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Migrainous Vertigo: Mutation Analysis of the Candidate Genes CACNA1A, ATP1A2, SCN1A, and CACNB4


  • Michael Von Brevern MD,

  • Nga Ta BS,

  • Anupama Shankar MS,

  • Anna Wiste BS,

  • Anne Siegel BS,

  • Andrea Radtke MD,

  • Thomas Sander MD,

  • Andrew Escayg PhD

  • From the Department of Human Genetics, Emory University, Atlanta, Georgia, USA (Ta, Shankar, Wiste, Siegel, and Escayg); Department of Neurology, Charite Hospital, Berlin, Germany (von Brevern, Radtke, and Sander); and Gene Mapping Center, Max-Delbrück-Centrum, Berlin, Germany (Sander).

Address all correspondence to Andrew Escayg, PhD, Department of Human Genetics, Emory University, Atlanta, GA 30322.


Background.—Migrainous vertigo (MV) is increasingly recognized as a common cause of episodic vertigo. MV displays several clinical similarities with familial hemiplegic migraine (FHM) and episodic ataxia type 2 (EA-2), which have been linked to mutations in 3 genes, CACNA1A, encoding a neuronal calcium channel α subunit, ATP1A2, encoding a catalytic subunit of a Na+/K+-ATPase, and most recently the voltage-gated sodium channel SCN1A. The present study explored the hypothesis that mutations in CACNA1A, ATP1A2, SCN1A, and the calcium channel β4 subunit CACNB4 confer susceptibility to MV.

Methods.—Mutation analysis of the coding exons and exon/intron junctions of CACNA1A, ATP1A2, SCN1A, and CACNB4 was performed in 14 unrelated MV patients by conformation sensitive gel electrophoresis and automated sequence analysis.

Results.—Analysis of the 4 candidate genes in the 14 MV patients resulted in the identification of a total of 26 sequence variants. The silent substitution D29D in CACNB4 was observed in 2 MV patients and was not present in 46 ethnically matched control DNA samples. The remaining variants were also observed in control DNA samples and the allele frequencies of variants that resulted in amino acid substitutions were not significantly different between patients and controls.

Conclusions.—Based on this group of patients there is no evidence that the genes causing FHM and EA-2 represent major susceptibility loci for MV.

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