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Auteur Alan K. PERCY
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Documents disponibles écrits par cet auteur (11)
Faire une suggestion Affiner la rechercheAnxiety-like behavior and anxiolytic treatment in the Rett syndrome natural history study / Caroline B. BUCHANAN in Journal of Neurodevelopmental Disorders, 14 (2022)
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Assessment of Caregiver Inventory for Rett Syndrome / Jane B. LANE in Journal of Autism and Developmental Disorders, 47-4 (April 2017)
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Titre : Assessment of Caregiver Inventory for Rett Syndrome Type de document : texte imprimé Auteurs : Jane B. LANE, Auteur ; Amber R. SALTER, Auteur ; Nancy JONES, Auteur ; Gary CUTTER, Auteur ; Joseph P. HORRIGAN, Auteur ; Steve A. SKINNER, Auteur ; Walter E. KAUFMANN, Auteur ; Daniel G. GLAZE, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur Article en page(s) : p.1102-1112 Langues : Anglais (eng) Mots-clés : Rett syndrome Caregiver Inventory MECP2 Factor analysis Index. décimale : PER Périodiques Résumé : Rett syndrome (RTT) requires total caregiver attention and leads to potential difficulties throughout life. The Caregiver Burden Inventory, designed for Alzheimer disease, was modified to a RTT Caregiver Inventory Assessment (RTT CIA). Reliability and face, construct, and concurrent validity were assessed in caregivers of individuals with RTT. Chi square or Fisher’s exact test for categorical variables and t tests or Wilcoxon two-sample tests for continuous variables were utilized. Survey completed by 198 caregivers; 70 caregivers completed follow-up assessment. Exploratory factor analysis revealed good agreement for physical burden, emotional burden, and social burden. Internal reliability was high (Cronbach’s alpha 0.898). RTT CIA represents a reliable and valid measure, providing a needed metric of caregiver burden in this disorder. En ligne : http://dx.doi.org/10.1007/s10803-017-3034-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=304
in Journal of Autism and Developmental Disorders > 47-4 (April 2017) . - p.1102-1112[article] Assessment of Caregiver Inventory for Rett Syndrome [texte imprimé] / Jane B. LANE, Auteur ; Amber R. SALTER, Auteur ; Nancy JONES, Auteur ; Gary CUTTER, Auteur ; Joseph P. HORRIGAN, Auteur ; Steve A. SKINNER, Auteur ; Walter E. KAUFMANN, Auteur ; Daniel G. GLAZE, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur . - p.1102-1112.
Langues : Anglais (eng)
in Journal of Autism and Developmental Disorders > 47-4 (April 2017) . - p.1102-1112
Mots-clés : Rett syndrome Caregiver Inventory MECP2 Factor analysis Index. décimale : PER Périodiques Résumé : Rett syndrome (RTT) requires total caregiver attention and leads to potential difficulties throughout life. The Caregiver Burden Inventory, designed for Alzheimer disease, was modified to a RTT Caregiver Inventory Assessment (RTT CIA). Reliability and face, construct, and concurrent validity were assessed in caregivers of individuals with RTT. Chi square or Fisher’s exact test for categorical variables and t tests or Wilcoxon two-sample tests for continuous variables were utilized. Survey completed by 198 caregivers; 70 caregivers completed follow-up assessment. Exploratory factor analysis revealed good agreement for physical burden, emotional burden, and social burden. Internal reliability was high (Cronbach’s alpha 0.898). RTT CIA represents a reliable and valid measure, providing a needed metric of caregiver burden in this disorder. En ligne : http://dx.doi.org/10.1007/s10803-017-3034-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=304 Characterizing the journey of Rett syndrome among females in the United States: a real-world evidence study using the Rett syndrome natural history study database / Damian MAY in Journal of Neurodevelopmental Disorders, 16 (2024)
