The Children’s Comprehensive Epilepsy Program is a nationally recognized leader in pediatric epilepsy with strengths in integrated multidisciplinary comprehensive clinical care, cutting edge clinical and basic research and patient education. The four major areas of focus include epilepsy pharmacology, epilepsy surgery, multimodality (MRI, fMRI, MEG) epilepsy imaging, and basic neuroscience. The pharmacology group (Drs. Glauser, Morita, Holland) aims to personalize care for children with new onset epilepsy by integrating multidisciplinary care, clinical research and patient education. The major research activities of this group include examination of the role of drug-gene interactions on the inter-individual variation in antiepileptic drug clinical response, laboratory studies of the functional significance of the genetic variations found, and study of parental adherence to prescribed medication regimens. Gene-drug interactions include research on the impact of variation in genes coding for drug metabolizing enzymes, drug transporters and drug receptors on clinical response to antiepileptic medications (pharmacogenetics) along with the impact of antiepileptic medications on gene expression (pharmacogenomics). The pharmacogenetics research is funded through an NIH U01 that is based at CCHMC and includes 31 other centers. The trial is a double blind, randomized, comparison trial of three antiepileptic medications focused on identifying the optimal initial therapy for children with absence epilepsy. The study is also designed to identify pharmacokinetic, pharmacodynamic, and pharmacogenetic factors that impact upon response to therapy. This landmark study has completed enrollment and will be announcing its results at the end of 2008.
The epilepsy surgery program, led by Drs. Lee and Mangano are undergoing a major expansion and expect to become a national leader in the surgical evaluation and management of children with treatment resistant epilepsy. The program is currently one of the busiest in the nation and utilizes a novel multimodality (MRI, fMRI, MEG) imaging approach to seizure lateralization and localization that aims to improve surgical outcome. The multimodality (MRI, fMRI, MEG) epilepsy imaging teams (Drs. Rose, Xiang, Vannest) also have active research programs focused using non-invasive imaging to better understand the interaction between epileptic seizures, brain development and brain activity. The basic neuroscience component of the epilepsy program focuses on determining the functional significance of the genetic variations found in the clinical pharmacogenetic studies (Dr. Holland) along with developing non-genetic biomarkers of epilepsy and response to therapy (Dr. Hallinan).