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Initiation of migraine-related cortical spreading depolarization by hyperactivity of GABAergic neurons and NaV1.1 channels
Oana Chever, … , Sandrine Cestèle, Massimo Mantegazza
Oana Chever, … , Sandrine Cestèle, Massimo Mantegazza
Published September 7, 2021
Citation Information: J Clin Invest. 2021;131(21):e142203. https://doi.org/10.1172/JCI142203.
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Research Article Neuroscience

Initiation of migraine-related cortical spreading depolarization by hyperactivity of GABAergic neurons and NaV1.1 channels

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Abstract

Spreading depolarizations (SDs) are involved in migraine, epilepsy, stroke, traumatic brain injury, and subarachnoid hemorrhage. However, the cellular origin and specific differential mechanisms are not clear. Increased glutamatergic activity is thought to be the key factor for generating cortical spreading depression (CSD), a pathological mechanism of migraine. Here, we show that acute pharmacological activation of NaV1.1 (the main Na+ channel of interneurons) or optogenetic-induced hyperactivity of GABAergic interneurons is sufficient to ignite CSD in the neocortex by spiking-generated extracellular K+ build-up. Neither GABAergic nor glutamatergic synaptic transmission were required for CSD initiation. CSD was not generated in other brain areas, suggesting that this is a neocortex-specific mechanism of CSD initiation. Gain-of-function mutations of NaV1.1 (SCN1A) cause familial hemiplegic migraine type-3 (FHM3), a subtype of migraine with aura, of which CSD is the neurophysiological correlate. Our results provide the mechanism linking NaV1.1 gain of function to CSD generation in FHM3. Thus, we reveal the key role of hyperactivity of GABAergic interneurons in a mechanism of CSD initiation, which is relevant as a pathological mechanism of Nav1.1 FHM3 mutations, and possibly also for other types of migraine and diseases in which SDs are involved.

Authors

Oana Chever, Sarah Zerimech, Paolo Scalmani, Louisiane Lemaire, Lara Pizzamiglio, Alexandre Loucif, Marion Ayrault, Martin Krupa, Mathieu Desroches, Fabrice Duprat, Isabelle Léna, Sandrine Cestèle, Massimo Mantegazza

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Figure 1

The selective NaV1.1 enhancer Hm1a specifically triggers CSD in the neocortex.

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The selective NaV1.1 enhancer Hm1a specifically triggers CSD in the neoc...
(A) Experimental setting: brain slices were perfused with 10 nM Hm1a, a concentration at which Hm1a is selective for NaV1.1 (Supplemental Figure 1), and CSD induction was monitored with extracellular LFP recordings and IOS imaging obtained in extended brain regions (4× objective, 0.35× camera adapter). (B) Representative LFP recording of a CSD observed in the neocortex during the perfusion with Hm1a. Scale bars: 1 mV, 20 seconds. (C) Overall results showing the lack of spontaneous CSD in control (0/17 slices), and success rate for neocortical induction with bath application of Hm1a (16/71), which never triggered CSD in other structures (Fisher’s exact test, Bonferroni correction, neocortex control versus neocortex Hm1a, *P = 0.04; neocortex Hm1a versus other structures’ Hm1a, ****P = 10–4). (D) Upper left panel, raw transmitted light image of a representative coronal slice including the neocortex, the hippocampus, the dorsal striatum, the globus pallidus, and the thalamus; upper right panel, illustration of a whole hemisphere (Brain Explorer, Allen Institute) in which the imaged area is indicated by the circle (see Supplemental Figure 2 for additional details). The 4 bottom panels correspond to time series of image processing of IOS acquisitions (one image every 5 seconds, the first one 5 seconds after CSD initiation; see Methods), which show that CSD was triggered only in the neocortex. Scale bar: 500 μm. (E) Raw transmitted light image of another representative coronal slice including the neocortex, the dorsal striatum, the globus pallidus, and the thalamus (upper left); illustration of a whole hemisphere (Brain Explorer, Allen Institute) in which the imaged area is indicated by the circle (see Supplemental Figure 2 for additional details). The 4 bottom panels are a time series of processed IOS images, which show that CSD was triggered only in the neocortex. Scale bar: 500 μm (see Supplemental Video 1).

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ISSN: 0021-9738 (print), 1558-8238 (online)

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