Ankyrin B (AnkB) is a scaffolding protein, acting as a bridge between ion channels and cytoskeleton networks. AnkB variants are associated with cognitive disorders including autism spectrum disorder and epilepsy. In the brain, AnkB interacts with Cav2.1, the pore-forming subunit of P/Q type voltage gated calcium channels. However, how AnkB regulates Cav2.1 is not fully understood. Using HEK293T cells, we discovered that AnkB increases Cav2.1 expression levels but does not change Cav2.1 surface levels. AnkB p.S646F increases Cav2.1 to an even greater level of expression, again without impacting Cav2.1 surface levels. Looking at a partial loss of AnkB in glutamatergic neurons, overall Cav2.1 levels decreased at P30 but the synaptosomal fraction was not impacted. Our findings indicate that AnkB plays a role in regulating an intracellular pool of Cav2.1 but does not affect the surface or the synaptosomal pools of Cav2.1. This intracellular pool of Cav2.1 may play an important role in neuronal function and homeostasis, suggesting a mechanism for neuronal pathogenicity of AnkB variants. / Graduate / 2020-08-06

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Migraine is a common, debilitating neurovascular disease charactensed by severe recurrent headache, nausea and vomiting, photophobia and phonophobia. It is clinically diagnosed based on criteria specified by the International Headache Society (IHS), defining two major classes of migraine: migraine with aura (MA) and migraine without aura (MO) MA sufferers experience neurovascular disturbances that precede the headache phase of an attack. Although migraine is partly influenced by environmental determinants, there is a significant genetic component, with disease heritability estimated to be up to 60% and mode of transmission multifactorial. The disorder is common with a large Dutch study reporting lifetime prevalence estimates of 33% in women and 13.3% in men, with an earlier study estimating 24% of women and 12% of men in the overall population. Mutations in various ion channel genes are responsible for neuromuscular and other neurological disorders. Inherited ion channel mutations or 'channelopathies' are increasingly found to be the cause of various neurological disorders in humans. In familial hemiplegic migraine (FHM), a rare subtype of migraine with aura, mutations in the CACNA1A gene (localised at C19p13) have been fbund (FHM1). This gene codes for the alphalA subunit of the neuronal voltage-dependent P/Q-type calcium channel. Recently a second gene, ATP1A2 (FHM2) (localised at C1q23), was implicated in some EHM families. The ATP1A2 ion channel gene, codes for the alpha2 subunit of the Na+, K+ ion ATPase pump. These findings of mutations in these genes have focused attention on central nervous system ionic channels and helped to better understand EHM pathophysiology, where the best genetic evidence providing molecular insight into migraine still comes flom the mutations detected in the rare form of migraine with aura; FHM. Migraine family studies, at the Genomic Research Centre (GRC), have utilised linkage analysis methods in providing results that have indicated suggestive linkage to the FHM1-CACNA1A region on l9p13, in a large multigenerational family (Migraine Family 1; MEl) affected with typical migraine. Also linkage studies conducted within the GRC have implicated an additional susceptibility region on chromosome 1q31, but still not ruling out a second susceptibility region on C1q23, with the possibility of there being two distinct loci, on the chromosome lq region. The focus of research in this thesis is on two main chromosomal regions, which were tested for migraine susceptibility on chromosome 1 and chromosome 19. The research involved a cross-disciplinary approach utilising association, linkage and mutation screening approaches. Allelic candidate gene studies can provide a suitable method for locating genes of small effect that contribute to complex genetic disorders, such as migraine. Family linkage studies are useful for detection of chromosomal susceptibility regions and association studies are powerful when a plausible candidate gene and a sequence variant with potential functional relevance is examined. Mutation screening studies can indicate a direct cause of disorders such as migraine, where possible sequence variants may alter the translation of proteins in genes, causing the disease. The first gene exanted on chromosome 19 was that of the Low Density Lipoprotein Receptor (LDLR) gene. The LDLR gene is a cell surface receptor that plays an important role in cholesterol homeostasis. We investigated the (TA)n polymorphism in exon 18 of the LDLR gene on chromosome l9pl3.2 performing an association analysis in 244 typical migraine affected patients, 151 suffering from migraine with aura, 96 with migraine without aura and 244 unaffected controls. The populations consisted of Caucasians only and controls were age and sex matched. The results showed no significant difference between groups for allele frequency distributions of the (TA)n polymorphism even after separation of the migraine affected individuals into subgroups of MA and MO affected