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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 5

The increase of GABAergic neuron’s persistent current facilitates the initiation of CSD in a computational model.

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The increase of GABAergic neuron’s persistent current facilitates the in...
(A) Diagram illustrating the conductance-based computational model that we used to model the effect of migraine mutations and of Hm1a by increasing the persistent Na+ current of the GABAergic neuron. gD,e and gD,i are glutamatergic conductances that model the baseline excitatory inputs (excitatory drive) of the pyramidal and of the GABAergic neuron, respectively. (B) Simulation, with GABAergic neuron’s physiologic persistent Na+ current (1%), of the effect of a constant external depolarizing input to the GABAergic neuron (gD,i = 0.1 mS/cm2) without input to the pyramidal neuron (gD,e = 0 mS/cm2): membrane potential of the GABAergic neurons (upper), membrane potential of the pyramidal neuron (middle), and extracellular K+ concentration (lower). (C) Same simulation with increased GABAergic neuron’s persistent Na+ current (6%, mimicking the effect of FHM3 mutations and of Hm1a); the right panels display with an enlarged time scale the first phase of the simulation shown in the panels on the left. The vertical dotted line indicates the beginning of the large [K+]out increase that leads to depolarizing block. (D) Effect of an increase of the GABAergic neuron’s persistent Na+ current on the lowest external input to the GABAergic neuron (gD,i) sufficient to induce depolarizing block. (E) Effect of an increase of the GABAergic neuron’s persistent Na+ current on the latency of depolarizing block with gD,i = 0.349 mS/cm2 (the lowest input to the GABAergic neuron able to generate CSD with 0% persistent Na+ conductance; see panel D). (F) Effect of the amount of persistent current on the firing frequency of the GABAergic neuron, in a simulation in which the pyramidal neuron was removed, reflecting the direct effect of the persistent current on the firing properties of the GABAergic neuron.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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