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Titre : Characterizing the journey of Rett syndrome among females in the United States: a real-world evidence study using the Rett syndrome natural history study database Type de document : texte imprimé Auteurs : Damian MAY, Auteur ; Kalé KPONEE-SHOVEIN, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur ; Malena MAHENDRAN, Auteur ; Nathaniel DOWNES, Auteur ; Grace CHEN, Auteur ; Talissa WATSON, Auteur ; Dominique C. PICHARD, Auteur ; Melissa KENNEDY, Auteur ; Patrick LEFEBVRE, Auteur Langues : Anglais (eng) Mots-clés : Humans Rett Syndrome/physiopathology/therapy/complications Female United States/epidemiology Adult Child Adolescent Retrospective Studies Young Adult Child, Preschool Severity of Illness Index Registries Infant Databases, Factual Clinical manifestations Disease progression Natural history Registry Rett syndrome Treatment patterns International Rett Syndrome Foundation. KKS, MM, ND, GC, TW, and PL are employees of Analysis Group, Inc., a consultancy that received funding from Acadia Pharmaceuticals, Inc. to conduct this study. AKP is co-editor of Translational Science of Rare Diseases, received research funding from the National Institutes of Health, and is a consultant for Acadia Pharmaceuticals Inc., Anavex Life Sciences Corp., AveXis, and GW Pharmaceuticals, as well as advisor to the International Rett Syndrome Foundation. JLN has received research funding from the International Rett Syndrome Foundation, the National Institutes of Health, and Rett Syndrome Research Trust and personal consultancy fees from Acadia Pharmaceuticals Inc., Analysis Group, AveXis, GW Pharmaceuticals, Hoffmann-La Roche, Myrtelle, Neurogene, Newron Pharmaceuticals, Signant Health, and Taysha Gene Therapies, and for the preparation of CME activities for Medscape and Peer Review Institute serves on the scientific advisory board of Alcyone Lifesciences is a scientific cofounder of LizarBio Therapeutics and was a member of a data safety monitoring board for clinical trials conducted by Ovid Therapeutics. Index. décimale : PER Périodiques Résumé : BACKGROUND: With the advent of the first targeted therapy for Rett Syndrome (RTT), a comprehensive assessment of the journey of RTT is needed to elucidate on present unmet needs in this population. This study characterized females with RTT in the United States and their disease journey with respect to longitudinal treatment patterns, RTT-related outcomes, and changes in disease severity. METHODS: This retrospective cohort study used registry data of females with RTT from the 5211 RTT Natural History Study (RNHS) (November 2015-July 2021). Pharmacological and supportive therapy use, RTT-related outcomes, and RTT severity, as measured by the Clinical Severity Scale and Motor Behavioral Assessment scale, were evaluated following the first RNHS visit. Analyses were conducted overall and in subgroups by RTT type (classic and atypical RTT) and age at first visit (pediatric and adult). RESULTS: A total of 455 females with RTT were included in the study, of whom 90.5% had classic RTT and 79.8% were pediatric individuals. Over a median follow-up of 4 years, use of pharmacological therapies, including prokinetic agents (42.7% vs. 28.3%), and supportive therapies, including physical therapy (87.3% vs. 40.2%) and speech-language therapy (86.8% vs. 23.9%), were more common in pediatric than adult individuals (all p < 0.05). Nearly half (44.6%) of all individuals had a hospital or emergency room visit, with a higher proportion of visits in individuals with classic RTT than atypical RTT and pediatric than adult individuals (both p = 0.001). An increasing trend in clinical severity was observed in pediatric individuals (mean change per year: 0.24; 95% confidence interval [CI]: 0.03, 0.44), while an increasing trend in motor-behavioral dysfunction was observed in pediatric individuals (mean change per year: 1.12; 95% CI: 0.63, 1.60) and those with classic RTT (mean change per year: 0.97; 95% CI: 0.53, 1.41). CONCLUSIONS: Findings from this study highlight the considerable burden of RTT across disease subtype and age. Despite reliance on supportive therapies and healthcare encounters, individuals with RTT experience increasing disease severity and motor-behavioral dysfunction in childhood and adolescence, underscoring the unmet needs of this population and the value of early intervention to manage RTT in the long-term. En ligne : https://dx.doi.org/10.1186/s11689-024-09557-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=575
in Journal of Neurodevelopmental Disorders > 16 (2024)[article] Characterizing the journey of Rett syndrome among females in the United States: a real-world evidence study using the Rett syndrome natural history study database [texte imprimé] / Damian MAY, Auteur ; Kalé KPONEE-SHOVEIN, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur ; Malena MAHENDRAN, Auteur ; Nathaniel DOWNES, Auteur ; Grace CHEN, Auteur ; Talissa WATSON, Auteur ; Dominique C. PICHARD, Auteur ; Melissa KENNEDY, Auteur ; Patrick LEFEBVRE, Auteur.
