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EpilepsyNCT04292093

Efficacy Study of a Neuropsychological Rehabilitation Intervention for Children With Non-symptomatic Epilepsy

A study testing Home rehabilitation training in people with Epilepsy, run by IRCCS Eugenio Medea.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Patients with non-symptomatic epilepsy, even in the presence of a normative cognitive functioning, present different levels of neuropsychological weaknesses, especially in executive functions and social competences. Such difficulties can significantly influence academic achievement and social inclusion. Read more about this study

Who is it for?
Ages 7 to 18 years
Conditions the study is for
Epilepsy
What is being tested?
Home rehabilitation training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
No sites listed yet
Study dates
1 May 2020to 28 Feb 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 7 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Clinical diagnosis of non-symptomatic epilepsy;
  • Absence of intellectual disability (total IQ> 70);
  • Absence of significant visual, auditory or motor impairments that may prevent the use of the computerized training;
  • Basic ability to use PC.

Who cannot join

  • Presence of psychiatric comorbidity and / or behavioral disturbances that may hamper the participation to training sessions;
  • Diagnosis of photosensitive epilepsy.

Trial locations and contacts

No sites are listed yet.

Alessandra Bardoni, MD, PhD contact

+39 031877111

alessandra.bardoni@lanostrafamiglia.it

About this study

Official title: Studio di Efficacia di Percorsi di Riabilitazione Neuropsicologica Tramite Piattaforma Lumosity: Evidenze Comportamentali e Neurofisiologiche in Pazienti Con Epilessia Non Sintomatica in età Pediatrica

Patients with non-symptomatic epilepsy, even in the presence of a normative cognitive functioning, present different levels of neuropsychological weaknesses, especially in executive functions and social competences. Such difficulties can significantly influence academic achievement and social inclusion. To date, there is limited evidence on small samples that training focusing on executive functions, also through tele-rehabilitation methods, may be effective in limiting these difficulties. Therefore, the purpose of this research project is to evaluate the effectiveness of a training of the executive functions (administered via the Lumosity platform) in patients with non-symptomatic focal and generalized epilepsy. A cognitive and behavioral assessment will be performed before and after the treatment to evaluate its efficacy. Moreover, a predefined neurophysiological marker will be recorded before and after treatment to detect changes in cortical activity which may reflect expected treatment effects.

Read the detailed description

First, all eligible patients will be screened for inclusion and exclusion and will be assigned to the experimental group and the control group. The experimental group will participate in a remote rehabilitation program via Lumosity platform, providing video-games aimed at strengthening specific cognitive functions for 30 minutes a day, 5 days a week, for a total of 8 weeks. The control group will watch a series of animated / TV shows, again for 30 minutes a day, 5 days a week, for 8 weeks. Once a week the patient (or his family) will be contacted by the researcher to check the progress of the treatment. All patients will be evaluated within a week before the start of treatment and after the end of treatment with a standardized neuropsychological assessment battery (NEPSY-II) designed to evaluate the effects of the treatment. Patients (or their parents according to participants' age) will also compile a questionnaire to assess behavioral problems (CBCL); a questionnaire for the assessment of cognitive functions in an ecological context (BRIEF-2); a quality of life questionnaire (TACQOL) and ad-hoc treatment appreciation questionnaire. In addition to the cognitive-behavioral assessment, specific parameters of cortical activity will be recorded (via EEG), in order to evaluate any changes in predefined neurophysiological markers able to reflect the effects of the treatment. Evidence gathered from the literature reports that the relationship between theta and beta waves (the so-called theta/beta ratio) may be considered an index of a behavioral adaptation deficit in populations with poor executive control. Therefore, this index appears to be the ideal candidate to detect changes in cortical activity which may underlay behavioral effects of home rehabilitation treatment. Thus, resting-state cortical activity will be recorded before and after the treatment.

Conditions
Epilepsy
Being tested
Home rehabilitation training, Home control activity
Keywords
Epilepsy, Children, Rehabilitation, Executive Functions
Medical subject headings
Epilepsy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Home rehabilitation trainingBehavioural

    The rehabilitation training will be provided via Lumosity platform. Participants will be asked to play computer video-games aimed at strengthening specific sub-functions pertaining to the macro area of executive functions for 30 minutes a day, 5 days a week, for a total of 8 weeks. Specifically, 20 games out of a total of 64 available games provided by the platform have been selected. The selected games are aimed at training 4 cognitive skills: memory, attention, cognitive flexibility and problem solving. In particular, 5 different games were chosen for each cognitive ability.

  • Home control activityBehavioural

    The control group will watch a series of animated / TV shows suitable for the sample age, again for 30 minutes a day, 5 days a week, for 8 weeks. The videos will be provided by the experimenter and participants will watch them on their personal computer. At the end of each videos, participants will answer a series of multiple-choice questions aimed at evaluating the attention deployed to the content of the videos.