patients. This is in contradiction to Mochi et al, 2003 who found a positive association of this variant with MO. Our study discusses possible differences between the two studies and extends this research by investigating circulating cholesterol levels in a migraine affected genetically-isolated population. Another gene examined on chromosome l9pl3 was the insulin receptor gene (1NSR). The aim of this study was to investigate through direct sequencing the INSR gene in DNA samples from a migraine affected family previously showing linkage to chromosome l9pl3 in an attempt to detect disease associated mutations. The insulin receptor gene (INSR) on chromosome 19pl3.3-13.2 is a gene of interest since a number of SNPs located within the gene have been implicated in migraine with (MA) and without aura (MO). Six DNA samples obtained from non-founding migraine affected members of migraine family one (MF 1) were used in this study. Genomic DNA was sequenced for the 1NSR gene in exons 1-22 and the promoter region. In the six migraine family member samples, previously reported single nucleotide polymorphisms (SNP5) were detected within two exonic DNA coding regions of the INSR gene. These SNPs, in exon 13 and 17, do not alter the normal INSR polypeptide sequence. In addition, intron 7 also revealed a DNA base sequence variation. For the 5' untranslated promoter region of the gene, no mutations were detected. In conclusion, this study detected no INSR mutations in affected members of a chromosome 19 linked migraine pedigree. Hence, migraine linkage to this chromosomal region may involve other candidate genes. The NOTCH3 gene on C19p13.2-p13.l has previously been shown to be a gene involved in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and may also be implicated in migraine as there are some symptom similarities between the two disorders. The TNFSF7 gene localised on Cl9pl3 is homologous to the ligands of the TNF receptor family, including TNF-alpha and TNF-beta, genes that have both been previously associated with migraine. This study investigated the migraine susceptibility locus at Cl9p13 studying two genes that may be involved in the disorder. The NOTCH3 gene was analysed by sequencing all exons with known CADASIL mutations in a family (MF1) that has previously been shown to be linked to Cl9pl3. The sequencing results for affected members of this pedigree proved to be negative for all known sequence variants giving rise to mutation causing amino acid changes for CADASIL. The direct sequencing results displayed that of a normal coding sequence for the NOTCH3 gene F or the TNFSF7 gene, this was investigated through SNP association analysis using a matched case-control migraine diagnosed population. Chi-square results showed non-significant P values across all populations tested against controls except for the MO subgroup which displayed a weak association with the TNFSF7 SNP (genotype, allele analysis P = 0.036, P = 0 017 respectively). Our results suggest that common migraine is not caused by any known CADASIL mutations in the NOTCH3 gene of interest however, the TNFSF7 gene displayed signs of involvement in a MO affected population, but, further studies are needed to confirm these results and to further explore a TNF receptor - migraine potential interaction. A final examination on chromosome 19 involved a case report of an extremely rare and severe form of migraine. As stated earlier Familial Hemiplegic Migraine (FHM) is a severe rare sub-type of migraine and gene mutations on chromosome 19 have been identified in the calcium channel gene CACNA1A (Cl9pl3) fOr FHM. Recently a gene mutation (S218L) for a dramatic syndrome originating from FHM, commonly named 'migraine coma', has implicated exon 5 of the CACNA1A gene. The occurrence of trivial head trauma, in FHM patients, may also be complicated by severe, sometimes even fatal, cerebral edema and coma occurring after a lucid interval. Hemiplegic migraine has also been found to be sporadic in which both forms share a similar spectrum of clinical presentations and genetic heterogeneity. The case report presented in this study enhances the involvement of the S218L CACNA1A mutation in the extremely rare disorder of minor head trauma induced migraine coma. It not only proves to be a powerful diagnostic tool in detecting cases of FHM head trauma induced coma but also for sporadic hemiplegic migraine (SHM) coma subjects. We conclude from this case study that the S218L mutation, in the CACNA1A calcium channel subunit gene, is involved in sporadic hemiplegic migraine (SHM), delayed cerebral edema and coma after minor head trauma. This thesis also involved analysis of chromosome 1 for migraine susceptibility, where FHM studies provided a foundation fOr common migraine research on chromosome 1. Studies have suggested that mutations in the CACNA1A gene on chromosome l9p cause FHM in only approximately 50% of affected pedigrees. The CACNAIA gene has previously been tested, within the Genomics Research Centre, in the common forms of migraine; however no new mutations or the FHM mutations were detected in these MA/MO affected samples. A second FHM susceptibility locus maps to