactivating Na⁺ conductance is likely to be the key mechanism underlying early SFA in spinal MNs.     

Two novel functional mutations in the Na+,K+-ATPase alpha2-subunit ATP1A2 gene in patients with familial hemiplegic migraine and associated neurological phenotypes

Mutations in the ATP1A2 gene, encoding the α2-subunit of the Na⁺,K⁺-ATPase, are associated with familial hemiplegic migraine type 2. The majority of ATP1A2 mutations were reported in patients with hemiplegic migraine without any additional neurological findings. Here, we report on two novel ATP1A2 mutations that were identified in two Portuguese probands with hemiplegic migraine and interesting additional clinical features. The proband's of family 1 (with a V362E mutation) had mood alterations, classified as a borderline personality. The proband in family 2 (with a P796S mutation) had mild mental impairment, in addition to hemiplegic migraine; more severe mental retardation was observed in his brother, who also had hemiplegic migraine and carried the same mutation. Cell-survival assays clearly showed abnormal functioning of mutant Na⁺,K⁺-ATPase, indicating that both ATP1A2 mutants are disease causing. Additionally, our results suggest a possible causal relationship of the ATP1A2 mutations with the complex clinical phenotypes observed in the probands.     

Sinus node dysfunction following targeted disruption of the murine cardiac sodium channel gene Scn5a

We have examined sino-atrial node (SAN) function in hearts from adult mice with heterozygous targeted disruption of the Scn5a gene to clarify the role of Scn5a-encoded cardiac Na⁺ channels in normal SAN function and the mechanism(s) by which reduced Na⁺ channel function might cause sinus node dysfunction. Scn5a ^+/− mice showed depressed heart rates and occasional sino-atrial (SA) block. Their isolated peripheral SAN pacemaker cells showed a reduced Na⁺ channel expression and slowed intrinsic pacemaker rates. Wild-type (WT) and Scn5a^+/− SAN preparations exhibited similar activation patterns but with significantly slower SA conduction and frequent sino-atrial conduction block in Scn5a^+/− SAN preparations. Furthermore, isolated WT and Scn5a^+/− SAN cells demonstrated differing correlations between cycle length, maximum upstroke velocity and action potential amplitude, and cell size. Small myocytes showed similar, but large myocytes reduced pacemaker rates, implicating the larger peripheral SAN cells in the reduced pacemaker rate that was observed in Scn5a^+/− myocytes. These findings were successfully reproduced in a model that implicated i _Na directly in action potential propagation through the SAN and from SAN to atria, and in modifying heart rate through a coupling of SAN and atrial cells. Functional alterations in the SAN following heterozygous-targeted disruption of Scn5a thus closely resemble those observed in clinical sinus node dysfunction. The findings accordingly provide a basis for understanding of the role of cardiac-type Na⁺ channels in normal SAN function and the pathophysiology of sinus node dysfunction and suggest new potential targets for its clinical management.     

Phosphorylation-dependent differences in the activation properties of distal and proximal dendritic Na+ channels in rat CA1 hippocampal neurons

At distal dendritic locations, the threshold for action potential generation is higher and the amplitude of back-propagating spikes is decreased. To study whether these characteristics depend upon Na⁺ channels, their voltage-dependent properties at proximal and distal dendritic locations were compared in CA1 hippocampal neurons. Distal Na⁺ channels activated at more hyperpolarized voltages than proximal (half-activation voltages were −20.4 ± 2.4 mV vs. −12.0 ± 1.7 mV for distal and proximal patches, respectively,   n = 16  ,   P < 0.01  ), while inactivation curves were not significantly different. The resting membrane potential of distal regions also appeared to be slightly but consistently more hyperpolarized than their proximal counterpart. Staurosporine, a non-selective protein kinase inhibitor, shifted the activation curves for both proximal and distal Na⁺ channels to the left so that they overlapped and also caused the resting potentials to be comparable. Staurosporine affected neither the inactivation kinetics of Na⁺ currents nor the reversal potential for Na⁺. These results suggest that the difference in the voltage dependence of activation of distal and proximal Na⁺ channels can be attributed to a different phosphorylation state at the two locations.