Childhood Status Epilepticus and Epilepsy Determinants of Outcome (SEED)

儿童期癫痫持续状态和癫痫结果决定因素 (SEED)

基本信息

批准号：
10595075
负责人：
Michele Michele Ramsay
金额：
$ 70.42万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10595075
关键词：
Academic Medical Centers Accident and Emergency department Address Africa Africa South of the Sahara African Age Asia Awareness Benzodiazepines Biological Sciences Blood Brain imaging Candidate Disease Gene Caring Central Nervous System Infections Cessation of life Child Childhood Cities Clinical Cohort Studies Collaborations Collection Community Health Country DNA Data Data Collection Data Coordinating Center Development EEG-based imaging Electroencephalography Electronics Emergency Situation Enrollment Epilepsy Europe Family Frequencies Funding Future Gender Genetic Genomics Grant Hospitals Human Hypoglycemia Incidence Income Infant Laboratories Life Medical History Medical Records Molecular Morbidity - disease rate Neurologic Neurological emergencies Neurology Nigeria North America Outcome Pharmaceutical Preparations Phenotype Physicians Population Control Prevention Probability Publishing Randomized, Controlled Trials Recording of previous events Recurrence Research Resistance Rest Risk Risk Factors Seizures Site South Africa Specialist Standardization Status Epilepticus Survivors System Teaching Hospitals Technology Testing Training Treatment Protocols United States National Institutes of Health Universities Variant Video Recording Wit brain magnetic resonance imaging clinical predictors clinical risk cohort disability disability risk experience genome wide association study genomic data genomic predictors global health high risk human disease improved innovation insight low and middle-income countries modifiable risk mortality mortality risk pediatric emergency phenotypic data point of care screening treatment strategy

项目摘要

Abstract Status epilepticus (SE) is the most common serious neurological emergency among children worldwide. In the low- and middle-income countries (LMICs) of sub-Saharan Africa, the burden of childhood SE-associated mortality and morbidity appears to be especially high. However, the phenotypes of childhood SE, clinical predictors of SE-associated mortality and of SE-associated neurodevelopmental morbidity, and genomic predictors of SE, SE-associated mortality and neurodevelopmental morbidity have not been well-characterized in this region. The clinical and genomic predictors of benzodiazepine-resistant SE, which is common and may contribute to SE-associated mortality, have also not been well-characterized, especially among African children. A large percentage of children (~80%) with SE in northern Nigeria experience SE as their first seizure, and the estimated incidence of childhood SE in Kano is relatively high. Little is known of the clinical and genomic risk factors for the development of epilepsy among African children who experience SE as their first seizure. The H3Africa consortium is yielding insights into the genomic factors of common human diseases across the African continent and and will provide controls for genome-wide association studies (GWAS) of SE. This project, Childhood Status Epilepticus and Epilepsy Determinants of Outcome (SEED), will establish a large cohort of children with SE in Kano, northern Nigeria who present to pediatric emergency rooms in Kano. Innovative capacity building will include the incorporation of point-of-care EEG and EEG-video in large pediatric emergency rooms in Kano, performed by specially trained community health extension workers (CHEWs) who will be trained in both basic epilepsy care and EEG technology. A team of specialists working together at Aminu Kano Teaching Hospital (AKTH) and at Vanderbilt University Medical Center (VUMC) will utilize video exams, EEG-video, detailed histories, and brain MRI to perform deep phenotyping on this large cohort of children with SE. Clinical risk factors for in-hospital SE-associated mortality, short-term SE- associated mortality, long-term SE-associated mortality, and SE-associated neurodevelopmental morbidity will be determined. GWAS will be performed on the entire cohort, with gender matched controls from H3Africa, through collaborations between AKTH, Bayero University Kano, the Sydney Brenner Institute for Molecular Bioscience in South Africa, and VUMC. Genomic risk factors for childhood SE-associated mortality and morbidity will be determined, as well as clinical and genomic risk factors for development of epilepsy among children who experience SE as their first seizure and clinical and genomic risk factors for benzodiazepine- resistant SE. SEED will provide valuable insights into childhood SE in sub-Saharan Africa.

抽象的癫痫持续状态（SE）是全球儿童中最常见的严重神经系统紧急事件。在撒哈拉以南非洲的低收入和中等收入国家（LMIC），童年相关的负担死亡率和发病率似乎特别高。但是，儿童期SE的表型，临床 SE相关死亡率和SE相关神经发育发病率和基因组的预测因子 SE，SE相关死亡率和神经发育发病率的预测因素尚未得到充分表征在这个地区。抗苯二氮卓类SE的临床和基因组预测因子，这很常见，可能有助于SE相关死亡率，也没有得到充分的特征，尤其是在非洲孩子们。尼日利亚北部的SE的大部分儿童（〜80％）作为他们的第一次癫痫发作，卡诺儿童SE的估计发病率相对较高。对临床知之甚少与经历SE的非洲儿童癫痫发展的基因组风险因素首次癫痫发作。 H3AFRICA联盟正在洞悉常见人类疾病的基因组因素在整个非洲大陆，并将为SE的全基因组关联研究（GWAS）提供控制。该项目，癫痫持续状态和结果的癫痫决定因素（种子）将建立一个尼日利亚北部卡诺（Kano）的大批儿童与SE的儿童参加了卡诺（Kano）的儿科急诊室。创新的能力建设将包括大量的保健脑电图和脑电图纳由特殊培训的社区卫生扩展工人表演的卡诺的儿科急诊室（咀嚼）将接受基本癫痫护理和脑电图技术的培训。一个专家团队在Aminu Kano教学医院（AKTH）和Vanderbilt大学医学中心（VUMC）一起利用视频考试，EEG-VIDEO，详细的历史和大脑MRI在此大型上进行深度表型 SE的儿童队列。院内SE相关死亡率的临床危险因素，短期SE- 相关的死亡率，长期SE相关死亡率和SE相关神经发育发病率将可以确定。 GWAS将在整个队列上进行，并具有来自H3africa的性别匹配的控件，通过AKTH，Bayero University Kano之间的合作，悉尼Brenner分子研究所南非的生物科学和VUMC。儿童期SE相关死亡率的基因组危险因素和将确定发病率，以及临床和基因组危险因素的发展癫痫发展经历SE作为苯二氮卓的首次癫痫发作，临床和基因组危险因素的儿童抗性SE。种子将为撒哈拉以南非洲的儿童SE提供宝贵的见解。