chromosome 1q23 and mutations in the ATP1A2 gene have recently been implicated in two Cl-linked FHM pedigrees. As FHM is considered a rare and severe form of MA, it is possible that the chromosome 1q23 locus, and the ATP1A2 gene, may be involved in the common forms of migraine with (MA) and possibly without aura (MO). Also, we have previously reported evidence of linkage to microsatellite markers on chromosome 1q31 in a large pedigree affected predominately with MA, which suggests the possibility that there are two distinct loci for migraine susceptibility on chromosome 1. The objectives of this study were to extend our linkage analysis of chromosome lq microsatellite markers in predominantly migraine with aura pedigrees. Also, our aim was to test the novel FHM-2 ATP1A2 gene for involvement in these migraine affected pedigrees and a previous pedigree (Migraine Family 14; MF 14) showing evidence of linkage of markers to Clq31. This was performed by a chromosome 1 scan (31 markers) in 21 multiplex pedigrees affected mainly with MA. Also, the known FHM-2 ATP1A2 gene mutations were tested, by sequencing, fOr involvement in MA and MO in these pedigrees. Mutation screening by direct sequencing was also performed throughout the coding areas of the ATP1A2 gene in 3 MA individuals fiom MF14. The results of this study detected evidence for linkage in our migraine pedigrees at chromosome 1q23, to microsatellite markers spanning the ATP1A2 (FHM-2) gene. However testing of the known ATP1A2 gene mutations (for FHM) in migraine probands of pedigrees showing excess allele sharing was negative, with no mutations detected in these migraineurs. Sequencing of the entire coding areas of the gene through 3 MA affecteds from MF14, a pedigree showing significant linkage to this region, was also negative for mutations. In conclusion, this study reported that microsatellite markers on chromosome 1q23 show evidence of excess allele sharing in MA and some MO pedigrees, suggesting linkage to the common forms of migraine and the presence of a susceptibility gene in this region. The new FHM-2 (ATPIA2 gene) mutations reported by Fusco et al, 2003 do not cause migraine in probands of affected pedigrees showing excess allele sharing to markers in this genomic region. Also no mutations were detected in all exons of the ATP1A2 gene in 3 MA affected individuals from a large pedigree (MF14) showing linkage to this region. Investigation in this thesis continued on chromosome 1, with other genes being examined on C1q23, as well as the C1q31 region for a migraine susceptibility locus or gene. Previously in our laboratory, evidence for linkage was shown to migraine at C1q31 in one family predominantly affected with MA, with microsatellite markers in this region. The initial Cl study (above; ATP1A2 gene) has also provided evidence for linkage to the chromosome 1 locus 1q23, with evidence for excess allele sharing of markers in predominantly MA affected pedigrees. To further investigate both chromosome I loci, an investigation with six candidate genes that lie within the C1q23 and 1q31 regions through association analysis was undertaken. The results from this study reported non-significant chi-square results, showing P values greater than 0.05 across all SNPs (and a CA rpt) tested. An exception was the rs704326 SNP from exon 43 of the CACNA1E gene on C1q31. P values significantly less than 0.001 were obtained in the total migraine population and the MA subgroup, with similar frequency comparisons ascertained in both genotype and allele analysis. Examination through contingency table analysis of the CACNA1E flequency data indicated that the risk allele (A) was over-represented in the migraine group compared to the control group. Further comparison of the genotype data indicated a difference in frequency distributions (P less than 0 0001). Stratified analyses of migraine subtypes indicated that this association was specifically attributed to the MA subtype group. Odds ratios produced an OR of 4.14 with a 95% CI of 2.36 - 7.26 (P less than 0.0001). The positive association results obtained within the CACNA1E gene are interesting in the fact that FHM is considered to be a rare and severe form of migraine with aura (MA) and FHM-1 is caused by mutations contained within the calcium channel gene CACNA1A (localized at Cl9p13). The idea that FHM and specifically an FHM gene in the C1q31 genomic region may also contribute to susceptibility to the more common forms of migraine i e. migraine with aura, strongly supports and reinforces the idea that a common defective gene may be influencing both FHM and typical migraine. In conclusion, this thesis undertook a cross-disciplinary approach to genetic research of a complex disorder. The research involved linkage, association and mutation analysis strategies of migraine. This research implicated a specific variant on chromosome 1 and further supported the heterogeneic nature of migraine. Future directions into migraine research should involve further investigation of this specific variant and this genomic region. Such studies may aid in the development of more precise diagnosis and treatment methods for this complex disorder.

