1 Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
2 Division of Biology, Hyogo College of Medicine, Nishinomiya, Japan.
Cephalalgia. 2018 Aug;38(9):1515-1524. doi: 10.1177/0333102417738249. Epub 2017 Oct 17.
Background Patients with familial hemiplegic migraine type 2 (FHM2) have a mutated ATP1A2 gene (encoding Na,K-ATPase α2 subunit) and show prolonged migraine aura. Cortical spreading depression (CSD), which involves mass depolarization of neurons and astrocytes that propagates slowly through the gray matter, is profoundly related to aura. Methods In two types of Atp1a2-defective heterozygous mice, Atp1a2 (C-KO) and Atp1a2 (N-KO), the sensitivity and responsiveness to CSD were examined under urethane anesthesia. Results In both cases, heterozygotes exhibited a low threshold for induction of CSD, faster propagation rate, slower recovery from DC deflection, and profound suppression of the electroencephalogram, compared to wild-type mice. A high dose of KCl elicited repeated CSDs for a longer period, with a tendency for a greater frequency of CSD occurrence in heterozygotes. The difference of every endpoint was slightly greater in N-KO than C-KO. Change of regional cerebral blood flow in response to CSD showed no significant difference. Conclusion Heterozygotes of Atp1a2-defective mice simulating FHM2 demonstrated high susceptibility to CSD rather than cortical vasoreactivity, and these effects may differ depending upon the knockout strategy for the gene disruption. These results suggest that patients with FHM2 may exhibit high susceptibility to CSD, resulting in migraine.
背景:家族性偏瘫性偏头痛 2 型(FHM2)患者的 ATP1A2 基因突变(编码 Na,K-ATPase α2 亚基),并表现出偏头痛先兆延长。皮质扩散性抑制(CSD)涉及神经元和星形胶质细胞的大量去极化,缓慢地通过灰质传播,与先兆有很深的关系。
方法:在两种类型的 Atp1a2 缺陷杂合子小鼠中,Atp1a2(C-KO)和 Atp1a2(N-KO),在脲烷麻醉下检查 CSD 的敏感性和反应性。
结果:在这两种情况下,杂合子对 CSD 的诱导具有较低的阈值,传播速度较快,从 DC 偏转恢复较慢,脑电图抑制明显,与野生型小鼠相比。高剂量 KCl 诱发重复 CSD 更长时间,杂合子中 CSD 发生的频率有增加的趋势。N-KO 比 C-KO 的每个终点差异稍大。CSD 反应的局部脑血流变化无显著差异。
结论:模拟 FHM2 的 Atp1a2 缺陷小鼠杂合子对 CSD 表现出高度易感性,而不是皮质血管反应性,并且这些影响可能因基因破坏的敲除策略而异。这些结果表明,FHM2 患者可能表现出对 CSD 的高易感性,导致偏头痛。
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