Study groups in NCT04292093
Study groupRoleWhat they receive
Home rehabilitation trainingExperimentalHome rehabilitation training
Receives: Behavioral: Home rehabilitation training
Home control activityActive comparatorHome control activity
Receives: Behavioral: Home control activity

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. NEPSY-II Neuropsychological Battery

    Assessment of executive functions, language, memory and visuo-spatial skills

    Subscales (all subscales range from 1 to 19 scalar scores):

    • Design fluency, raw score 0/70
    • Auditory attention, 0/30 and Response Set 0/36
    • Inhibition (denomination 0/80 - 0/360') (inhibition 0/80 - 480') (switching 0/80 - 480') REVERSE (higher raw scores indicate worse perfomance)
    • Animal sorting, 0/12
    • Word generation, 0/75
    • Memory for faces, 0/32
    • Word list interference (repetition 0/20; recall 0/40)
    • Imitating hand position, (0/24)
    • Visuo-motor precision (0/307; 0/360') REVERSE (higher raw scores indicate worse perfomance)
    • Manual motor sequences, 0/60
    • Affect recognition, 0/35
    • Design copying (general 0/21; motor 0/42; global 0/42; local 0/36; total specific 0/120)
    • Picture puzzles, 0/20
    • Geometric puzzles, 0/40

    Measured: baseline

  2. Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV)

    Assessment of general intellectual ability. Indexes (higher T scores indicate better perfomance for all indexes)

    • Verbal Comprehension Index (40/160)
    • Fluid Reasoning Index (40/160)
    • Working Memory Index (40/160)
    • Processing Speed Index (40/160)
    • Full Scale IQ (40/160)

    Measured: baseline

  3. NEPSY-II Neuropsychological Battery (change)

    Assessment of executive functions, language, memory and visuo-spatial skills

    Measured: within 1 week after intervention

  4. NEPSY-II Neuropsychological Battery (change)

    Assessment of executive functions, language, memory and visuo-spatial skills

    Measured: 3 month after intervention

Secondary outcomes (15)
  1. Child Behavior Checklist (CBCL) (parent compiled for 6-18 years old participants)

    Questionnaire for the assessment of emotional and behavioural problems.

    The CBCL 6-18 is aimed at assessing psychological adjustment and behavioral functioning of children, as rated by parents. This instrument provides a total score, an internalizing score and an externalizing score, together with 8 syndrome scale scores and 6 DSM-oriented scale scores. It contains 113 items. Raw scores of the Total Problems Scale range from 0 to 226. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: baseline

  2. Youth Self Report (CBCL self-report version for 11-18 years old participants)

    Questionnaire for the assessment of emotional and behavioural problems.

    YSR 11-18 is direcly compiled by adolescents aged 11-18 years. It provides a total score, an internalizing score and an externalizing score, together with eight empirically based syndromes and DSM-oriented scales. It contains 112 items. Raw scores of the Total Problems Scale range from 0 to 224. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: baseline

  3. The Children's Quality of Life (TACQOL)

    Questionnaire for the assessment of health-related quality of life.

    Scales (higher raw scores indicate higher quality of life)

    • Body (physical functioning) 0/32
    • Motor functioning 0/32
    • Autonomy 0/32
    • Social functioning 0/32
    • Cognition 0/32
    • Emotions (positive) 0/16
    • Emotions (negative) 0/16

    Measured: baseline

  4. Behavior Rating Inventory of Executive Function (BRIEF-2) (parent compiled for 5-10 years old participants; self-report version for 11-18 years old participants)

    Questionnaire for the assessesment of executive function and self-regulation competence.

    The BRIEF (parent version) questionnaire is aimed at assessing executive functioning at home and school and contains 63 items. Raw scores of the global scale range from 63 to 189; T scores (M = 50, SD = 10). The self-report version contains 55 items. Raw scores of the global scale range from 55 to 165; T scores (M = 50, SD = 10). Higher scores mean a worse outcome.

    Subscale and Indexes

    • Inhibit
    • Shift
    • Self-Monitor
    • Emotional Control
    • Initiate
    • Working Memory
    • Plan/Organize
    • Behavioral regulation Index
    • Emotion regulation Index
    • Cognitive regulation Index
    • Global Executive Index

    Measured: baseline

  5. Theta/beta ratio

    Low theta/beta ratio is a cortical activity considered an index of poor attentional resources. Its recording will be conducted with a 32-channels EEG system at rest (4 minutes: 2 min eyes open and 2 min eyes closed).

    Measured: baseline

  6. Child Behavior Checklist CBCL (change)

    Questionnaire for the assessment of emotional and behavioural problems

    The CBCL 6-18 is aimed at assessing psychological adjustment and behavioral functioning of children, as rated by parents. This instrument provides a total score, an internalizing score and an externalizing score, together with 8 syndrome scale scores and 6 DSM-oriented scale scores. It contains 113 items. Raw scores of the Total Problems Scale range from 0 to 226. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: within 1 week after intervention

  7. Youth Self Report (CBCL self-report version for 11-18 years old participants)

    Questionnaire for the assessment of emotional and behavioural problems.