Voltage-gated calcium (Cav) channels are a prerequisite for signal transmission at the first olfactory sensory neuron (OSN) synapse within the glomeruli of the main olfactory bulb (MOB). We showed previously that the N-type Cav channel subunit Cav2.2 is present in the vast majority of glomeruli and plays a central role in presynaptic transmitter release. Here, we identify a distinct subset of glomeruli in the MOB of adult mice that is characterized by expression of the P/Q-type channel subunit Cav2.1. Immunolocalization shows that Cav2.1+ glomeruli reside predominantly in the medial and dorsal MOB, and in the vicinity of the necklace glomerular region close to the accessory olfactory bulb. Few glomeruli are detected on the ventral and lateral MOB. Cav2.1 labeling in glomeruli colocalizes with the presynaptic marker vGlut2 in the axon terminals of OSNs. Electron microscopy shows that Cav2.1+ presynaptic boutons establish characteristic asymmetrical synapses with the dendrites of second-order neurons in the glomerular neuropil. Cav2.1+ glomeruli receive axonal input from OSNs that express molecules of canonical OSNs: olfactory marker protein, the ion channel Cnga2, and the phosphodiesterase Pde4a. In the main olfactory epithelium, Cav2.1 labels a distinct subpopulation of OSNs whose distribution mirrors the topography of the MOB glomeruli, that shows the same molecular signature, and is already present at birth. Together, these experiments identify a unique Cav2.1+ multiglomerular domain in the MOB that may form a previously unrecognized olfactory subsystem distinct from other groups of necklace glomeruli that rely on cGMP signaling mechanisms.

Les mutations héréditaires causant une perte de fonction du gène CACNA1A, encodant la sous-unité α1 du canal CaV2.1, entraînent chez l’humain le développement d’une ataxie épisodique s’accompagnant parfois d’épilepsie et d’atteintes cognitives. Également, des mutations de novo de CACNA1A ont été rapportées chez près de 1 % des enfants souffrant d’encéphalopathies épileptogènes, ainsi que chez des enfants présentant un trouble du spectre de l’autisme isolé. Ensemble, ces données suggèrent que les altérations de CACNA1A peuvent jouer un rôle central dans la pathogenèse de divers troubles neurodéveloppementaux avec atteintes cognitives et développementales. D’ailleurs, notre évaluation de 16 patients, issus de quatre familles non consanguines, porteurs de différentes mutations induisant une perte de fonction de CACNA1A a révélé l’existence de déficits neurocognitifs modérés à sévères chez la majorité des individus atteints, allant de déficits d’attention avec difficultés d’apprentissage à une déficience intellectuelle avec ou sans trouble du spectre de l’autisme. Alors que les mécanismes pathologiques exacts par lesquels l’haploinsuffisance de CACNA1A induit de tels troubles cognitifs sont encore indéterminés, les mécanismes conduisant à l’épilepsie ont été mieux étudiés. La délétion embryonnaire du canal CaV2.1 dans les interneurones (IN) émanant de l’éminence ganglionnaire médiale (MGE), incluant les IN exprimant la parvalbumine (IN PV) et ceux exprimant la somatostatine (IN SOM), entraîne une épilepsie avec crises tonico-cloniques ainsi que des crises de type absences résultant en une mortalité précoce chez la souris Nkx2.1Cre; Cacna1ac/c. Cependant, la perte du canal dans les IN SOM, chez le modèle SOMCre; Cacna1ac/c, n’induit pas d’épilepsie et la perte ciblée aux IN PV, chez le modèle PVCre; Cacna1ac/c, entraîne une épilepsie caractérisée par des crises d’absence et de rares crises motrices. L’objectif de cette thèse consistait donc, dans un premier temps, de comprendre les mécanismes sous-jacents aux différences épileptiques entre les modèles Nkx2.1Cre; Cacna1ac/c et PVCre; Cacna1ac/c. Les techniques