The purpose of this project is to study the efficacy of triheptanoin oil in patients with Alternating Hemiplegia of Childhood (AHC) due to ATP1A3 gene mutation.
The clinical spectrum of Alternating Hemiplegia of Childhood (AHC) is wide and characterized by the association of permanent and paroxysmal (palsy, dystonia, ocular, epileptic, dysautonomic events) neurological events, with onset in childhood. Most of AHC patients carry mutations in the ATP1A3 gene. This gene encodes the Na+/K+ ATPase witch is a transmembrane ion pump generating chemical and electrical gradient of sodium and potassium across the plasma membrane. Those paroxystic events in AHC patients with mutations in the ATP1A3 gene could be associated with a glucidic/energetic metabolism or intracerebral excitability disorder. Triheptanoin is a triglyceride, whose derivatives pass the blood - brain barrier and enhance the Krebs cycle functions. Triheptanoin could therefore allow energy supply to the brain, which is essential for the functioning of the Na+/ K+ ATPase that consumes a significant amount of energy in the brain. The investigators goal is to do a pilot study to test the effectiveness on paroxystic manifestations and the safety of triheptanoin in a small group of patients with Alternating Hemiplegia of Childhood secondary to ATP1A3 mutations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
10
Triheptanoin is a triglyceride composed of three heptanoate (C7 fatty acid) esters. Triheptanoin is manufactured by chemical synthesis from glycerol and heptanoic acid. Triheptanoin is a liquid, intended for oral (PO) administration. Participants will be given approximately 1g/kg of Triheptanoin divided at least in three doses (at 8 am, 12 noon, and 8 pm). A one-day titration period will be used, using 0.5 g/kg increments before arriving at the full dose.
Placebo is a oily liquid, intended for oral (PO) administration. Participants will be given approximately 1g/kg of Placebo divided at least in three doses (at 8 am, 12 noon, and 8 pm). A one-day titration period will be used, using 0.5 g/kg increments before arriving at the full dose.
Groupe hospitalier Pitié Salpêtrière
Paris, France
Number of neurologic paroxystic events report in patient diary
visit 1 at day 0, visit 2 at week 12, visit 3 at week 16, visit 4 at week 28
Time frame: 7 months
Composite score allying the number of neurological paroxystic events, their duration and severity.
visit 1 at day 0, visit 2 at week 12, visit 3 at week 16, visit 4 at week 28
Time frame: 7 months
Clinical Global Impression Scales - Improvement
visit 2 at week 12, visit 4 at week 28
Time frame: 7 months
The Short Form (36) Health Survey
visit 1 at day 0, visit 2 at week 12, visit 3 at week 16, visit 4 at week 28
Time frame: 7 months
Brain 31phosphorus magnetic resonance spectroscopy
Ratio of Inorganic Phosphate (Pi) over Phosphocreatine during visual stimulation visit 2 at week 12, visit 4 at week 28
Time frame: 7 months
Clinical Safety as measured by questionnaire
visit 2 at week 12, visit 4 at week 28
Time frame: 7 months
Biological Safety as measured by acylcarnitine profile, organic acid dosage
visit 2 at week 12, visit 4 at week 28
Time frame: 7 months
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