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CACNA1H – Childhood absence epilepsy

Childhood absence epilepsy (CAE) is a generalized epilepsy syndrome characterized by frequent brief lapses of consciousness and spike-wave discharges on electroencephalography. CACNA1H encodes the Cav3.2 T-type calcium channel, a key regulator of thalamocortical oscillations, and has been implicated as a susceptibility gene for CAE (CACNA1H; Childhood absence epilepsy).

Multiple sequencing studies in unrelated Han Chinese CAE cohorts identified 12 heterozygous missense variants in 14 of 118 probands, absent in 230 controls, supporting a role in disease susceptibility ([PMID:12891677]). No large-scale segregation data are available, and linkage analysis in European pedigrees failed to confirm a major locus. Functional assays of five patient-derived Cav3.2 mutants (including Phe161Leu) demonstrated hyperpolarizing shifts in activation and slowed inactivation kinetics, consistent with gain-of-function effects that enhance neuronal excitability ([PMID:14729682]).

Overall, CACNA1H variants have been repeatedly observed in CAE patients but show incomplete segregation and variable penetrance, suggesting a complex, oligogenic inheritance model. Electrophysiological studies provide concordant evidence that these variants perturb channel gating in directions predicted to facilitate absence seizures.

References

  • Annals of neurology • 2003 • Association between genetic variation of CACNA1H and childhood absence epilepsy. PMID:12891677
  • Journal of biological chemistry • 2004 • Gating effects of mutations in the Cav3.2 T-type calcium channel associated with childhood absence epilepsy. PMID:14729682

Evidence Based Scoring (AI generated)

Gene–Disease Association

Moderate

12 heterozygous missense variants in 14 of 118 probands absent in 230 controls; replication in independent cohorts; consistent functional data

Genetic Evidence

Moderate

Multiple case-control studies identified CAE-specific CACNA1H variants in unrelated probands absent from controls

Functional Evidence

Moderate

Patch-clamp studies of five variants show gain-of-function channel alterations concordant with absence seizure susceptibility