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NCT Number: NCT06701084

Molecular Genetic Mechanisms of Infantile Epilepsies and the Impact of Genetic Diagnosis

The goal of this study is to discover new genetic causes of infantile epilepsies and evaluate the impact of these discoveries on infants with epilepsy and their families.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Boston Children's Hospital

Boston, Massachusetts, 02115, United States

Location status: Recruiting

Location contact

Alissa M D'Gama, MD, PhD

PRINCIPAL_INVESTIGATOR

Beth R Sheidley, MS

CONTACT

[email protected]

8572185533

About this study

Infantile epilepsies are common, affecting 1 in 1000 infants, and are associated with significant morbidity, mortality, healthcare costs, and caregiver burden. Although most infantile epilepsies are believed to have genetic causes, most infants with epilepsy remain genetically "unsolved" and the full genetic landscape of infantile epilepsies is unknown, which limits our ability to develop precision therapies and ultimately improve outcomes for this vulnerable population. This study aims to discover new genetic causes of infantile epilepsies and evaluate the impact of these discoveries on infants with epilepsy and their families, contributing to knowledge that will inform our scientific understanding of normal and abnormal brain development and guide clinical care and implementation of precision medicine for infants with epilepsy.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Infant Criteria

Inclusion criteria

  • Seizure onset at less than 12 months of age
  • Enrollment within 6 weeks of seizure-related presentation
  • Patient at Boston Children's Hospital

Exclusion criteria

  • Simple febrile seizures
  • Acute provoked seizures (e.g., due to sepsis, hemorrhage, electrolyte abnormality, cerebral infarction, hypoxic ischemic encephalopathy, non-accidental injury)
  • Genetic or acquired cause of epilepsy already identified, including brain magnetic resonance imaging findings consistent with a specific genetic etiology (e.g., tuberous sclerosis complex)
  • Deceased prior to enrollment

Parent Criteria Inclusion Criteria - Parent of eligible infant (see above)

Exclusion criteria

  • Not the legal guardian of the eligible infant

Treatment and study plan

Genomic sequencing

Genetic

Genomic sequencing data will be comprehensively analyzed for pathogenic variants that explain the participants epilepsy.

Primary outcomes

  1. Diagnostic Yield

    Time frame: Collected after return of genetic results approximately 2 weeks after infant is enrolled

    The diagnostic yield of genomic sequencing will be calculated as the percentage of enrolled infants with epilepsy who receive a genetic diagnosis.

  2. Short-term clinical utility of genetic testing

    Time frame: Collected after return of genetic results approximately 2 weeks after infant is enrolled

    The short-term clinical utility of genetic testing will be evaluated using the validated C-GUIDE measure. The C-GUIDE total score will be compared between infants with epilepsy who did vs did not receive a genetic diagnosis.

  3. Parent-perceived (personal) utility of genetic testing

    Time frame: Collected when infant is 2.5 years old

    The parent-perceived utility of genetic testing will be evaluated using the validated GENE-U measure. The GENE-U total score will be compared between infants with epilepsy who did vs did not receive a genetic diagnosis.

Secondary outcomes

  1. Developmental progress

    Time frame: Collected when infant is 2.5 years old

    Developmental progress will be evaluated using the Bayley Scales of Infant and Toddler Development Fourth Edition. The cognitive, language, and motor subscale scores will be compared between infants with epilepsy who did vs did not receive a genetic diagnosis.

  2. Seizure frequency

    Time frame: Collected at return of genetic results approximately 2 weeks after infant is enrolled and when infant is 2.5 years old

    The seizure frequency will be evaluated using the seizure frequency outcome measure developed by the American Academy of Neurology and dichotomized as decrease vs no decrease between the two timepoints. The percentage of infants with this outcome will be compared between infants with epilepsy who did vs did not receive a genetic diagnosis.

  3. Parental experiences with genetic testing

    Time frame: Collected when infant is 2.5 years old

    This outcome will be evaluated using a qualitative approach. Semi-structured interviews will be performed with a subset of parents using purposive sampling and will be analyzed using a grounded theory iterative approach.

Study contacts

Contact information is provided by the study sponsor or research team.

Beth R Sheidley, MS

CONTACT

[email protected]

8572185533

Sponsors and collaborators

Lead sponsor

Boston Children's Hospital

Other

Registry information

Official study title

Molecular Genetic Mechanisms of Infantile Epilepsies and the Impact of Genetic Diagnosis: Gene-Shortening Time of Evaluation in Pediatric Epilepsy Services (Gene-STEPS)

Important dates

Study start
2021
Primary completion
2029
Study completion
2029
First posted
Nov 22, 2024
Registry last updated
Apr 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.