CACNA1A
Chr 19calcium voltage-gated channel subunit alpha1 A
Also known as: APCA, BI, CACNL1A4, CAV2.1, DEE42, EA2, EIEE42, FHM
The CACNA1A gene encodes the alpha-1A subunit of voltage-dependent calcium channels that mediate calcium entry into neurons and regulate neurotransmitter release. Mutations cause autosomal dominant disorders including familial hemiplegic migraine, episodic ataxia type 2, spinocerebellar ataxia 6 (from CAG repeat expansions), and developmental and epileptic encephalopathy 42. The gene is highly intolerant to loss-of-function variants, and mutations can cause disease through multiple mechanisms depending on the specific variant type.
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Population Genetics & Constraint
gnomAD v4 — loss-of-function & missense intolerance
Among the most LoF-intolerant genes (~top 3%)
Extremely missense-constrained (top ~0.01%)
Cav2.1 mechanism is phenotype-dependent. FHM1 variants are GOF (enhanced P/Q-type current). EA2 variants are LOF (reduced current). SCA6 involves polyglutamine expansion. G2P classifies as undetermined.
This gene has evidence for multiple mechanisms of pathogenicity (loss-of-function, gain-of-function and dominant-negative). The Badonyi & Marsh model scores gain-of-function highest among its predictions, but genomic evidence (constraint, ClinVar variant spectrum, and literature) most strongly supports loss-of-function (haploinsufficiency). Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.
Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.
Literature Evidence
Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.
ClinVar Variant Classifications
0 submitted variants in ClinVar
Protein Context — Lollipop Plot
CACNA1A · protein map & ClinVar variants
Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.
3D Protein StructureAlphaFold
External Resources
Links to major genomics databases and tools
Clinical Trials
Active and recruiting trials from ClinicalTrials.gov
A Retrospective Survey-based Multicenter Study to Delineate the Molecular and Phenotypic Spectrum of Epilepsy-dyskinesia Syndromes
RECRUITINGPivotal Study of N-acetyl-L-leucine for CACNA1A
NOT YET RECRUITINGRegistry and Natural History of Epilepsy-Dyskinesia Syndromes
RECRUITINGExternal Resources
Links to major genomics databases and tools