Langues : Anglais (eng)
in Journal of Neurodevelopmental Disorders > 16 (2024)
Mots-clés : Humans Rett Syndrome/physiopathology/therapy/complications Female United States/epidemiology Adult Child Adolescent Retrospective Studies Young Adult Child, Preschool Severity of Illness Index Registries Infant Databases, Factual Clinical manifestations Disease progression Natural history Registry Rett syndrome Treatment patterns International Rett Syndrome Foundation. KKS, MM, ND, GC, TW, and PL are employees of Analysis Group, Inc., a consultancy that received funding from Acadia Pharmaceuticals, Inc. to conduct this study. AKP is co-editor of Translational Science of Rare Diseases, received research funding from the National Institutes of Health, and is a consultant for Acadia Pharmaceuticals Inc., Anavex Life Sciences Corp., AveXis, and GW Pharmaceuticals, as well as advisor to the International Rett Syndrome Foundation. JLN has received research funding from the International Rett Syndrome Foundation, the National Institutes of Health, and Rett Syndrome Research Trust and personal consultancy fees from Acadia Pharmaceuticals Inc., Analysis Group, AveXis, GW Pharmaceuticals, Hoffmann-La Roche, Myrtelle, Neurogene, Newron Pharmaceuticals, Signant Health, and Taysha Gene Therapies, and for the preparation of CME activities for Medscape and Peer Review Institute serves on the scientific advisory board of Alcyone Lifesciences is a scientific cofounder of LizarBio Therapeutics and was a member of a data safety monitoring board for clinical trials conducted by Ovid Therapeutics. Index. décimale : PER Périodiques Résumé : BACKGROUND: With the advent of the first targeted therapy for Rett Syndrome (RTT), a comprehensive assessment of the journey of RTT is needed to elucidate on present unmet needs in this population. This study characterized females with RTT in the United States and their disease journey with respect to longitudinal treatment patterns, RTT-related outcomes, and changes in disease severity. METHODS: This retrospective cohort study used registry data of females with RTT from the 5211 RTT Natural History Study (RNHS) (November 2015-July 2021). Pharmacological and supportive therapy use, RTT-related outcomes, and RTT severity, as measured by the Clinical Severity Scale and Motor Behavioral Assessment scale, were evaluated following the first RNHS visit. Analyses were conducted overall and in subgroups by RTT type (classic and atypical RTT) and age at first visit (pediatric and adult). RESULTS: A total of 455 females with RTT were included in the study, of whom 90.5% had classic RTT and 79.8% were pediatric individuals. Over a median follow-up of 4 years, use of pharmacological therapies, including prokinetic agents (42.7% vs. 28.3%), and supportive therapies, including physical therapy (87.3% vs. 40.2%) and speech-language therapy (86.8% vs. 23.9%), were more common in pediatric than adult individuals (all p < 0.05). Nearly half (44.6%) of all individuals had a hospital or emergency room visit, with a higher proportion of visits in individuals with classic RTT than atypical RTT and pediatric than adult individuals (both p = 0.001). An increasing trend in clinical severity was observed in pediatric individuals (mean change per year: 0.24; 95% confidence interval [CI]: 0.03, 0.44), while an increasing trend in motor-behavioral dysfunction was observed in pediatric individuals (mean change per year: 1.12; 95% CI: 0.63, 1.60) and those with classic RTT (mean change per year: 0.97; 95% CI: 0.53, 1.41). CONCLUSIONS: Findings from this study highlight the considerable burden of RTT across disease subtype and age. Despite reliance on supportive therapies and healthcare encounters, individuals with RTT experience increasing disease severity and motor-behavioral dysfunction in childhood and adolescence, underscoring the unmet needs of this population and the value of early intervention to manage RTT in the long-term. En ligne : https://dx.doi.org/10.1186/s11689-024-09557-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=575 Comparison of evoked potentials across four related developmental encephalopathies / Joni N. SABY in Journal of Neurodevelopmental Disorders, 15 (2023)
