CommentaryDravet syndrome (DS) is a severe pediatric epileptic encephalopathy with disease onset in the first year of life. Patients have normal presentation before seizure onset and then experience frequent seizures, ataxia, cognitive deficits, and a high risk of sudden unexpected death in epilepsy (1). The majority of DS cases are caused by de novo loss-of-function mutations in SCN1A, encoding the voltage-gated sodium channel Na v 1.1, resulting in haploinsufficiency (2-4).Early studies in Scn1a −/+ mice showed selective reductions in excitability and sodium current density in hippocampal interneurons, with pyramidal neurons unaffected, at postnatal day (P)13 to 14 (4). These data pointed to selective impairment of GABAergic interneurons in DS, leading to disinhibition and epilepsy. Subsequent work with cell type specific Scn1a deletions to study the roles of inhibitory interneuron subtypes supported this hypothesis (5-7). However, work in DS patientderived induced pluripotent stem cell neurons and in DS mice during the time of disease onset (P21-24) suggested a role for increased pyramidal neuron excitability in pathogenesis (8, 9). Disease onset and severity are correlated with increased
Scn1a−/+ hippocampal pyramidal neuron excitability compared to wildtype (WT), while interneuron excitability is decreased before and after disease onset (9). Regardless of contributions from other neuron types, interneurons are involved in various network oscillations, suggesting their dysfunction should translate to dramatic network effects in vivo (10).In their article in Cerebral Cortex, De Stasi et al. set out to address the in vivo network impacts of SCN1A-linked DS in mice. In vivo local field potential (LFP) and multiunit activity (MUA) recordings were performed in the somatosensory cortex of P16 to 18 WT and Scn1a −/+ mice. Importantly, Scn1a−/+ mice in this age range have not yet begun to exhibit seizures and have been shown using whole cell patch clamp in acute brain slices to have hypoexcitability of parvalbumin positive (PV+) and somatostatin positive (SOM+) interneurons of the cortex and hippocampus (4, 5, 9). Here, under urethane anesthesia, De Stasi et al. demonstrated that the only differences in the LFP power spectrum between genotypes are modest reductions in the δ (2-4 Hz) and θ (4-8 Hz) frequency bands when recording from superficial cortical layers. In deep layer recordings, no differences were found between genotypes in the LFP power spectrum at any frequency. To test if the subtle differences were due to anesthesia, experiments were repeated in awake animals; however, no differences were found in the LFP power spectrum at any frequency. In addition, no differences in neuronal spiking were detected in the MUA signal Severe myoclonic epilepsy of infancy (SMEI) is associated with loss of function of the SCN1A gene encoding the NaV1.1 sodium channel isoform. Previous studies in Scn1a −/+ mice during the pre-epileptic period reported selective reduction in interneuron excitability and proposed this as the m...