combinées d’imagerie immunohistochimique, d’imagerie 2-photon, d’électrophysiologie, d’analyse d’électroencéphalogramme et de croisement de modèles conditionnels nous ont permis d’identifier les conséquences cellulaires et électrophysiologiques de la délétion de Cacna1a de manière précoce ou tardive dans les IN PV. Elles ont dévoilé, chez le modèle PVCre; Cacna1ac/c, un gain d’inhibition dendritique dans les cellules pyramidales (CP) résultant d’une arborescence axonale accrue des IN SOM. Ce remodelage, dépendant de mTORC1, suffit à prévenir l’apparition de crises motrices et l’inhibition de cette croissance axonale à l’aide de rapamycine renverse l’effet protecteur observé chez la souris PVCre; Cacna1ac/c. Enfin, nous démontrons que l’activation chémogénétique des IN SOM corticaux prévient l’apparition de crises motrices dans un modèle d’épilepsie induite à l’acide kaïnique. Puisque les IN PV en panier du cortex sont essentiels à plusieurs processus cognitifs, telles la flexibilité cognitive et l’attention, qu’ils sont affectés par la perte de fonction homozygote de CaV2.1 et afin de reproduire une condition semblable à celle de nos patients, nous avons exploré dans un deuxième temps l’implication pathologique de ces neurones dans les troubles cognitifs associés à l’haploinsuffisance de Cacna1a. À l’aide du modèle murin portant une délétion hétérozygote de Cacna1a ciblée aux populations neuronales exprimant la PV (PVCre; Cacna1ac/+), nous démontrons par électrophysiologie que la perte du canal CaV2.1 dans ces neurones suffit à réduire l’inhibition corticale. Les tests comportementaux incluant l’Openfield, l’Elevated Plus Maze, le Morris Water Maze, une tâche testant la rigidité cognitive ainsi qu’une tâche évaluant l’attention, ont démontré que les mutants PVCre; Cacna1ac/+ présentent de l’impulsivité, de la rigidité cognitive ainsi qu’un déficit d’attention sélective. Bien que l’ablation homozygote du canal réduise la relâche synaptique des CP chez le mutant homozygote Emx1Cre; Cacna1ac/c, aucun déficit de relâche synaptique, comportemental ou cognitif n’a été observé chez les souris Emx1Cre; Cacna1ac/+ suggérant qu’au niveau cortical, la délétion hétérozygote de Cacna1a affecte sélectivement les IN PV. De plus, à l’aide de délétions ciblées au cortex orbito-frontal (OFC) et au cortex préfrontal médial (mPFC), nous démontrons que l’haploinsuffisance de Cacna1a dans ces régions entraîne de la rigidité cognitive et des troubles de l’attention, respectivement. Enfin, nous révélons que ces deux atteintes peuvent être corrigées via une activation chémogénétique locale des IN PV. Dans son ensemble, ce travail contribue au développement des connaissances portant sur les délétions de Cacna1a. Il présente également de nouvelles avenues pour le traitement de crises épileptiques motrices et pour la prise en charge des atteintes cognitives chez les patients souffrant d’haploinsuffisance de CACNA1A. / Loss-of-function mutations in the CACNA1A gene, encoding the α1 subunit of voltage-gated CaV2.1 channels, result in epilepsy and neurocognitive impairments, including attention deficits, intellectual deficiency and autism. Also, de novo mutations in CACNA1A have been reported in nearly 1% of children with epileptogenic encephalopathies, as well as in children with isolated autism spectrum problems. Taken together, these data suggest that alterations in CACNA1A may play a central role in the pathogenesis of various neurodevelopmental disorders with cognitive and developmental impairment. Moreover, our evaluation of 16 patients, from four non-consanguineous families, carriers of different mutations inducing a loss of function of CACNA1A have shown the existence of moderate to severe neurocognitive deficits in the majority of affected individuals, ranging