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Titre : Comparison of evoked potentials across four related developmental encephalopathies Type de document : texte imprimé Auteurs : Joni N. SABY, Auteur ; Sarika U. PETERS, Auteur ; Timothy A. BENKE, Auteur ; Shannon M. STANDRIDGE, Auteur ; Lindsay C. SWANSON, Auteur ; David N. LIEBERMAN, Auteur ; Heather E. OLSON, Auteur ; Alexandra P. KEY, Auteur ; Alan K. PERCY, Auteur ; Jeffrey L. NEUL, Auteur ; Charles A. NELSON, Auteur ; Timothy P.L. ROBERTS, Auteur ; Eric D. MARSH, Auteur Langues : Anglais (eng) Mots-clés : Epileptic Syndromes Rett Syndrome X-Linked Intellectual Disability Child Humans Spasms, Infantile Evoked Potentials Evoked Potentials, Visual Index. décimale : PER Périodiques Résumé : BACKGROUND: Developing biomarkers is a priority for drug development for all conditions, but vital in the rare neurodevelopmental disorders where sensitive outcome measures are lacking. We have previously demonstrated the feasibility and tracking of evoked potentials to disease severity in Rett syndrome and CDKL5 deficiency disorder. The aim of the current study is to characterize evoked potentials in two related developmental encephalopathies, MECP2 duplication syndrome and FOXG1 syndrome, and compare across all four groups to better understand the potential of these measures to serve as biomarkers of clinical severity for the developmental encephalopathies. METHODS: Visual and auditory evoked potentials were acquired from participants with MECP2 duplication syndrome and FOXG1 syndrome across five sites of the Rett Syndrome and Rett-Related Disorders Natural History Study. A group of age-matched individuals (mean = 7.8 years; range = 1-17) with Rett syndrome, CDKL5 deficiency disorder, and typically-developing participants served as a comparison group. The analysis focused on group-level differences as well as associations between the evoked potentials and measures of clinical severity from the Natural History Study. RESULTS: As reported previously, group-level comparisons revealed attenuated visual evoked potentials (VEPs) in participants with Rett syndrome (n = 43) and CDKL5 deficiency disorder (n = 16) compared to typically-developing participants. VEP amplitude was also attenuated in participants with MECP2 duplication syndrome (n = 15) compared to the typically-developing group. VEP amplitude correlated with clinical severity for Rett syndrome and FOXG1 syndrome (n = 5). Auditory evoked potential (AEP) amplitude did not differ between groups, but AEP latency was prolonged in individuals with MECP2 duplication syndrome (n = 14) and FOXG1 syndrome (n = 6) compared to individuals with Rett syndrome (n = 51) and CDKL5 deficiency disorder (n = 14). AEP amplitude correlated with severity in Rett syndrome and CDKL5 deficiency disorder. AEP latency correlated with severity in CDKL5 deficiency disorder, MECP2 duplication syndrome, and FOXG1 syndrome. CONCLUSIONS: There are consistent abnormalities in the evoked potentials in four developmental encephalopathies some of which correlate with clinical severity. While there are consistent changes amongst these four disorders, there are also condition specific findings that need to be further refined and validated. Overall, these results provide a foundation for further refinement of these measures for use in future clinical trials for these conditions. En ligne : https://dx.doi.org/10.1186/s11689-023-09479-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=575
in Journal of Neurodevelopmental Disorders > 15 (2023)[article] Comparison of evoked potentials across four related developmental encephalopathies [texte imprimé] / Joni N. SABY, Auteur ; Sarika U. PETERS, Auteur ; Timothy A. BENKE, Auteur ; Shannon M. STANDRIDGE, Auteur ; Lindsay C. SWANSON, Auteur ; David N. LIEBERMAN, Auteur ; Heather E. OLSON, Auteur ; Alexandra P. KEY, Auteur ; Alan K. PERCY, Auteur ; Jeffrey L. NEUL, Auteur ; Charles A. NELSON, Auteur ; Timothy P.L. ROBERTS, Auteur ; Eric D. MARSH, Auteur.
