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Evaluating the Role of Inflammation in Neonatal Epileptogenesis

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状态招聘中
赞助商
University of California, San Francisco
合作者
University of Michigan
Boston Children’s Hospital
UCSF Benioff Children’s Hospital Oakland

关键词

抽象

The purpose of this study evaluate the relationship between inflammation and epilepsy in neonates with seizures after birth.

描述

Seizures are a common symptom of neurologic dysfunction in the neonatal period, affecting more than 16,000 newborns in the United States per year. Over 25% of neonates with acute symptomatic seizures develop post- neonatal epilepsy (PNE), which is often resistant to medical therapies. There is a critical need to identify those patients most at risk for PNE and understand the mechanisms by which early seizures increase the propensity for recurrent seizures, in hopes of identifying novel therapeutic targets in this population. There is increasing evidence for the role of neuro-inflammation in the development of epilepsy. Levels of cytokines and micro-RNA (miRNA) may serve as markers of disease severity and have been implicated in epileptogenesis in animal models. The purpose of this study is to evaluate plasma cytokine and miRNA levels after neonatal-onset acute symptomatic seizures and determine their association with acute seizure severity and PNE.

日期

最后验证: 05/31/2020
首次提交: 02/03/2020
提交的预估入学人数: 02/03/2020
首次发布: 02/05/2020
上次提交的更新: 06/11/2020
最近更新发布: 06/15/2020
实际学习开始日期: 12/14/2018
预计主要完成日期: 05/30/2023
预计完成日期: 11/29/2023

状况或疾病

Neonatal Seizure
Epilepsy
Seizures
Inflammatory Response

干预/治疗

Diagnostic Test: Blood draw

Other: Acute symptomatic seizures

-

手臂组

干预/治疗
Acute symptomatic seizures
This is a cohort of 72 participants who will be enrolled into this study from the neonatal intensive care unit (NICU) after being diagnosed with seizures. They will be asked to contribute a blood specimen obtained within 24-72 hours after seizures are diagnosed, to participate in an optional blood draw at 2-4 months of age, and to complete surveys at 12 & 24 months of age.
Other: Acute symptomatic seizures
Regarding epilepsy and development.
Control
This is a cohort of 15 participants who will be enrolled into this study from the neonatal intensive care unit (NICU) after having an EEG for possible seizures, but found to have a normal EEG. They will be asked to contribute a blood specimen obtained within 24-96 hours after birth.

资格标准

有资格学习的性别All
取样方式Non-Probability Sample
接受健康志愿者没有
标准

For participants in the acute symptomatic seizure group:

Inclusion Criteria:

- Neonates <44 weeks corrected age at seizure onset

- Seizures due to acute brain injury

- Parent(s) who are English or Spanish literate (with assistance of interpreter)

Exclusion Criteria:

- Neonates at risk for adverse outcome independent of seizures and underlying brain injury

- Neonates with mild, temporary causes for seizures

- Newborns with neonatal-onset epilepsy syndromes

- Neonates who do not survive the initial hospital admission

- Neonates will not be excluded based on race, ethnicity, gender or gestational age

For participants in the control group:

Inclusion Criteria:

- Neonates that are born > 37 weeks and <44 weeks gestational age

- Neonates referred for video-EEG monitoring for spells, with normal EEG AND normal neuroimaging (head ultrasound or MRI)

- Neonates considered for cooling but felt not to meet formal criteria for hypoxic ischemic encephalopathy

结果

主要结果指标

1. Seizure burden [At study entry]

Investigators will evaluate the seizure burden from the initial diagnostic electroencephalogram (EEG) after birth by determining the average number of seizures per hour.

2. Percentage of participants diagnosed with epilepsy [24 months of age]

The investigators will determine the proportion of participants who develop clinical and or electrographic seizures.

次要成果指标

1. Percentage of participants diagnosed with epilepsy [12 months of age]

The investigators will determine the proportion of participants who develop clinical and or electrographic seizures.

2. Epilepsy Severity [12 months of age]

The investigators will administer an investigator-developed questionnaire designed to define the frequency of seizures (monthly, weekly, daily, or greater than daily).

3. Epilepsy Severity [24 months of age]

The investigators will administer an investigator-developed questionnaire designed to define the frequency of seizures (monthly, weekly, daily, or greater than daily).

4. Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) [Assessment takes up to 15 minutes and will be conducted at 12 months of age]

The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) will be assessed at 12 months of age. The score ranges from 50 to 200 with higher scores associated with normal development.

5. Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) [Assessment takes up to 15 minutes and will be conducted at 24 months of age]

The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) will be assessed at 24 months of age. The score ranges from 50 to 200 with higher scores associated with normal development.

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