KCNA1

protein-coding

potassium voltage-gated channel subfamily A member 1, the group of Potassium voltage-gated channels

Gene summary

This gene encodes a voltage-gated delayed potassium channel that is phylogenetically related to the Drosophila Shaker channel. The encoded protein has six putative transmembrane segments (S1-S6), and the loop between S5 and S6 forms the pore and contains the conserved selectivity filter motif (GYGD). The functional channel is a homotetramer. The N-terminus of the channel is associated with beta subunits that can modify the inactivation properties of the channel as well as affect expression levels. The C-terminus of the channel is complexed to a PDZ domain protein that is responsible for channel targeting. Mutations in this gene have been associated with myokymia with periodic ataxia (AEMK). [provided by RefSeq, Jul 2008]

Previous symbols:
  • AEMK

MANE transcript

NM_000217.3

Inheritance

AD, AR

ClinVar variants

P:57U:364B:197

Top phenotype

Episodic ataxia, type 1/myokymia syndrome

gnomAD constraint

pLI —, LoF o/e 0.32

Max pathogenic AF

—

Genomic locus

chr12:4,909,905-4,918,256

External References & Databases

Transcript & Mutation Effects

hg38 • Region Span ~8.4 kb
Loading mutation effect viewer...

GenCC Phenotypes & Disease Associations

Curated gene-disease validity assertions and inheritance patterns

episodic ataxia type 1STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008047

Submitter: Genomics England PanelApp

episodic ataxia type 1DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008047

Submitter: ClinGen

*KCNA1* was first reported in relation to autosomal dominant episodic ataxia type 1 in 1994 (Browne et al., PMID: 7842011). Episodic ataxia type 1 is characterized by continuous muscle fiber activation or rippling (myokymia) and periodic ataxia, although the phenotype is highly variable. Of note, type 1 episodic ataxia is generally associated with brief periods of ataxia, lasting seconds, whereas other types of episodic ataxia present with longer episodes, usually hours (PMID:17575281). Episodic ataxia 1 may also include hypomagnesemia and renal magnesium wasting, features which may be underdiagnosed in patients with this condition due to lack of testing (PMID:32316562). About 20% of individuals with KCNA1-related episodic ataxia have seizures, and we did not identify any cases with isolated epilepsy (PMID: 32316562, 34566847). Per criteria outlined by the ClinGen Lumping and Splitting Working Group, we found no consistent differences in molecular mechanism, inheritance pattern, or variant location on phenotypic variability, so we are unable to “split” out the patients with seizures. Therefore, we are choosing to curate these cases under episodic ataxia type 1 (MONDO:0008047). Eighteen variants (missense and nonsense) that have been reported in 20 probands in 8 publications (PMIDs: 7842011, 8541859, 11026449, 23349320, 28666963, 28676720, 20660867, 32705822) are included in this curation. Multiple variants have been shown to segregate with disease in families. Of note, we did not identify any cases with isolated epilepsy. More evidence is available in the literature, but the maximum score for genetic evidence (12 pts.) has been reached. The mechanism of pathogenicity is unclear, as pathogenic variants have been found to have various effects in vitro (loss of function, gain of function, and dominant negative in PMIDs: 34778950, 9526001, and 11773313). This gene-disease relationship is also supported by experimental evidence: hippocampal brain slices lacking *KCNA1* showed hyperexcitability and a mouse model expressing p.V408A showed impaired coordination under stress (PMIDs: 9581771, 12612586). In summary, there is a definitive relationship between *KCNA1* and autosomal dominant episodic ataxia type 1. This has been repeatedly demonstrated in both the research and clinical diagnostic settings, and has been upheld over time. This classification was approved by the ClinGen Epilepsy Gene Curation Expert Panel on the meeting date March 7th, 2023 (SOP Version 9). In July 2024, this record underwent administrative changes to reflect additional review by the Tubulopathy GCEP and inclusion of information about hypomagnesemia. The classification remains the same.

episodic kinesigenic dyskinesia 1SUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0007494

Submitter: Orphanet

episodic ataxia type 1SUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008047

Submitter: Orphanet

episodic ataxia type 1STRONG

Inheritance Pattern: AD

Disease ID:MONDO:0008047

Submitter: Labcorp Genetics (formerly Invitae)

episodic ataxia type 1DEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0008047

Submitter: Ambry Genetics

isolated autosomal dominant hypomagnesemia, Glaudemans typeSUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0016048

Submitter: Orphanet

epilepsySTRONG

Inheritance Pattern: AD

Disease ID:MONDO:0005027

Submitter: PanelApp Australia

genetic developmental and epileptic encephalopathyLIMITED

Inheritance Pattern: AR

Disease ID:MONDO:0100062

Submitter: G2P

genetic developmental and epileptic encephalopathySUPPORTIVE

Inheritance Pattern: AD

Disease ID:MONDO:0100062

Submitter: Orphanet

genetic developmental and epileptic encephalopathyDEFINITIVE

Inheritance Pattern: AD

Disease ID:MONDO:0100062

Submitter: G2P

Clinical Genomic Database (CGD)

