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Jaarboek no. 89. 2010/2011 - Koninklijke Maatschappij voor ...

Jaarboek no. 89. 2010/2011 - Koninklijke Maatschappij voor ...

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tering and leaner exhibit decreased susceptibility<br />

for CSD, manifesting as an increased threshold for<br />

inducing a CSD event. Functionally, these mutations<br />

convey clear electrophysiological loss-of-function<br />

effects to the channels. In contrast, in keeping with a<br />

gain-of-function effect in FHM1, the R192Q k<strong>no</strong>ckin<br />

mice exhibited a decreased threshold for inducing a<br />

CSD event. Together, these findings suggest a direct<br />

positive correlation between channel function and<br />

spreading depression: more Ca2+ influx leads to an<br />

increased susceptibility for spreading depression<br />

in the cortex. This may have clinical significance, as<br />

decreasing calcium channel activity to wild-type<br />

levels in the brain might help rescue the migraine<br />

brain.<br />

B. Na + /K + -ATPase α2 transporter (FHM2)<br />

To date, 45 mutations in the ATP1A2 gene have been<br />

linked to FHM (Fig. 2), and several have been studied<br />

functionally. In vitro assays revealed that mutant<br />

proteins have decreased transporter activity, ranging<br />

from <strong>no</strong> activity at all to decreased affinity for K + ,<br />

Natuurkundige <strong>voor</strong>drachten I Nieuwe reeks 89<br />

Migraine: de ontrafeling van een complexe ziekte<br />

Figure 2<br />

Schematic topographic drawing of the α2 subunit of the Na + /K + -ATPase transporter encoded by the FHM2 gene<br />

ATP1A2. The protein contains 10 transmembrane helices (S1–S10). The approximate locations of mutations linked to<br />

FHM are indicated. Ami<strong>no</strong> acid positions refer to GenBank accession number NM_000702.<br />

and/or decreased catalytic tur<strong>no</strong>ver. Thus, the mutation<br />

leads to reduced reuptake of K + and glutamate<br />

from the synaptic cleft into glial cells. Because the<br />

FHM2 mutations impair protein function, it is interesting<br />

to compare the FHM2 phe<strong>no</strong>type with that of<br />

mice lacking Atp1a2 expression. Two lines of k<strong>no</strong>ckout<br />

mice have been generated, and in both cases<br />

the mice die immediately at birth due to severe<br />

motor deficits and failing respiration. Examination<br />

of the developing embryos revealed neuronal loss<br />

in the amygdala and piriform cortex secondary to<br />

neural hyperactivity. Moreover, Atp1a2 k<strong>no</strong>ckout<br />

mice on a 129sv genetic background survive briefly<br />

(

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