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Neurophysiologic Biomarkers in Rett Syndrome

Recruiting
Conditions
RTT
Rett Syndrome, Atypical
Rett Syndrome
Interventions
Other: EEG and Auditory and Visual Evoked Potentials (AEP and VEP)
Other: Clinical assessment
Registration Number
NCT05932589
Lead Sponsor
Children's Hospital of Philadelphia
Brief Summary

The goal of this observational study is to identify candidate biomarkers in individuals with Rett Syndrome (RTT). The main questions it aims to answer are:

* Do these biomarkers change during clinical changes in individuals with RTT?

* Are biomarkers stable over time in clinically stable individuals?

* Do these biomarkers correlate with severity of RTT?

Participants will be asked to undergo an electroencephalogram (EEG) with measurements of Evoked Potentials (EP) to measure electrical activity in the brain.

Researchers will compare findings in individuals with RTT to those in typically developing individuals to see if there are differences between the two groups.

Detailed Description

The main goal of the project is to identify potential biomarkers that can become measures for intervention and other translational studies and, at the same time, provide insight into abnormal synaptic activity and pathogenesis of RTT. Therefore, the proposed assessments will be performed with females with RTT and age matched typically developing females. These electrophysiological assessments will be compared to established clinical outcome measures from previous work in the NIH funded Rett and Rett related disorders natural history study. The neurophysiological parameters for RTT will be correlated with each other and also to disease staging, overall clinical severity scores and through exploratory analyses with specific clinical features. The investigators will also be testing procedures to perform the recordings, electrode types and placement, and ways to reduce movement and artifact within the data to establish best practices.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
202
Inclusion Criteria
  1. Rett Group: Females ages 3-18 (inclusive) with a clinical diagnosis of RTT with a likely pathogenic or known pathogenic variant in MECP2.
  2. Likely Rett Group: Females from 1 year to < 5 years of age with MECP2 variant if regression has not yet occurred or child is within 6 months of last skill loss.
  3. Typically developing (TD) Group: Females age matched to RTT population (1-18) with no developmental or cognitive concerns as assessed using the Child/Adult Behavioral Checklist, Survey of Well-Being of Young Children (<5yo), or the Wide Range Achievement Test-4 (>5 yo).
Exclusion Criteria

Rett and Likely Rett Groups:

  1. Presence of a duplication in MECP2 or any other identified pathogenic mutation in another gene.
  2. Active medical conditions not typically found in RTT.

Typically Developing Group:

  1. Score below norms on the performance tests
  2. Have a known neurological disorder (excluding migraine)
  3. Being on neuroactive medications.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
RTT FemalesEEG and Auditory and Visual Evoked Potentials (AEP and VEP)Females with Rett Syndrome
RTT FemalesClinical assessmentFemales with Rett Syndrome
ControlsEEG and Auditory and Visual Evoked Potentials (AEP and VEP)Females with typical development
Primary Outcome Measures
NameTimeMethod
Visual Evoked Potential (VEP) amplitude5 years

N1-P1 amplitude at Oz and other occipital electrodes will be calculated.

Auditory Evoked Potential (AEP) amplitude5 years

Amplitude of P1, P2 and N1 peaks (uV)

EEG Analysis5 years

EEG Root mean square (RMS) amplitude, Amplitude variability, 1/f constant, power bands in typical bands (Delta, theta, alpha, Beta, gamma) and ratios will be calculated.

Auditory Evoked Potential (AEP) latency (ms)5 years

Calculated N1, P1 latencies in Cz and other electrodes \[posterior temporal region (T5/P3/T3) electrodes\], will be used for analysis.

Visual Evoked Potential (VEP) latencies (ms)5 years

The latencies of the N1, P1, and N2 components will be identified primarily at occipital electrodes with Oz will be the primary electrode of analysis. N1-P1 time will be analyzed.

Secondary Outcome Measures
NameTimeMethod
VEP spectral analysis, dipole determination and spatial distribution5 years

spectral analysis of the individual waveforms, dipole determination of N1 and P1 peaks and spatial distribution of peak values.

AEP spectral analysis, dipole determination and spatial distribution5 years

spectral analysis of the individual waveforms, dipole determination of N1 and P1 peaks and spatial distribution of peak values.

Trial Locations

Locations (6)

Children's Hospital of Los Angeles

🇺🇸

Los Angeles, California, United States

Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

Boston Children's Hospital

🇺🇸

Brookline, Massachusetts, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

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