Episodic ataxia, type 1/myokymia syndromeAD

Manifestation: Neurologic; Renal

Intervention: Renal

Rationale: Individuals can have severe hypomagnesemia, which is responsive to magnesium therapy

Comments: For episodic ataxia medical treatment (eg, with phenytoin) may be effective, but the benefit of an early (genetic) diagnosis is unclear

Refs: 7842011; 11026449; 17136396; 19307729Source: CGD (NHGRI)

ClinVar Associated Diseases & Phenotypes

Reported disease conditions connected to KCNA1 variants in ClinVar

18 Conditions Cataloged
Episodic ataxia type 1Total: 501
not providedTotal: 176
Inborn genetic diseasesTotal: 51
not specifiedTotal: 38
KCNA1-related disorderTotal: 25
Myokymia 1Total: 3
Hereditary ataxiaTotal: 2
Epileptic encephalopathyTotal: 1

ClinVar Variants & Pathogenicity by Type

Statistics based on transcript NM_000217.3. Only rare variants are included.

We include only reliable ClinVar variants with their consequences to MANE Select, MANE Plus Clinical transcripts, or transcripts with TSL equal to 1. Click a count to filter the variants table below.

Slight differences between displayed counts and ClinVar may occur due to a different transcript/consequence chosen by our variant effect predictor, or because we classify Benign/Likely benign as Likely benign and Pathogenic/Likely pathogenic as Likely pathogenic.

EffectPLPVUSLBBSum
synonymous
9
clinvar
188
clinvar
1
clinvar
198
missense
23
clinvar
30
clinvar
333
clinvar
7
clinvar
393
nonsense
2
clinvar
1
clinvar
12
clinvar
15
start loss
3
clinvar
1
clinvar
4
frameshift
1
clinvar
6
clinvar
7
splice donor/acceptor (+/-2bp)
1
clinvar
1
Total25323641952618

Highest pathogenic variant AF is 6.84149e-7

Loading ClinVar variants...

Transcript Catalog

Annotated transcript isoforms across RefSeq and Ensembl databases

Showing 4 of 4 transcripts
Transcript IDSourceProtein IDCoding ExonsMANE Status
NM_000217.3RefSeqNP_000208.21MANE Select
ENST00000382545.5EnsemblENSP00000371985.31MANE Select
ENST00000639306.1EnsemblENSP00000492506.11Standard
ENST00000639680.1EnsemblENSP00000492218.12Standard

Gene Ontology (GO) Annotations & Pathways

Biological processes, molecular functions, cellular components and pathways

Pathways ConsensusPathDB

  • Neuronal System
  • Voltage gated Potassium channels
  • Potassium Channels

Biological Process

  • startle response
  • potassium ion transport
  • regulation of muscle contraction
  • chemical synaptic transmission
  • neuroblast proliferation

Molecular Function

  • voltage-gated potassium channel activity
  • delayed rectifier potassium channel activity
  • potassium channel activity
  • protein binding
  • potassium ion transmembrane transporter activity

Cellular Component

  • endoplasmic reticulum
  • cytosol
  • plasma membrane
  • integral component of plasma membrane
  • voltage-gated potassium channel complex

gnomAD Constraint

Source: gnomAD

Gene type
protein_coding
Transcript type
protein_coding
Transcript
ENST00000382545
Coding exons
1
Length
21457
Individuals with no LoFs
125741
Homozygous LoFs
0
Heterozygous LoFs
7
Defined
125748
p
0.0000278
Z-ScoreObservedExpectedObserved/ExpectedMutation RateTotal Possible
Missense3.331483140.4720.00002163296
Missense (PolyPhen)37167.350.221091777
Synonymous-0.9481541401.100.0000112985
Loss of Function2.23412.50.3196.35e-7141

Population LoF Frequency

PopulationCAFp-valueStatus
African0.0000620.000062rare
Latino/Admixed American00.0absent
Ashkenazi Jewish00.0absent
East Asian0.0000550.000054rare
Finnish00.0absent
European (Non-Finnish)0.0000350.000035rare
South Asian0.0000330.000033rare
Other00.0absent