Langues : Anglais (eng)
in Journal of Neurodevelopmental Disorders > 15 (2023)
Mots-clés : Epileptic Syndromes Rett Syndrome X-Linked Intellectual Disability Child Humans Spasms, Infantile Evoked Potentials Evoked Potentials, Visual Index. décimale : PER Périodiques Résumé : BACKGROUND: Developing biomarkers is a priority for drug development for all conditions, but vital in the rare neurodevelopmental disorders where sensitive outcome measures are lacking. We have previously demonstrated the feasibility and tracking of evoked potentials to disease severity in Rett syndrome and CDKL5 deficiency disorder. The aim of the current study is to characterize evoked potentials in two related developmental encephalopathies, MECP2 duplication syndrome and FOXG1 syndrome, and compare across all four groups to better understand the potential of these measures to serve as biomarkers of clinical severity for the developmental encephalopathies. METHODS: Visual and auditory evoked potentials were acquired from participants with MECP2 duplication syndrome and FOXG1 syndrome across five sites of the Rett Syndrome and Rett-Related Disorders Natural History Study. A group of age-matched individuals (mean = 7.8 years; range = 1-17) with Rett syndrome, CDKL5 deficiency disorder, and typically-developing participants served as a comparison group. The analysis focused on group-level differences as well as associations between the evoked potentials and measures of clinical severity from the Natural History Study. RESULTS: As reported previously, group-level comparisons revealed attenuated visual evoked potentials (VEPs) in participants with Rett syndrome (n = 43) and CDKL5 deficiency disorder (n = 16) compared to typically-developing participants. VEP amplitude was also attenuated in participants with MECP2 duplication syndrome (n = 15) compared to the typically-developing group. VEP amplitude correlated with clinical severity for Rett syndrome and FOXG1 syndrome (n = 5). Auditory evoked potential (AEP) amplitude did not differ between groups, but AEP latency was prolonged in individuals with MECP2 duplication syndrome (n = 14) and FOXG1 syndrome (n = 6) compared to individuals with Rett syndrome (n = 51) and CDKL5 deficiency disorder (n = 14). AEP amplitude correlated with severity in Rett syndrome and CDKL5 deficiency disorder. AEP latency correlated with severity in CDKL5 deficiency disorder, MECP2 duplication syndrome, and FOXG1 syndrome. CONCLUSIONS: There are consistent abnormalities in the evoked potentials in four developmental encephalopathies some of which correlate with clinical severity. While there are consistent changes amongst these four disorders, there are also condition specific findings that need to be further refined and validated. Overall, these results provide a foundation for further refinement of these measures for use in future clinical trials for these conditions. En ligne : https://dx.doi.org/10.1186/s11689-023-09479-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=575 Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder / Heather E. OLSON in Journal of Neurodevelopmental Disorders, 13 (2021)
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Titre : Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder Type de document : texte imprimé Auteurs : Heather E. OLSON, Auteur ; Carolyn I. DANIELS, Auteur ; Isabel HAVILAND, Auteur ; Lindsay C. SWANSON, Auteur ; Caitlin A. GREENE, Auteur ; Anne Marie M. DENNY, Auteur ; Scott T. DEMAREST, Auteur ; Elia PESTANA-KNIGHT, Auteur ; Xiaoming ZHANG, Auteur ; Ahsan N. MOOSA, Auteur ; Andrea FIDELL, Auteur ; Judith L. WEISENBERG, Auteur ; Bernhard SUTER, Auteur ; Cary FU, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur ; Eric D. MARSH, Auteur ; Timothy A. BENKE, Auteur ; Annapurna PODURI, Auteur Langues : Anglais (eng) Mots-clés : Epilepsy/genetics/therapy Epileptic Syndromes/genetics/therapy Humans Protein Serine-Threonine Kinases/genetics Spasms, Infantile/genetics/therapy CDKL5 deficiency disorder Clinical trials Developmental