from deficits from attention with learning difficulties to intellectual disabilities with or without an autism spectrum problem. While the exact pathological mechanisms by which CACNA1A haploinsufficiency induces such cognitive impairment are still unknown, the mechanisms leading to epilepsy have been better studied. Embryonic deletion of CaV2.1 in interneurons (IN) emanating from the medial ganglionic eminence (MGE), including INs expressing parvalbumin (PV IN) and those expressing somatostatin (SOM IN), causes epilepsy with tonic-clonic seizures and absence seizures resulting in early mortality in the Nkx2.1Cre; Cacna1ac/c mice model. However, loss of the channel in SOM IN (SOMCre; Cacna1ac/c) does not induce epilepsy whereas targeted loss in PV IN (PVCre; Cacna1ac/c) causes epilepsy with absence and rare motor seizures. The objective of this thesis was therefore, first of all, to understand the mechanisms underlying the epileptic differences between the Nkx2.1Cre ;Cacna1ac/c and the PVCre; Cacna1ac/c mice. The combined techniques of immunohistochemistry, 2-photon imaging, electrophysiology, electroencephalogram analysis and the crossing of different conditional models identified the cellular and electrophysiological consequences of the deletion of Cacna1a in the IN PV. Compared to Nkx2.1Cre; Cacna1ac/c mice, PVCre; Cacna1ac/c mice have a net increase in cortical inhibition, with a gain of dendritic inhibition through sprouting of SOM IN axons, largely preventing motor seizures. This beneficial compensatory remodeling of cortical GABAergic innervation is mTORC1-dependent and its inhibition with rapamycin leads to a striking increase in motor seizures. Furthermore, we show that a direct chemogenic activation of cortical SOM-INs prevents motor seizures in a model of kainate-induced seizures. Cortical PV IN basket cells are essential for several cognitive processes, such as cognitive flexibility and attention and they are affected by CaV2.1 knock-out. CACNA1A haploinsufficiency also causes cause epilepsy, ataxia, and a range of neurocognitive deficits, including inattention, impulsivity, intellectual deficiency and autism. Therefore, this thesis had for second objective to clarify the consequences of Cacna1a haploinsufficiency in PV IN. Using the mice model carrying a heterozygous deletion of Cacna1a targeted at neuronal populations expressing PV (PVCre; Cacna1ac/+), we demonstrated by electrophysiology that the loss of the CaV2.1 in this neuronal population is sufficient to reduce cortical inhibition. Behavioral tests including the OpenField, the Elevated Plus Maze, the Morris Water Maze, a cognitive rigidity task as well as an attention set-shifting task have shown that PVCre; Cacna1ac/+ exhibit impulsivity, cognitive rigidity, and selective attention deficit. Although Cacna1a homozygous ablation reduced synaptic release of PC in the Emx1Cre; Cacna1ac/c mice mutant, no synaptic, behavioural or cognitive relaxation deficits were observed in the Emx1Cre; Cacna1ac/+ mice suggesting that, at the cortical level, the heterozygous deletion of Cacna1a selectively affects PV IN. These findings have enabled us to determine, using targeted deletions within the orbitofrontal cortex (OFC) and the medial prefrontal cortex (mPFC), that the haploinsufficiency of Cacna1a in PV IN results in reversal learning deficits and impairs selective attention, respectively. These deficits can be rescued by the selective chemogenetic activation of cortical PV IN respectively in the OFC or mPFC of PVCre; Cacna1ac/+ mutants As a whole, this work contributes to the development of knowledge on Cacna1a deletions. It also presents new avenues for the treatment of motor epileptic seizures and for the management of cognitive impairment in patients with CACNA1A haploinsufficiency.