Elevated neuronal excitability and seizure susceptibility in a mouse model of SCN2A-related developmental and epileptic encephalopathy

Pathogenic variants in SCN2A cause a spectrum of neurodevelopmental disorders, including developmental and epileptic encephalopathies (DEE). The patient-associated SCN2A-p.E430A variant selectively shifts voltage-dependence of activation, a mechanism predicted to enhance neuronal excitability. To investigate the functional consequences of the SCN2A-E430A variant, we generated the novel Scn2aE430A mouse model and assessed neuronal excitability, brain activity, seizure susceptibility, and phenytoin responsiveness. Heterozygous Scn2aE430A mice retained normal Scn2a expression levels and did not exhibit premature lethality. Hippocampal pyramidal neurons from heterozygous Scn2aE430A mice were hyperexcitable compared to wild-type neurons. Enhanced long-term potentiation was observed in the CA1 circuit of Scn2aE430A mice. Video-EEG data revealed recurrent epileptiform discharges and spectral abnormalities, but no spontaneous generalized seizure events. In multiple seizure-induction assays, Scn2aE430A mice had no difference in latency to first seizure signs, but exhibited faster seizure generalization and more lethality compared to wild-type mice, indicating alterations in seizure propagation and/or cessation rather than seizure initiation. Pretreatment with phenytoin improved seizure outcomes across all seizure induction methods. Together, these findings demonstrate that selective disruption of Scn2a activation gating is sufficient to drive neuronal hyperexcitability and network dysfunction, establishing the Scn2aE430A mouse as clinically relevant and pharmacologically tractable model of SCN2A-related DEE.