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Migraine is a complex brain disorder, and understanding the complexity of this prevalent disease could improve quality of life for millions of people. Familial Hemiplegic Migraine type 2 (FHM2) is a subtype of migraine with aura and co-morbidities like epilepsy/seizures, cognitive impairments and psychiatric manifestations, such as obsessive-compulsive disorder (OCD). FHM2 disease-mutations locate to the  ATP1A2  gene encoding the astrocyte-located α 2 -isoform of the sodium-potassium pump (α 2 Na + /K + -ATPase). We show that knock-in mice heterozygous for the FHM2-associated G301R-mutation (α 2  +/G301R ) phenocopy several FHM2-relevant disease traits e.g., by mimicking mood depression and OCD.  In vitro  studies showed impaired glutamate uptake in hippocampal mixed astrocyte-neuron cultures from α 2  G301R/G301R  E17 embryonic mice, and moreover, induction of cortical spreading depression (CSD) resulted in reduced recovery in α 2  +/G301R  male mice. Moreover, NMDA-type glutamate receptor antagonists or progestin-only treatment reverted specific α 2  +/G301R  behavioral phenotypes. Our findings demonstrate that studies of an  in vivo  relevant FHM2 disease knock-in mouse model provide a link between the female sex hormone cycle and the glutamate system and a link to co-morbid psychiatric manifestations of FHM2.

Glutamate-system defects behind psychiatric manifestations in a familial hemiplegic migraine type 2 disease-mutation mouse model