|
|
![]() |
![]() |
![]() |
![]() |
|
![]() |
|
![]() |
|
![]() |
|
![]() |
![]() |
![]() |
|
![]() |
|||||||||||||||||||||||||||||||||||||||||||||
| Sponsored by: |
National Institute of Child Health and Human Development (NICHD) |
| Information provided by: | National Institute of Child Health and Human Development (NICHD) |
| ClinicalTrials.gov Identifier: | NCT00069550 |
Purpose
Rett syndrome (RTT) is a disorder in which the nervous system does not develop properly. RTT generally affects girls, but there are some boys who have been diagnosed with RTT. Symptoms of RTT include small brain size, poor language skills, repetitive hand movements, and seizures. This study will evaluate the effectiveness of two drugs in treating the symptoms of RTT.
| Condition | Intervention | Phase |
|
Rett Syndrome |
Drug: dextromethorphan Drug: donepezil hydrochloride |
Phase III |
| Genetics Home Reference related topics: | familial encephalopathy with neuroserpin inclusion bodies L1 syndrome Rett syndrome |
| MedlinePlus related topics: | Rett Syndrome |
| ChemIDplus related topics: | Donepezil E 2020 Dextromethorphan Dextromethorphan hydrobromide Levomethorphan Racemethorphan Glutamic acid |
| Study Type: | Interventional |
| Study Design: | Treatment, Randomized, Open Label, Dose Comparison, Factorial Assignment, Efficacy Study |
| Official Title: | Pathogenesis of Rett Syndrome: Natural History and Treatment |
| Estimated Enrollment: | 90 |
| Study Start Date: | September 2004 |
| Estimated Study Completion Date: | June 2008 |
RTT is a neurodevelopmental disorder characterized by apparently normal early development followed by loss of purposeful hand use, distinctive hand stereotypies, slowed brain growth, loss of language, respiratory irregularities, GI disturbances, gait abnormalities, seizures, and mental retardation. These symptoms appear between ages 6 and 18 months (stage 2 of the disease) following apparently normal development (stage 1). Subsequently, there is gradual stabilization of severe mental retardation and motor compromise (stage 3). The majority (70% to 80%) of patients demonstrate mutations in the methyl-CpG-binding-protein-2 (MeCP2) gene, a transcription repressor located on chromosome Xq28. The disorder predominantly affects females, but a few males with mutations in MeCP2 have been identified, even though many of them do not have the classic symptoms recognized in females.
Recent studies demonstrate increased brain N-methyl-D-aspartate (NMDA) receptors in stages 2 and 3 of the disease. This age-specific increase in glutamate levels and their receptors contribute to brain damage. This first study will examine the effectiveness of dextromethorphan, an NMDA receptor antagonist, to ameliorate symptoms. Participants will be randomized to receive one of three doses of dextromethorphan. All participants will be admitted to the hospital for three days at the beginning of the study. During the hospitalization, participants will undergo physical exam, Dexascan, MRI, EEG, behavioral assessment, laboratory testing, and neuropsychological evaluations. Six months after baseline assessment, participants will be rehospitalized for 3 days for similar assessments.
Reduction in choline acetyltransferase activity in RTT patients may also contribute to disturbed cortical development and psychomotor retardation in RTT. Therefore, the second part of the study will evaluate the effect of donepezil hydrochloride, an inhibitor of acetylcholine-esterase, on acetylcholine levels. This portion of the study will not begin until pharmacokinetic data for donepezil in children is available.
Eligibility
| Ages Eligible for Study: | 1 Year to 15 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria
Exclusion Criteria
Contacts and Locations| Contact: SakkuBai R. Naidu, MD | 443-923-2778 | |
| Contact: Barbara Ann Bradford | 443-923-2778 | bradford@kennedykrieger.org |
| United States, Maryland | |||||
| Kennedy Krieger Institute | Recruiting | ||||
| Baltimore, Maryland, United States | |||||
| Contact: SakkuBai R. Naidu, MD 443-923-2778 | |||||
| Contact: Genila Bibat, MD 443-923-2778 bibat@kennedykrieger.org | |||||
| Principal Investigator: | SakkuBai R. Naidu, MD | Kennedy-Krieger Research Institute |
More Information
| Study ID Numbers: | HD024448, 5 PO1 HD024448 |
| First Received: | September 29, 2003 |
| Last Updated: | June 23, 2005 |
| ClinicalTrials.gov Identifier: | NCT00069550 |
| Health Authority: | United States: Food and Drug Administration |
|
|
|
|
|