dbNSFP Gene Annotations

Source: dbNSFP

Function
FUNCTION: Voltage-gated potassium channel that mediates transmembrane potassium transport in excitable membranes, primarily in the brain and the central nervous system, but also in the kidney (PubMed:19903818). Contributes to the regulation of the membrane potential and nerve signaling, and prevents neuronal hyperexcitability (PubMed:17156368). Forms tetrameric potassium- selective channels through which potassium ions pass in accordance with their electrochemical gradient. The channel alternates between opened and closed conformations in response to the voltage difference across the membrane (PubMed:19912772). Can form functional homotetrameric channels and heterotetrameric channels that contain variable proportions of KCNA1, KCNA2, KCNA4, KCNA5, KCNA6, KCNA7, and possibly other family members as well; channel properties depend on the type of alpha subunits that are part of the channel (PubMed:12077175, PubMed:17156368). Channel properties are modulated by cytoplasmic beta subunits that regulate the subcellular location of the alpha subunits and promote rapid inactivation of delayed rectifier potassium channels (PubMed:12077175, PubMed:17156368). In vivo, membranes probably contain a mixture of heteromeric potassium channel complexes, making it difficult to assign currents observed in intact tissues to any particular potassium channel family member. Homotetrameric KCNA1 forms a delayed-rectifier potassium channel that opens in response to membrane depolarization, followed by slow spontaneous channel closure (PubMed:19912772, PubMed:19968958, PubMed:19307729, PubMed:19903818). In contrast, a heterotetrameric channel formed by KCNA1 and KCNA4 shows rapid inactivation (PubMed:17156368). Regulates neuronal excitability in hippocampus, especially in mossy fibers and medial perforant path axons, preventing neuronal hyperexcitability. Response to toxins that are selective for KCNA1, respectively for KCNA2, suggests that heteromeric potassium channels composed of both KCNA1 and KCNA2 play a role in pacemaking and regulate the output of deep cerebellar nuclear neurons (By similarity). May function as down- stream effector for G protein-coupled receptors and inhibit GABAergic inputs to basolateral amygdala neurons (By similarity). May contribute to the regulation of neurotransmitter release, such as gamma-aminobutyric acid (GABA) release (By similarity). Plays a role in regulating the generation of action potentials and preventing hyperexcitability in myelinated axons of the vagus nerve, and thereby contributes to the regulation of heart contraction (By similarity). Required for normal neuromuscular responses (PubMed:11026449, PubMed:17136396). Regulates the frequency of neuronal action potential firing in response to mechanical stimuli, and plays a role in the perception of pain caused by mechanical stimuli, but does not play a role in the perception of pain due to heat stimuli (By similarity). Required for normal responses to auditory stimuli and precise location of sound sources, but not for sound perception (By similarity). The use of toxins that block specific channels suggest that it contributes to the regulation of the axonal release of the neurotransmitter dopamine (By similarity). Required for normal postnatal brain development and normal proliferation of neuronal precursor cells in the brain (By similarity). Plays a role in the reabsorption of Mg(2+) in the distal convoluted tubules in the kidney and in magnesium ion homeostasis, probably via its effect on the membrane potential (PubMed:23903368, PubMed:19307729). {ECO:0000250|UniProtKB:P10499, ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:12077175, ECO:0000269|PubMed:15837928, ECO:0000269|PubMed:17136396, ECO:0000269|PubMed:17156368, ECO:0000269|PubMed:19307729, ECO:0000269|PubMed:19903818, ECO:0000269|PubMed:19912772, ECO:0000269|PubMed:19968958, ECO:0000269|PubMed:21106501, ECO:0000269|PubMed:23903368}.;
Disease
DISEASE: Episodic ataxia 1 (EA1) [MIM:160120]: An autosomal dominant disorder characterized by brief episodes of ataxia and dysarthria. Neurological examination during and between the attacks demonstrates spontaneous, repetitive discharges in the distal musculature (myokymia) that arise from peripheral nerve. Nystagmus is absent. {ECO:0000269|PubMed:10355668, ECO:0000269|PubMed:11013453, ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:12077175, ECO:0000269|PubMed:15532032, ECO:0000269|PubMed:17156368, ECO:0000269|PubMed:7842011, ECO:0000269|PubMed:8541859, ECO:0000269|PubMed:8845167, ECO:0000269|PubMed:8871592, ECO:0000269|PubMed:9600245}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Myokymia isolated 1 (MK1) [MIM:160120]: A condition characterized by spontaneous involuntary contraction of muscle fiber groups that can be observed as vermiform movement of the overlying skin. Electromyography typically shows continuous motor unit activity with spontaneous oligo- and multiplet-discharges of high intraburst frequency (myokymic discharges). Isolated spontaneous muscle twitches occur in many persons and have no grave significance. {ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:17136396, ECO:0000269|PubMed:19307729, ECO:0000269|PubMed:19903818}. Note=The disease is caused by mutations affecting the gene represented in this entry.;

Recessive Scores

pRec
0.299

Intolerance Scores

LoFtool
0.0791
RVIS EVS
-0.56
RVIS percentile EVS
19.54

Essentials

Essential (CRISPR)
N
Essential (CRISPR2)
N
Essential (gene trap)
N
Indispensability pred.
E
Indispensability score
0.803

Gene Damage Prediction

AllRecessiveDominant
MendelianMediumMediumMedium
Primary ImmunodeficiencyMediumMediumMedium
CancerMediumMediumMedium
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