encephalopathy Emerging therapies Epileptic encephalopathy Ketogenic diet Movement disorders Vagus nerve stimulator Therapeutics and Marinus Pharmaceuticals. PI of "Diagnosis and genotype-phenotype correlations in early life epilepsy and CDKL5 disorder" NINDS award (1K23NS107646). Funding for the Boston Children’s Hospital CDKL5 Center of Excellence provided by the International Foundation for CDKL5 Research. Consulting for Takeda and Ovid Therapeutics. Scott T. Demarest: site PI of clinical trials in CDD sponsored by Ovid Therapeutics and Marinus Pharmaceuticals. Consulting for Upsher-Smith and BioMarin. All remuneration has been made to his department. Elia Pestana-Knight: site PI of clinical trial in CDD sponsored by Marinus Pharmaceuticals. Co-PI of Cleveland Clinic CDD Center of Excellence established by the International Foundation for CDKL5 Research. Consultant for Marinus Pharmaceuticals. Ahsan N. Moosa: site co-investigator for clinical trials in CDD sponsored by Marinus Pharmaceuticals. Bernhard Suter: site PI of a clinical trial in CDD sponsored by Marinus Pharmaceuticals. Site PI of a clinical trial in Rett syndrome sponsored by RSRT, the investigator-initiated trial using ketamine. PI of Texas Children’s Hospital CDD Center of Excellence established by the International Foundation for CDKL5 Research. Jeffrey L. Neul: consultancy to GW Pharmaceuticals, Acadia, AveXis, Ovid Therapeutics. Data and Safety Monitoring Board for Roche, Ovid Therapeutics. Alan K. Percy: PI of the NICHD-funded Natural History Study. Site PI of clinical trials in Rett syndrome sponsored by Anavex and Acadia and the investigator-initiated trial using ketamine. Consultant with Acadia. Eric D. Marsh: site PI of clinical trial in CDD sponsored by Marinus Pharmaceuticals. Site PI for clinical trials for DS and LGS trials sponsored by Zogenix. Provides research support and clinical Center of Excellence support for the International Foundation for CDKL5 Research. Timothy A. Benke: site co-PI of clinical trials in CDD sponsored by Ovid Therapeutics and Marinus Pharmaceuticals. Consulting for AveXis, Ovid Therapeutics, Takeda, and Marinus Pharmeceuticals. All remuneration has been made to his department. Annapurna Poduri: SAB for TevardBio, no personal remuneration. Carolyn Daniels, Isabel Haviland, Lindsay Swanson, Caitlin Greene, AnneMarie M. Denny, Andrea Fidell, Cary Fu, Xiaoming Zhang, Judith L. Weisenberg: no competing interests. Index. décimale : PER Périodiques Résumé : BACKGROUND: CDKL5 deficiency disorder (CDD) is associated with refractory infantile onset epilepsy, global developmental delay, and variable features that include sleep, behavioral disturbances, and movement disorders. Current treatment is primarily symptom-based and informed by experience in caring for this population. METHODS: We describe medication and non-medication approaches to treatment of epilepsy and additional key neurologic symptoms (sleep disturbances, behavioral issues, movement disorders, and swallowing dysfunction) in a cohort of 177 individuals meeting criteria for CDD, 154 evaluated at 4 CDKL5 Centers of Excellence in the USA and 40 identified through the NIH Natural History Study of Rett and Related Disorders. RESULTS: The four most frequently prescribed anti-seizure medications were broad spectrum, prescribed in over 50% of individuals. While the goal was not to ascertain efficacy, we obtained data from 86 individuals regarding response to treatment, with 2-week response achieved in 14-48% and sustained 3-month response in 5-36%, of those with known response. Additional treatments for seizures included cannabis derivatives, tried in over one-third of individuals, and clinical trial medications. In combination with pharmacological treatment, 50% of individuals were treated with ketogenic diet for attempted seizure control. Surgical approaches included vagus nerve stimulators, functional hemispherectomy, and corpus callosotomy, but numbers were too limited to assess response. Nearly one-third of individuals