Department of Human Genetics, Emory University, Atlanta, GA 30322, USA.
Epilepsia. 2013 Apr;54(4):625-34. doi: 10.1111/epi.12060. Epub 2013 Jan 11.
Mutations in the voltage-gated sodium channel (VGSC) gene SCN1A are responsible for a number of epilepsy disorders, including genetic epilepsy with febrile seizures plus (GEFS+) and Dravet syndrome. In addition to seizures, patients with SCN1A mutations often experience sleep abnormalities, suggesting that SCN1A may also play a role in the neuronal pathways involved in the regulation of sleep. However, to date, a role for SCN1A in the regulation of sleep architecture has not been directly examined. To fill this gap, we tested the hypothesis that SCN1A contributes to the regulation of sleep architecture, and by extension, that SCN1A dysfunction contributes to the sleep abnormalities observed in patients with SCN1A mutations.
Using immunohistochemistry we first examined the expression of mouse Scn1a in regions of the mouse brain that are known to be involved in seizure generation and sleep regulation. Next, we performed detailed analysis of sleep and wake electroencephalography (EEG) patterns during 48 continuous hours of baseline recordings in a knock-in mouse line that expresses the human SCN1A GEFS+ mutation R1648H (RH mutants). We also characterized the sleep-wake pattern following 6 h of sleep deprivation.
Immunohistochemistry revealed broad expression of Scn1a in the neocortex, hippocampus, hypothalamus, thalamic reticular nuclei, dorsal raphe nuclei, pedunculopontine, and laterodorsal tegmental nuclei. Co-localization between Scn1a immunoreactivity and critical cell types within these regions was also observed. EEG analysis under baseline conditions revealed increased wakefulness and reduced non-rapid eye movement (NREM) and rapid eye movement (REM) sleep amounts during the dark phase in the RH mutants, suggesting a sleep deficit. Nevertheless, the mutants exhibited levels of NREM and REM sleep that were generally similar to wild-type littermates during the recovery period following 6 h of sleep deprivation.
These results establish a direct role for SCN1A in the regulation of sleep and suggest that patients with SCN1A mutations may experience chronic alterations in sleep, potentially leading to negative outcomes over time. In addition, the expression of Scn1a in specific cell types/brain regions that are known to play critical roles in seizure generation and sleep now provides a mechanistic basis for the clinical features (seizures and sleep abnormalities) associated with human SCN1A mutations.
电压门控钠离子通道(VGSC)基因 SCN1A 的突变可导致多种癫痫疾病,包括热性惊厥附加症(GEFS+)和 Dravet 综合征。除了癫痫发作外,SCN1A 突变患者通常还伴有睡眠异常,这表明 SCN1A 可能在调节睡眠的神经元通路中也发挥作用。然而,到目前为止,SCN1A 在调节睡眠结构中的作用尚未被直接研究。为了填补这一空白,我们假设 SCN1A 有助于调节睡眠结构,并由此推断 SCN1A 功能障碍可能导致 SCN1A 突变患者观察到的睡眠异常。
我们首先使用免疫组织化学方法检测了已知参与癫痫发作和睡眠调节的小鼠大脑区域中 Scn1a 的表达。接下来,我们在表达人类 SCN1A GEFS+突变 R1648H(RH 突变体)的基因敲入小鼠系中进行了 48 小时连续基线记录的详细睡眠和觉醒脑电图(EEG)模式分析。我们还描述了 6 小时睡眠剥夺后的睡眠-觉醒模式。
免疫组织化学显示 Scn1a 在新皮层、海马体、下丘脑、丘脑网状核、中缝背核、脚桥核和外侧背侧被盖核中广泛表达。在这些区域内,Scn1a 免疫反应性与关键细胞类型之间也存在共定位。在基线条件下的 EEG 分析显示,在 RH 突变体的暗期,觉醒增加,非快速眼动(NREM)和快速眼动(REM)睡眠时间减少,表明存在睡眠不足。然而,突变体在 6 小时睡眠剥夺后的恢复期间,表现出与野生型同窝仔鼠相似的 NREM 和 REM 睡眠时间水平。
这些结果确立了 SCN1A 在睡眠调节中的直接作用,并表明 SCN1A 突变患者可能经历慢性睡眠改变,随着时间的推移可能导致负面后果。此外,Scn1a 在已知在癫痫发作和睡眠中发挥关键作用的特定细胞类型/脑区的表达,为与人类 SCN1A 突变相关的临床特征(癫痫发作和睡眠异常)提供了机制基础。