Diet Treatment Glucose Transporter Type 1 Deficiency (G1D)
Dietary Treatment of Glucose Transporter Type 1 Deficiency (G1D)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
Texas
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Dallas, Texas, United States, 75390
- University of Texas Southwestern Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of glucose transporter type I deficiency (G1D), confirmed by clinical genotyping at a CLIA-certified laboratory or by PET scan.
- Stable diet on either a modified atkins diet or on no dietary therapy (i.e., no dietary therapy for 1 month).
- Males and females 24 months to 35 years old, inclusive.
Exclusion Criteria:
- Subjects with evidence of independent, unrelated metabolic and/or genetic disease.
- Subjects with a chronic gastrointestinal disorder, such as irritable bowel syndrome, Crohn's disease, or colitis that could increase the subject's risk of developing diarrhea or stomach pain.
- Subjects with a BMI (body mass index) greater than or equal to 30.
- Subjects currently on dietary therapy (i.e., ketogenic diet, medium chain triglyceride supplemented diets, Atkins diet, low glycemic index diet).
- Subjects with no evidence of abnormal EEG (spike wave discharges) in the last 12 months.
- Women who are pregnant or breast-feeding may not participate. Women who plan to become pregnant during the course of the study, or who are unwilling to use birth control to prevent pregnancy (including abstinence) may not participate. Females age 10 and over will be asked to provide a urine sample for a pregnancy test via dipstick. Subjects will be asked to agree to abstinence or another form of birth control for the duration of the study.
- Allergy/sensitivity to C7.
- Previous use of triheptanoin in the past 1 month. Subjects who participate in Protocol 1 of this study are thus eligible.
- Subjects exhibiting signs of dementia, or diagnosed with any degenerative brain disorder (such as Alzheimer's disease) that would confound assessment of cognitive changes, in the opinion of the investigator.
- Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.
- Inability or unwillingness of subject or legal guardian/representative to give written informed consent, or assent for children age 10-17.
- Addition of a new antiseizure drug in the previous 3 months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Triheptanoin
This is a single arm study.
|
. Triheptanoin will be taken 4 times per day (approximately every 6 hours: prior to breakfast, lunch and dinner and a mid-afternoon snack) by mouth.
It is dosed 4 times per day, divided evenly.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Neuropsychological Score of Sustained Attention
Time Frame: Change post 6 months of treatment
|
Sustained attention was evaluated using a subtest of Conners' Kiddie Continuous Performance Test Second Edition (K-CPT 2): CPT-Hit Reaction Time Block Change.
CPT HRT BC indicates the change in mean response speed as the administration of the test progresses in blocks.
A decrease in CPT HRT BC indicates a decrease in reaction time, which means the participant's information processing efficiency increases, and an improvement in sustained attention is noted.
The number of participants that showed a decrease in the CPT HRT BC score after 6 months of treatment as compared to baseline is noted here.
|
Change post 6 months of treatment
|
|
Neuropsychological Score of Sustained Attention
Time Frame: Change after 3 months off treatment
|
Sustained attention was evaluated using a subtest of Conners' Kiddie Continuous Performance Test Second Edition (K-CPT 2): CPT-Hit Reaction Time Block Change.
CPT HRT BC indicates the change in mean response speed as the administration of the test progresses in blocks.
A decrease in CPT HRT BC indicates a decrease in reaction time, which means the participant's information processing efficiency increases, and an improvement in sustained attention is noted.
The off-treatment period of 3 months was implemented to study whether the impact of treatment persists or goes back to baseline.
The number of patients that displayed an increase in CPT HRT BC score (towards baseline) after 3 months off treatment as compared to 6 months on treatment is noted here.
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Change after 3 months off treatment
|
|
Neuropsychological Score of Working Memory Index Scale (WMI)
Time Frame: Change post 6 months of treatment
|
Subjects were administered the Working Memory Index Scale (WMI) from either the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition (WPPSI-IV), Wechsler Intelligence Scale for Children, 5th Edition (WISC-V), or the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) according to the age of subject.
An increase WMI score would indicate an improvement in the cognitive ability of identifying, reorganizing and retaining information for a brief period of time.
The number of participants that showed an increase in the WMI score after 6 months of treatment is noted here.
|
Change post 6 months of treatment
|
|
Neuropsychological Score of Working Memory Index Scale (WMI)
Time Frame: Change after 3 months off-treatment
|
Subjects were administered the Working Memory Index Scale (WMI) from either the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition (WPPSI-IV), Wechsler Intelligence Scale for Children, 5th Edition (WISC-V), or the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) according to the age of subject.
An increase WMI score would indicate an improvement in the cognitive ability of identifying, reorganizing and retaining information for a brief period of time.
The 3 months off-treatment period was designed to study whether the impact of treatment persists or goes back to baseline.
The number of participants that showed a decrease in the WMI score after 3 months off treatment as compared to 6 months on treatment was calculated.
|
Change after 3 months off-treatment
|
|
Neuropsychological Score of Processing Speed Index (PSI)
Time Frame: Change post 6 months of treatment
|
Subjects were administered the Processing Speed Index Scale (PSI) from either the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition (WPPSI-IV), Wechsler Intelligence Scale for Children, 5th Edition (WISC-V) or the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) according to the age of subject.
An increase PSI score would indicate an improvement in the motor-based estimate of the subject's cognitive processing speed.
