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ANK3: Bipolar Disorder and Brain Development

The brain is simply amazing – controlling thoughts, movement, essential bodily functions, emotions, mood, and life. At a basic level, all of this brain activity is dependent on electrons flowing through neurons, which is where the ANK3 gene comes in.

I will attempt to explain how ANK3 impacts neuronal formation and transmission – and how this ties into an increased risk of psychiatric disorders. Included also are ANK3 genetic variants to check in your raw data.

As always, the information here is for educational purposes. If you think you have bipolar disorder or schizophrenia, please seek help from a medical professional.

What is ANK3?

Ankyrin 3 (ANK3) is a protein that acts in neurons as a partner, or scaffold, necessary to the voltage-gated sodium channels important in neuronal firing.

Neurons are the brain and nervous system cells that transmit electrical signals — they tell your muscles to move, heart to beat, and brain to think. The impulses sent via neurons are little electrical charges that build up and then ‘fire’.

Along the neuron is a myelin sheath that insulates it, but spaces interrupting the myelin sheath allow ions to flow in. It is where ANK3 comes in — helping the axon structure to initially form and function well. Specifically, it helps to put the sodium channels in the right place.[ref]

Here’s a very quick overview video of how neurons work:


The genetic variants in the ANK3 gene impact the risk of psychiatric disorders that include bipolar disorder and autism spectrum disorders, and heart arrhythmia.

Wiring the brain: AKN3

ANK3 helps wire the brain in two ways:

  1. ANK3 interacts with the way that neurons transmit signals
  2. ANK3 is important in neuron formation during fetal development[ref]

There are several different versions, or isoforms, of ANK3, which act in multiple ways in the brain and throughout the nervous system.[ref]

Neuronal firing:

GABAergic neurons are regulated and kept from being overstimulated by GABA, an inhibitory neurotransmitter within the brain. It’s commonly thought of like the brakes that keep neurons from firing too much. It is important in cognitive function, mood, and behavior.

Recent research shows that one form of ANK3 is important in how GABA binds to its receptor (GABARAP) in certain types of neurons. A rare mutation in ANK3 alters this binding and has strong links to causing bipolar disorder.[ref]

Additionally, the ANK3 protein is important in how the neurons fire in certain regions of the brain. The protein helps the way that sodium channels are structured in the axon of the neuron. Sodium channels are essential for changing the ion gradient so that a neuron fires.

CC Image PMC3492013

You may be wondering how the brain can even work if there is a problem with the neurons firing. There are different types of neurons and specific variations of sodium channels — the ANK3 protein is only important in specific neurons in certain parts of the brain and peripheral nervous system. Variants in ANK3 don’t affect all neurons.

Bipolar disorder and ANK3 variants:

Bipolar disease is reportedly 80% heritable, which means that the genetic component is very high.[ref] But there is not just one gene mutation that causes someone to have bipolar disorder. Instead, many different genetic variants come together to increase susceptibility to this mood disorder.

Executive function refers to the higher-order thinking that people use when making complex decisions or goal-oriented planning. Research shows that people with bipolar disorder are more likely to have executive function deficits, and it is one of the heritable features of bipolar.[ref]

Postmortem studies on the brains of people with bipolar disorder (BD) show that they have lower expression of ANK3. This association indicates that alterations in ANK3 may change how the neurons developed and/or the activity of neurons in specific brain regions, increasing susceptibility to BD.[ref]

Interestingly, new research shows that ANK3 interacts with GSK3B, the target of lithium, a commonly used medication for bipolar disorder.[ref]

Autism Spectrum Disorder:

Rare mutations in ANK3 have been identified in some patients with autism spectrum disorder. Autism is likely to have many different genetic causes, and ANK3 mutations are just one possibility. [ref]

Researchers believe that ANK3 mutations can cause autism or neurodevelopmental disorders by disrupting the proper formation of the axon during fetal development.[ref][ref]

Researchers have found that early stress during the prenatal or early postnatal period alters the interaction of ANK3 in the neuron. Common genetic variants in ANK3, when combined with prenatal stress, are linked to deficits in working memory. In this study, prenatal stress was determined by complications during the pregnancy or birth.[ref]


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Variants in ANK3 physically affect how the brain works.

Animal studies show that lithium works well as a treatment for alterations in the ANK3 pathway.[ref][ref]. If you suspect you have a mood disorder, obviously, talk to your doctor first before trying any supplements. Lithium orotate, a low-dose supplement formula, is available online from supplement suppliers.

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About the Author:
Debbie Moon is the founder of Genetic Lifehacks. Fascinated by the connections between genes, diet, and health, her goal is to help you understand how to apply genetics to your diet and lifestyle decisions. Debbie has a BS in engineering from Colorado School of Mines and an MSc in biological sciences from Clemson University. Debbie combines an engineering mindset with a biological systems approach to help you understand how genetic differences impact your optimal health.