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Decreased Na + , K + -ATPase (NKA) activity causes energy deficiency, which is commonly observed in neurodegenerative diseases. The NKA is constituted of three subunits: α, β, and γ, with four distinct isoforms of the catalytic α subunit (α 1−4 ). Genetic mutations in the  ATP1A2  gene and  ATP1A3  gene, encoding the α 2  and α 3  subunit isoforms, respectively can cause distinct neurological disorders, concurrent to impaired NKA activity. Within the central nervous system (CNS), the α 2  isoform is expressed mostly in glial cells and the α 3  isoform is neuron-specific. Mutations in  ATP1A2  gene can result in familial hemiplegic migraine (FHM2), while mutations in the  ATP1A3  gene can cause Rapid-onset dystonia-Parkinsonism (RDP) and alternating hemiplegia of childhood (AHC), as well as the cerebellar ataxia, areflexia, pescavus, optic atrophy and sensorineural hearing loss (CAPOS) syndrome. Data indicates that the central glutamatergic system is affected by mutations in the α 2  isoform, however further investigations are required to establish a connection to mutations in the α 3  isoform, especially given the diagnostic confusion and overlap with glutamate transporter disease. The age-related decline in brain α 2∕3  activity may arise from changes in the cyclic guanosine monophosphate (cGMP) and cGMP-dependent protein kinase (PKG) pathway. Glutamate, through nitric oxide synthase (NOS), cGMP and PKG, stimulates brain α 2∕3  activity, with the glutamatergic N-methyl-D-aspartate (NMDA) receptor cascade able to drive an adaptive, neuroprotective response to inflammatory and challenging stimuli, including amyloid-β. Here we review the NKA, both as an ion pump as well as a receptor that interacts with NMDA, including the role of NKA subunits mutations. Failure of the NKA-associated adaptive response mechanisms may render neurons more susceptible to degeneration over the course of aging.

The Influence of Na+, K+-ATPase on Glutamate Signaling in Neurodegenerative Diseases and Senescence