    YSR 11-18 is direcly compiled by adolescents aged 11-18 years. It provides a total score, an internalizing score and an externalizing score, together with eight empirically based syndromes and DSM-oriented scales. It contains 112 items. Raw scores of the Total Problems Scale range from 0 to 224. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: within 1 week after intervention

  8. The Children's Quality of Life TACQOL (change)

    Questionnaire for the assessment of health-related quality of life. Scales (higher raw scores indicate higher quality of life)

    • Body (physical functioning) 0/32
    • Motor functioning 0/32
    • Autonomy 0/32
    • Social functioning 0/32
    • Cognition 0/32
    • Emotions (positive) 0/16
    • Emotions (negative) 0/16

    Measured: within 1 week after intervention

  9. Behavior Rating Inventory of Executive Function (BRIEF-2) (change)

    Questionnaire for the assessesment of executive function and self-regulation competence.

    The BRIEF (parent version) questionnaire is aimed at assessing executive functioning at home and school and contains 63 items. Raw scores of the global scale range from 63 to 189; T scores (M = 50, SD = 10). The self-report version contains 55 items. Raw scores of the global scale range from 55 to 165; T scores (M = 50, SD = 10). Higher scores mean a worse outcome.

    Subscale and Indexes

    • Inhibit
    • Shift
    • Self-Monitor
    • Emotional Control
    • Initiate
    • Working Memory
    • Plan/Organize
    • Behavioral regulation Index
    • Emotion regulation Index
    • Cognitive regulation Index
    • Global Executive Index

    Measured: within 1 week after intervention

  10. Theta/beta ratio (change)

    Low theta/beta ratio is a cortical activity considered an index of poor attentional resources. Its recording will be conducted with a 32-channels EEG system at rest (4 minutes: 2 min eyes open and 2 min eyes closed).

    Measured: within 1 week after intervention

  11. Ad-hoc compliance to treatment questionnaire

    A 5 items of a 5-point Likert questionnaire created ad-hoc for the assessment of the compliance to the treatment.

    Higher scores indicare better compliance (except for item 4)

    Measured: within 1 week after intervention

  12. Child Behavior Checklist CBCL (change)

    Questionnaire for the assessment of emotional and behavioural problems

    The CBCL 6-18 is aimed at assessing psychological adjustment and behavioral functioning of children, as rated by parents. This instrument provides a total score, an internalizing score and an externalizing score, together with 8 syndrome scale scores and 6 DSM-oriented scale scores. It contains 113 items. Raw scores of the Total Problems Scale range from 0 to 226. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: 3 months after intervention

  13. Youth Self Report (CBCL self-report version for 11-18 years old participants)

    Questionnaire for the assessment of emotional and behavioural problems.

    YSR 11-18 is direcly compiled by adolescents aged 11-18 years. It provides a total score, an internalizing score and an externalizing score, together with eight empirically based syndromes and DSM-oriented scales. It contains 112 items. Raw scores of the Total Problems Scale range from 0 to 224. T scores (M = 50, SD = 10) are used to interpret the level of behavioral functioning. Higher scores mean a worse outcome.

    Measured: 3 month after intervention

  14. The Children's Quality of Life TACQOL (change)

    Questionnaire for the assessment of health-related quality of life.

    Scales (higher raw scores indicate higher quality of life)

    • Body (physical functioning) 0/32
    • Motor functioning 0/32
    • Autonomy 0/32
    • Social functioning 0/32
    • Cognition 0/32
    • Emotions (positive) 0/16
    • Emotions (negative) 0/16

    Measured: 3 months after intervention

  15. Behavior Rating Inventory of Executive Function (BRIEF-2) (change)

    Questionnaire for the assessesment of executive function and self-regulation competence.

    The BRIEF (parent version) questionnaire is aimed at assessing executive functioning at home and school and contains 63 items. Raw scores of the global scale range from 63 to 189; T scores (M = 50, SD = 10). The self-report version contains 55 items. Raw scores of the global scale range from 55 to 165; T scores (M = 50, SD = 10). Higher scores mean a worse outcome.

    Subscale and Indexes

    • Inhibit
    • Shift
    • Self-Monitor
    • Emotional Control
    • Initiate
    • Working Memory
    • Plan/Organize
    • Behavioral regulation Index
    • Emotion regulation Index
    • Cognitive regulation Index
    • Global Executive Index

    Measured: 3 month after intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Mar 2020
  2. Study start1 May 2020 (estimated)
  3. Primary completion28 Feb 2022 (estimated)
  4. Study completion28 Feb 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Care provider, Investigator
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04292093
Sponsor's protocol ID
769
Status last verified
Mar 2020
First submitted
25 Feb 2020
Last updated
26 Mar 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Home rehabilitation training in people with Epilepsy, run by IRCCS Eugenio Medea.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 26 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Alessandra Bardoni, MD, PhD (+39 031877111, alessandra.bardoni@lanostrafamiglia.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

NEPSY-II Neuropsychological Battery (time frame: baseline). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Mar 2020.

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