A disease concept model for STXBP1-related disorders.

STXBP1-related disorders developmental and epileptic encephalopathy disease concept model outcome measures quality of life

Journal

Epilepsia open
ISSN: 2470-9239
Titre abrégé: Epilepsia Open
Pays: United States
ID NLM: 101692036

Informations de publication

Date de publication:
06 2023
Historique:
received: 10 08 2022
accepted: 31 12 2022
medline: 5 6 2023
pubmed: 11 1 2023
entrez: 10 1 2023
Statut: ppublish

Résumé

STXBP1-related disorders are rare genetic epilepsies and neurodevelopmental disorders, but the impact of symptoms across clinical domains is poorly understood. Disease concept models are formal frameworks to assess the lived experience of individuals and their families and provide a basis for generating outcome measures. We conducted semistructured, qualitative interviews with 19 caregivers of 16 individuals with STXBP1-related disorders and 7 healthcare professionals. We systematically coded themes using NVivo software and grouped concepts into the domains of symptoms, symptom impact, and caregiver impact. We quantified the frequency of concepts throughout the lifespan and across clinical subgroups stratified by seizure history and developmental trajectories. Over 25 hours of interviews, we coded a total of 3626 references to 38 distinct concepts. In addition to well-recognized clinical features such as developmental delay (n = 240 references), behavior (n = 201), and seizures (n = 147), we identified previously underrepresented symptoms including gastrointestinal (n = 68) and respiratory symptoms (n = 24) and pain (n = 30). The most frequently referenced symptom impacts were autonomy (n = 96), socialization (n = 64), and schooling (n = 61). Emotional impact (n = 354), support (n = 200), and daily life & activities (n = 108) were highly cited caregiver impacts. We found that seizures were more commonly referenced in infancy than in other age groups, while behavior and socialization were more likely to be referred to in childhood. We found that caregivers of individuals with ongoing seizures were less likely to reference developmental delay, possibly due to the relatively high impact of seizures. STXBP1-related disorders are complex conditions affecting a wide range of clinical and social domains. We comprehensively mapped symptoms and their impact on families to generate a comprehensive disease model as a foundation for clinical endpoints in future trials.

Identifiants

pubmed: 36625631
doi: 10.1002/epi4.12688
pmc: PMC10235567
doi:

Substances chimiques

STXBP1 protein, human 0
Munc18 Proteins 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

320-333

Subventions

Organisme : NINDS NIH HHS
ID : U24 NS120854
Pays : United States
Organisme : NINDS NIH HHS
ID : K02 NS112600
Pays : United States

Informations de copyright

© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.

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Auteurs

Katie R Sullivan (KR)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Sarah M Ruggiero (SM)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Julie Xian (J)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Kim M Thalwitzer (KM)

The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Rahma Ali (R)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Sydni Stewart (S)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Mahgenn Cosico (M)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Jackie Steinberg (J)

STXBP1 Foundation, Apex, Holly Springs, North Carolina, USA.

James Goss (J)

STXBP1 Foundation, Apex, Holly Springs, North Carolina, USA.

Anna C Pfalzer (AC)

Vanderbilt University, Nashville, Tennessee, USA.

Kyle J Horning (KJ)

Vanderbilt University, Nashville, Tennessee, USA.
COMBINEDBrain, Brentwood, Tennessee, USA.

Nicole Weitzel (N)

Vanderbilt University, Nashville, Tennessee, USA.

Sydney Corey (S)

Vanderbilt University, Nashville, Tennessee, USA.

Laura Conway (L)

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Charlene Son Rigby (CS)

STXBP1 Foundation, Apex, Holly Springs, North Carolina, USA.

Terry Jo Bichell (TJ)

Vanderbilt University, Nashville, Tennessee, USA.
COMBINEDBrain, Brentwood, Tennessee, USA.

Ingo Helbig (I)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
The Epilepsy NeuroGenetics Initiative (ENGIN), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Biomedical and Health Informatics (DBHi), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

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Classifications MeSH