The number of participants that showed an increase in the PSI score after 6 months of treatment as compared to baseline is noted here.
|
Change post 6 months of treatment
|
|
Neuropsychological Score of Processing Speed Index (PSI)
Time Frame: Change after 3 months off-treatment
|
Subjects were administered the Processing Speed Index Scale (PSI) from either the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition (WPPSI-IV), Wechsler Intelligence Scale for Children, 5th Edition (WISC-V) or the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) according to the age of subject.
An increase PSI score would indicate an improvement in the motor-based estimate of the subject's cognitive processing speed.
The 3 months off-treatment period was designed to study whether the impact of treatment persists or goes back to baseline.
The number of participants that showed a decrease in the WMI score after 3 months off treatment as compared to 6 months on treatment was calculated.
|
Change after 3 months off-treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
EEG Changes: Generalized Spike Wave Activity and Burst
Time Frame: Change post 6 months of treatment
|
The number of generalized spike wave (GSW) activity and bursts were extracted from the patient EEGs.
GSW and bursts per hour was calculated.
A decrease in the spike wave and burst indicated an improvement.
The number of patients that displayed a decrease in GSW and burst per hour after 6 months of treatment in noted here.
|
Change post 6 months of treatment
|
|
EEG Changes: Generalized Spike Wave Activity and Burst
Time Frame: Change after 3 months off-treatment
|
The number of generalized spike wave (GSW) activity and bursts were extracted from the patient EEGs.
GSW and bursts per hour was calculated.
A decrease in the spike wave and burst indicated an improvement.
The off-treatment period of 3 months was implemented to study whether the impact of treatment persists or goes back to baseline.
The number of patients that displayed an increase in GSW and burst per hour (towards baseline) after 3 months off treatment as compared to 6 months on treatment is noted here.
|
Change after 3 months off-treatment
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|
Brief Ataxia Rating Scale
Time Frame: Change post 6 months of treatment
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Ataxia is scored as per the Brief ataxia rating scale (BARS) - a modified form of the International Cooperative Ataxia Rating Scale (ICARS).
The possible range for the scores is from 0 (normal, no ataxia) to 30 (severe ataxia).
A decrease in the BARS score indicates an improvement in the ataxia symptoms.
The number of participants that showed a decrease in BARS score after 6 months of intervention is reported here.
|
Change post 6 months of treatment
|
|
Brief Ataxia Rating Scale
Time Frame: Change after 3 months off treatment
|
Ataxia is scored as per the Brief ataxia rating scale (BARS) - a modified form of the International Cooperative Ataxia Rating Scale (ICARS).
The possible range for the scores is from 0 (normal, no ataxia) to 30 (severe ataxia).
A decrease in the BARS score indicates an improvement in the ataxia symptoms.
The off-treatment period of 3 months was implemented to study whether the impact of treatment persists or goes back to baseline.
The number of participants that showed a subsequent increase in BARS score (towards baseline) after the of 3 months of no treatment as compared to 6 months on treatment are recorded here.
|
Change after 3 months off treatment
|
|
Clinical Global Impression Severity Scale
Time Frame: Change post 6 months of treatment
|
The Clinical global impression - Severity (CGI-S) scale is used to evaluate the illness severity where the scores range from 1 (very much improved) through to 7 (very much worse).
A decrease in the CGI-S score indicates a decrease in illness severity.
The number of participants that showed a decrease in CGI-S score after 6 months of intervention as compared to baseline is reported here.
|
Change post 6 months of treatment
|
|
Clinical Global Impression Severity Scale
Time Frame: Change after 3 months off-treatment
|
The Clinical global impression - Severity (CGI-S) scale is used to evaluate the illness severity where the scores range from 1 (very much improved) through to 7 (very much worse).
A decrease in the CGI-S score indicates a decrease in illness severity.
The off-treatment period of 3 months was designed to study whether the impact of treatment persists or goes back to baseline.
The number of participants that showed an increase in CGI-S score (towards baseline) after 3 months off treatment as compared to 6 months on treatment is reported
|
Change after 3 months off-treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Juan Pascual, MD, Study Principal Investigator
Publications and helpful links
General Publications
- Pascual JM, Liu P, Mao D, Kelly DI, Hernandez A, Sheng M, Good LB, Ma Q, Marin-Valencia I, Zhang X, Park JY, Hynan LS, Stavinoha P, Roe CR, Lu H. Triheptanoin for glucose transporter type I deficiency (G1D): modulation of human ictogenesis, cerebral metabolic rate, and cognitive indices by a food supplement. JAMA Neurol. 2014 Oct;71(10):1255-65. doi: 10.1001/jamaneurol.2014.1584.
- Pascual JM, Ronen GM. Glucose Transporter Type I Deficiency (G1D) at 25 (1990-2015): Presumptions, Facts, and the Lives of Persons With This Rare Disease. Pediatr Neurol. 2015 Nov;53(5):379-93. doi: 10.1016/j.pediatrneurol.2015.08.001. Epub 2015 Aug 10.
- Hao J, Kelly DI, Su J, Pascual JM. Clinical Aspects of Glucose Transporter Type 1 Deficiency: Information From a Global Registry. JAMA Neurol. 2017 Jun 1;74(6):727-732. doi: 10.1001/jamaneurol.2017.0298.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 122016-013
- 1R01NS094257-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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