received pharmacologic treatment for sleep disturbances, 13% for behavioral dysregulation and movement disorders, and 43% had gastrostomy tubes. CONCLUSIONS: Treatment for neurologic features of CDD is currently symptom-based and empiric rather than CDD-specific, though clinical trials for CDD are emerging. Epilepsy in this population is highly refractory, and no specific anti-seizure medication was associated with improved seizure control. Ketogenic diet is commonly used in patients with CDD. While behavioral interventions are commonly instituted, information on the use of medications for sleep, behavioral management, and movement disorders is sparse and would benefit from further characterization and optimization of treatment approaches. The heterogeneity in treatment approaches highlights the need for systematic review and guidelines for CDD. Additional disease-specific and disease-modifying treatments are in development. En ligne : https://dx.doi.org/10.1186/s11689-021-09384-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=574
in Journal of Neurodevelopmental Disorders > 13 (2021)[article] Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder [texte imprimé] / Heather E. OLSON, Auteur ; Carolyn I. DANIELS, Auteur ; Isabel HAVILAND, Auteur ; Lindsay C. SWANSON, Auteur ; Caitlin A. GREENE, Auteur ; Anne Marie M. DENNY, Auteur ; Scott T. DEMAREST, Auteur ; Elia PESTANA-KNIGHT, Auteur ; Xiaoming ZHANG, Auteur ; Ahsan N. MOOSA, Auteur ; Andrea FIDELL, Auteur ; Judith L. WEISENBERG, Auteur ; Bernhard SUTER, Auteur ; Cary FU, Auteur ; Jeffrey L. NEUL, Auteur ; Alan K. PERCY, Auteur ; Eric D. MARSH, Auteur ; Timothy A. BENKE, Auteur ; Annapurna PODURI, Auteur.
Langues : Anglais (eng)
in Journal of Neurodevelopmental Disorders > 13 (2021)
Mots-clés : Epilepsy/genetics/therapy Epileptic Syndromes/genetics/therapy Humans Protein Serine-Threonine Kinases/genetics Spasms, Infantile/genetics/therapy CDKL5 deficiency disorder Clinical trials Developmental encephalopathy Emerging therapies Epileptic encephalopathy Ketogenic diet Movement disorders Vagus nerve stimulator Therapeutics and Marinus Pharmaceuticals. PI of "Diagnosis and genotype-phenotype correlations in early life epilepsy and CDKL5 disorder" NINDS award (1K23NS107646). Funding for the Boston Children’s Hospital CDKL5 Center of Excellence provided by the International Foundation for CDKL5 Research. Consulting for Takeda and Ovid Therapeutics. Scott T. Demarest: site PI of clinical trials in CDD sponsored by Ovid Therapeutics and Marinus Pharmaceuticals. Consulting for Upsher-Smith and BioMarin. All remuneration has been made to his department. Elia Pestana-Knight: site PI of clinical trial in CDD sponsored by Marinus Pharmaceuticals. Co-PI of Cleveland Clinic CDD Center of Excellence established by the International Foundation for CDKL5 Research. Consultant for Marinus Pharmaceuticals. Ahsan N. Moosa: site co-investigator for clinical trials in CDD sponsored by Marinus Pharmaceuticals. Bernhard Suter: site PI of a clinical trial in CDD sponsored by Marinus Pharmaceuticals. Site PI of a clinical trial in Rett syndrome sponsored by RSRT, the investigator-initiated trial using ketamine. PI of Texas Children’s Hospital CDD Center of Excellence established by the International Foundation for CDKL5 Research. Jeffrey L. Neul: consultancy to GW Pharmaceuticals, Acadia, AveXis, Ovid Therapeutics. Data and Safety Monitoring Board for Roche, Ovid Therapeutics. Alan K. Percy: PI of the NICHD-funded Natural History Study. Site PI of clinical trials in Rett syndrome sponsored by Anavex and Acadia and the investigator-initiated trial using ketamine. Consultant with Acadia. Eric D. Marsh: site PI of clinical trial in CDD sponsored by Marinus Pharmaceuticals. Site PI for clinical trials for DS and LGS trials sponsored by Zogenix. Provides research support and clinical Center of Excellence support for the International Foundation for CDKL5 Research. Timothy A. Benke: site co-PI of clinical trials in CDD sponsored by Ovid Therapeutics and Marinus