Brain P-gp and Inflammation in People With Epilepsy

Completed

Conditions studied: Epilepsies, Partial

In brief

Background: * The brain is protected by a barrier that keeps toxins in the blood from reaching the brain. However, this barrier can also keep useful medications from reaching the brain. P-glycoprotein (P-gp) is a brain protein that is part of the blood-brain barrier. The level of P-gp is higher in people with epilepsy than in people without epilepsy. These different levels of P-gp may explain why some people have seizures that do not respond well to medications. Researchers want to see if P-gp can affect the response to epilepsy medications. * Epilepsy may also be associated with brain inflammation. Researchers also want to look at the part of the brain affected by epilepsy to see if inflammation is present. Objectives: * To see if P-gp can affect the response to epilepsy medications. * To see if inflammation is present in the part of the brain affected by epilepsy. Eligibility: * \<TAB\>Individuals between 18 and 60 years of age who have temporal lobe epilepsy. We plan to study some patients whose seizures are well controlled by drugs, and some whose seizures are not controlled. * \<TAB\> * Healthy volunteers between 18 and 60 years of age. Design: * This study requires four or five visits to the NIH Clinical Center over the course of a year. The visits will be outpatient visits and will last from 2 to 5 hours. * Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected. * All participants will have two positron emission tomography (PET) scans. The scans will take place during different visits. Different drugs will be used in each scan. One drug will be used to temporarily block the effect of P-gp in the brain. The other drug will show areas of inflammation in the brain. * Participants with epilepsy will have a third PET scan. This scan will also look at P-gp activity in the brain. However, it will not use the drug that blocks the effect of P-gp. * All participants will also have one magnetic resonance imaging scan. This scan will help show brain function.

Key facts

Study ID

NCT01663545

Run by

National Institute of Neurological Disorders and Stroke (NINDS)

People needed

38

Starts

2012-07-31

Expected to finish

2017-10-04

Last updated by the study team

2018-07-05

Who can join

Age: 18 and older, up to 60. Sex: any. Healthy volunteers: accepted.

You may not qualify if…

• For patients
• Previous research radiation exposure (X-rays, PET scans etc.) that, together with study procedures, would exceed the NIH RSC 5 rad per year research limit.
• Claustrophobia to a degree that the subject would feel uncomfortable in the MRI machine.
• History of brain disease other than epilepsy.
• Cannot lie on their back for at least two hours.
• Serious medical illness, other than epilepsy.
• Clinically significant laboratory abnormalities.
• Brain abnormality such as a brain tumor, infection, stroke, brain damage from head trauma or blood vessel abnormalities, on an MRI scan.
• Pregnancy or breast feeding.
• Able to get pregnant but does not use birth control.
• Risk for MRI scan, such as a pacemaker or other implanted electrical devices, brain stimulators, some types of dental implants, aneurysm clips (metal clips on the wall of a large artery), metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pump, or shrapnel fragments. Welders and metal workers are also at risk for injury because of possible small metal fragments in the eye of which they may be unaware.
• PBR28 non-binders.
• For drug-responsive subjects: occurrence of a seizure within the last three months.
• NIH employee or staff member
• For healthy volunteers
• Clinically significant laboratory abnormalities.
• Unable to have a MRI scan.
• History of neurologic illness or injury with the potential to affect study data interpretation.
• History of seizures, other than in childhood and related to fever.
• Previous research radiation exposure (X-rays, PET scans etc.) that, together with study procedures, would exceed the NIH RSC 5 rad per year research limit.
• Inability to lie flat on camera bed for at least two hours.
• PBR28 non-binders
• Pregnancy or breast feeding.
• Able to get pregnant but does not use birth control.
• NIH employee or staff member

Where it is running

• National Institutes of Health Clinical Center, 9000 Rockville Pike — Bethesda, Maryland, United States

Full record on ClinicalTrials.gov

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