Voltage-gated Na channels in several classes of neurons, including cells of the cerebellum, are subject to an open-channel block and unblock by an endogenous protein. The Na V β4 (Scn4b) subunit is a candidate blocking protein because a free peptide from its cytoplasmic tail, the β4 peptide, can block open Na channels and induce resurgent current as channels unblock upon repolarization. In heterologous expression systems, however, Na V β4 fails to produce resurgent current. We therefore tested the necessity of this subunit in generating resurgent current, as well as its influence on Na channel gating and action potential firing, by studying cultured cerebellar granule neurons treated with siRNA targeted against Scn4b. Knockdown of Scn4b, confirmed with quantitative RT-PCR, led to five electrophysiological phenotypes: a loss of resurgent current, a reduction of persistent current, a hyperpolarized half-inactivation voltage of transient current, a higher rheobase, and a decrease in repetitive firing. All disruptions of Na currents and firing were rescued by the β4 peptide. The simplest interpretation is that Na V β4 itself blocks Na channels of granule cells, making this subunit the first blocking protein that is responsible for resurgent current. The results also demonstrate that a known open-channel blocking peptide not only permits a rapid recovery from nonconducting states upon repolarization from positive voltages but also increases Na channel availability at negative potentials by antagonizing fast inactivation. Thus, Na V β4 expression determines multiple aspects of Na channel gating, thereby regulating excitability in cultured cerebellar granule cells., one of four β subunits of voltage-gated Na channels (1), is implicated in several pathologies: Na V β4 is down-regulated in Huntington's disease (2), cleaved by enzymes activated in Alzheimer's Disease (3), and mutated in some long-QT syndromes (4), raising the question of how it modulates Na currents in neurons and other cells. Among the proposed roles for Na V β4, based on studies of a peptide fragment of its cytoplasmic tail, is that it may act as an open-channel blocker of Na channels in neurons that produce resurgent current, i.e., reopening of Na channels upon repolarization from positive voltages (5).Resurgent current is present in several neuronal classes, including cell types in the cerebellum, brainstem, subthalamic nuclei, and dorsal root ganglia (6-11). As in other cells, voltage-gated Na channels in these neurons are closed at negative voltages and open upon depolarization. After opening, however, channels are blocked rapidly by an endogenous protein that prevents the fast inactivation gate from binding. Upon repolarization, this blocker is expelled, and resurgent current flows as channels reopen before either inactivating or deactivating, depending on the voltage (12). In Purkinje cells, modeling studies (13,14) and experiments on Na V 1.6 mutant mice, in which resurgent currents are reduced (14-16), have led to the proposal that Na channels t...