Pharmaceuticals. Consulting for AveXis, Ovid Therapeutics, Takeda, and Marinus Pharmeceuticals. All remuneration has been made to his department. Annapurna Poduri: SAB for TevardBio, no personal remuneration. Carolyn Daniels, Isabel Haviland, Lindsay Swanson, Caitlin Greene, AnneMarie M. Denny, Andrea Fidell, Cary Fu, Xiaoming Zhang, Judith L. Weisenberg: no competing interests. Index. décimale : PER Périodiques Résumé : BACKGROUND: CDKL5 deficiency disorder (CDD) is associated with refractory infantile onset epilepsy, global developmental delay, and variable features that include sleep, behavioral disturbances, and movement disorders. Current treatment is primarily symptom-based and informed by experience in caring for this population. METHODS: We describe medication and non-medication approaches to treatment of epilepsy and additional key neurologic symptoms (sleep disturbances, behavioral issues, movement disorders, and swallowing dysfunction) in a cohort of 177 individuals meeting criteria for CDD, 154 evaluated at 4 CDKL5 Centers of Excellence in the USA and 40 identified through the NIH Natural History Study of Rett and Related Disorders. RESULTS: The four most frequently prescribed anti-seizure medications were broad spectrum, prescribed in over 50% of individuals. While the goal was not to ascertain efficacy, we obtained data from 86 individuals regarding response to treatment, with 2-week response achieved in 14-48% and sustained 3-month response in 5-36%, of those with known response. Additional treatments for seizures included cannabis derivatives, tried in over one-third of individuals, and clinical trial medications. In combination with pharmacological treatment, 50% of individuals were treated with ketogenic diet for attempted seizure control. Surgical approaches included vagus nerve stimulators, functional hemispherectomy, and corpus callosotomy, but numbers were too limited to assess response. Nearly one-third of individuals received pharmacologic treatment for sleep disturbances, 13% for behavioral dysregulation and movement disorders, and 43% had gastrostomy tubes. CONCLUSIONS: Treatment for neurologic features of CDD is currently symptom-based and empiric rather than CDD-specific, though clinical trials for CDD are emerging. Epilepsy in this population is highly refractory, and no specific anti-seizure medication was associated with improved seizure control. Ketogenic diet is commonly used in patients with CDD. While behavioral interventions are commonly instituted, information on the use of medications for sleep, behavioral management, and movement disorders is sparse and would benefit from further characterization and optimization of treatment approaches. The heterogeneity in treatment approaches highlights the need for systematic review and guidelines for CDD. Additional disease-specific and disease-modifying treatments are in development. En ligne : https://dx.doi.org/10.1186/s11689-021-09384-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=574 Developmental delay in Rett syndrome: data from the natural history study / Jeffrey L. NEUL in Journal of Neurodevelopmental Disorders, 6-1 (December 2014)
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PermalinkPsychometric Assessment of the Rett Syndrome Caregiver Assessment of Symptom Severity (RCASS) / Melissa RASPA in Journal of Autism and Developmental Disorders, 55-3 (March 2025)
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PermalinkPermalinkRett syndrome: On Clinical and Genetic Features, and Experimental Models based on Mecp2 dysfunction / Gaston CALFA
PermalinkTop caregiver concerns in Rett syndrome and related disorders: data from the US natural history study / Jeffrey L. NEUL in Journal of Neurodevelopmental Disorders, 15 (2023)
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PermalinkVariable phenotypic expression of a MECP2 mutation in a family / Kimberly AUGENSTEIN in Journal of Neurodevelopmental Disorders, 1-4 (December 2009)
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