Functional Analysis of Mutations in the TRESK K2P Potassium Channel Associated with ‘migraine with Aura’

Abstract

An inherited mutation in the KCNK18 gene has been shown to be associated with ‘migraine with aura’. This is a common, debilitating, recurrent headache disorder associated with transient and reversible focal neurological symptoms. KNCK18 encodes the TWIK-related spinal cord potassium channel (TRESK), a member of the K2P family of potassium channels. The F139WfsX24 mutation, segregates perfectly with typical migraine with aura in a large pedigree and functional characterization of this mutation demonstrates that it causes a complete loss of TRESK function and that the mutant subunit suppresses wild-type channel function through a dominant-negative effect, thus explaining the dominant penetrance of this allele (Lafreniere et al, doi:10.1038/nm.2216). This identifies a role for TRESK in the pathogenesis of typical migraine with aura and further supports the role of this channel as a potential therapeutic target. In this study we have examined the electrophysiological properties of other mutations identified in the human KCNK18 gene and find that several of these variants also produce a dramatic dominant-negative phenotype.