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Completed

NCT Number: NCT02738281

Natural History of Rett Syndrome & Related Disorders

The purpose of this study is to advance understanding of the natural history of Rett syndrome (RTT), MECP2-duplication disorder (MECP2 Dup), CDKL5, FOXG1, and individuals with MECP2 mutations who do not have RTT including the range of clinical involvement and to correlate genotype-phenotype over a broad spectrum of phenotypes. While much has been learned about RTT, improvements are required in understanding the role of factors such as X chromosome inactivation, genetic background, and others including the environment, on the great variability observed even between individuals with the same MECP2 mutation. These data will be essential to the development and conduct of clinical trials that are anticipated from ongoing studies in animal models for RTT. This study will not include clinical trials, but should set the stage for such trials and other translational research projects (e.g., development of biomarkers).

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Key information

Conditions

Rett Syndrome CDKL5 Disorder CDKL5 deficiency disorder Congenital, Hereditary, and Neonatal Diseases and Abnormalities FOXG1 Syndrome Genetic Diseases, Inborn Genetic Diseases, X-Linked Heredodegenerative Disorders, Nervous System Intellectual Disability MECP2 Duplication Disorder Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations X-Linked Intellectual Disability

Sex eligibility

All sexes

Study type

Observational

Primary location

University of Alabama at Birmingham, Birmingham, Alabama, United States

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About this study

At the present time, effective treatments for RTT, MECP2 Dup, or Rett-related disorders are lacking. Substantial progress has been made in RTT over the past eleven years such that this study represents a narrowing of focus to mutations or duplications of the MECP2 gene and related disorders, including those with phenotypic overlap. Understanding of RTT has advanced remarkably well through the Rett Syndrome Natural History Clinical Protocol (NHS) and correspondingly advancement in the basic science realm has moved forward with equivalent success. Thus, progress in clinical and basic science has led to the establishment of clinical trials and other translational studies that hold promise for additional clinical trials in future. In the process, however, additional MECP2- and RTT-related disorders that were unknown at the time the original proposal have been identified. In addition, substantial clinical variability in individuals with RTT that cannot be explained by differences in mutations alone must be explored further. In fact, variability among individuals with identical mutations has led to the search for additional explanations. At the time of the initial application (2002), just three years after the identification of the gene, MECP2, as the molecular link to RTT, the variation in clinical disorders related to MECP2 mutations or to the related but quite different MECP2 Dup were unknown. Each disorder is characterized by significant neurodevelopmental features related either to alterations in the MECP2 gene or related to phenotypes closely resembling those seen in individuals with RTT. Further, the phenotypic overlap with RTT due to mutations in CDKL5 and FOXG1 was also unexplored. This new study will build on the substantial progress made in understanding both classic and variant RTT and to add these related disorders, MECP2 Dup and the Rett-related disorders including CDKL5, FOXG1, and individuals with MECP2 mutations who do not have RTT. A comprehensive clinical research program will be performed including clinical, neurophysiologic, and molecular and biochemical markers across these different, but related disorders. This protocol will address the natural history components only and will serve as the basis for other study protocols including the neurophysiologic and biomarker studies. Thereby, these studies will represent a continuing pathway to focus and inform not only the ongoing but also the emerging clinical trials.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Individuals of both genders and of all ages, with RTT, MECP2 Dup, and, RTT-related disorders including those with mutations or deletions in CDKL5 and FOXG1 genes, or those with RTT (atypical or typical) who are mutation negative.

Exclusion criteria

  • Individuals who do not meet the above criteria will be excluded.

Treatment and study plan

Primary outcomes

  1. Clinical longitudinal assessments in Rett syndrome (RTT) as measured by mean growth over 5 years.

    Time frame: at 5 years after enrollment

    subject's height will be measured in inches at baseline and at 5 years. The change will be calculated and then the mean change will be reported.

  2. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as measured by mean change in head circumference over 5 years

    Time frame: at 5 years after enrollment

    the mean change in head circumference (measured in Centimeters) will be reported

  3. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as measured by mean number of stereotypic movements at 5 years

    Time frame: at 5 years after enrollment

    The mean number of stereotypic movements in a 24 hour period at 5 years.

  4. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as the percent of subjects with reported epilepsy at 5 years

    Time frame: 5 years after enrollment

    The Percent of subjects reporting epilepsy by 5 years

  5. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as the percent of subjects with reported scoliosis at 5 years

    Time frame: at 5 years after enrollment

    Percent of subjects with reported scoliosis

  6. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as the percent of subjects with MECP2 mutations at 5 years

    Time frame: at 5 years after enrollment

    % of subjects with MECP2 mutations to 5 years

  7. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as reported by the mean Clinical Severity Scale (CSS) at 5 years

    Time frame: at 5 years after enrollment

    The CSS is the clinical severity scale.

  8. Clinical and neurobehavioral longitudinal assessments in Rett syndrome (RTT) as measured by the mean Motor Behavioral Assessment (MBA) at 5 years

    Time frame: at 5 years after enrollment

    the MBA is the motor behavioral (performance) score

  9. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: mean growth rate over 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    subject's height will be measured in inches at baseline and at 5 years. The change will be calculated and then the mean change will be reported.

  10. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: mean change in head circumference 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    the mean change in head circumference (measured in Centimeters) will be reported

  11. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: mean number of stereotypic movements in a 24 hour period at 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    The mean number of stereotypic movements in a 24 hour period at 5 years.

  12. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: percent of subjects reporting scoliosis 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    Percent of subjects with reported scoliosis

  13. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: percent of subjects surviving at 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    Percent of subjects surviving at 5 years after start of study

  14. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: the mean CSS score at 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    the CSS........

  15. Clinical and neurobehavioral longitudinal assessments in MECP2 duplication syndrome: the mean MAB score at 5 years with subjects having MECP2 duplication syndrome

    Time frame: at 5 years after enrollment

    the MBA........

Secondary outcomes

  1. Quality of Life Measures in RTT

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments for children (CHQ), the mean score will.be reported

  2. Quality of Life Measures in MECP2 duplication syndrome

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments for children (CHQ), the mean scores will be reported.

  3. Quality of Life Measures in RTT-related disorders.

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments for children (CHQ), the mean score will be reported.

  4. Quality of Life Measures in RTT

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments from the principal caregiver (SF-36), the mean score will be reported.

  5. Quality of Life Measures in MECP2 duplication syndrome

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments from the principal caregiver (SF-36), the mean score will be reported.

  6. Quality of Life Measures in RTT-related disorders

    Time frame: at 5 years post enrollment

    Summative data are provided by the quality of life assessments from the principal caregiver (SF-36), the mean score will be reported.

Sponsors and collaborators

Lead sponsor

University of Alabama at Birmingham

Other

Collaborators

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
  • National Center for Advancing Translational Sciences (NCATS)
  • National Institute of Neurological Disorders and Stroke (NINDS)
  • National Institutes of Health (NIH)
  • Rare Diseases Clinical Research Network

Registry information

Official study title

Rett Syndrome, MECP2 Duplication Disorder, and Rett- Related Disorders Natural History Protocol

Important dates

Study start
2015
Primary completion
2021
Study completion
2021
First posted
Apr 14, 2016
Registry last updated
Aug 5, 2021

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.

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