DeCure for Autosomal dominant nocturnal frontal lobe epilepsy
DeCure's autonomous Neuro AI scientist is researching a drug-repurposing hypothesis for autosomal dominant nocturnal frontal lobe epilepsy — screening already-approved drugs against its 7-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleAutosomal dominant nocturnal frontal lobe epilepsy maps to a 7-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for autosomal dominant nocturnal frontal lobe epilepsy is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
corticotropin releasing hormone (CRH) — CRH is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet 2-hydroxy-ethyldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 3EHU · 1.96 Å · ligand 2-[BIS-(2-HYDROXY-ETHYL)-AMINO]-2-HYDROXYMETHYL-PROPANE-1,3-DIOL (BTB). Experimental structure, not a prediction.
What the evidence adds up to
Autosomal dominant nocturnal frontal lobe epilepsy is a rare monogenic disorder caused by mutations in at least two subunit genes of the neuronal nicotinic acetylcholine receptor. The first genetic defect in any idiopathic epilepsy was found in this syndrome. Both autosomal dominant nocturnal frontal lobe epilepsy and benign familial neonatal convulsions are caused by ion channel mutations. Some of the nAChR mutations appear to increase the risk for additional neurologic symptoms.
About 30% of nocturnal frontal lobe epilepsy cases are refractory to antiepileptic medication. In a consecutive surgical series of 522 patients with drug-resistant focal epilepsy, 21 cases (4%) had seizures that occurred almost exclusively during sleep. Mean age at seizure onset was 6.2 years, mean age at surgery was 24.7 years, and seizure frequency ranged from fewer than 20 per month to more than 300 per month. Nine patients reported excessive daytime sleepiness. MRI was unrevealing in 10 cases and showed a focal abnormality in one frontal lobe in 11 cases. Eighteen patients underwent stereo-EEG evaluation. All received a microsurgical resection in one frontal lobe; two patients required a second operation due to poor results after the first.
Histology showed Taylor-type focal cortical dysplasia in 16 patients, architectural FCD in 4, and no histological change in one. After a mean follow-up of 42.5 months, all 16 patients with Taylor-type FCD were in Engel Class Ia (seizure-free), while the other 5 were in Engel Classes II or III (not seizure-free). Excessive daytime sleepiness resolved in all 9 patients who had reported it pre-operatively. The authors conclude that resective surgery can provide excellent results for drug-resistant sleep-related frontal lobe seizures, but that accurate pre-surgical evaluation, often requiring invasive EEG, is mandatory.
What remains missing is a clear explanation for the apparent link between Taylor-type focal cortical dysplasia and sleep-related seizures. No drug repurposing trial for autosomal dominant nocturnal frontal lobe epilepsy has been reported in these abstracts. No data exist on whether nAChR mutations predict surgical outcome or drug response. Patient stratification by genotype, larger surgical series, and prospective studies of non-surgical treatments for the refractory subgroup are all absent.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Current Opinion in Neurology · 1997 · 37 citations
Genetics of human partial epilepsy
AbstractA minor genetic predisposition to partial epilepsy has been long recognized. Recently, a group of idiopathic partial epilepsies with autosomal dominant inheritance has been identified. The clinical features and molecular genetic findings in these epilepsies are outlined in the present review. The first genetic defect in an idiopathic epilepsy has been found in autosomal dominant nocturnal frontal lobe epilepsy, the archetype of this newly recognized group of inherited partial epilepsies.
New insights into the molecular and genetic mechanisms underlying idiopathic epilepsies
AbstractFor many years, idiopathic epilepsies have been known to have a strong genetic background. In most subtypes, the mode of inheritance appears to be complex, with only some rare idiopathic epilepsies being monogenic disorders. Thus far, several gene loci have been reported for the common subtypes, such as juvenile myoclonic epilepsy, but the results of linkage studies in independent samples have often been conflicting. Recently, the gene defects underlying two monogenic epilepsies, autosomal dominant nocturnal frontal lobe epilepsy and benign familial neonatal convulsions, have been identified. Both diseases are caused by ion channel mutations, a similarity which may shed light on the understanding of the basic mechanisms of epileptogenesis.
AbstractSummary Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is characterized by clusters of brief motor seizures. This rare syndrome is caused by mutations in at least two subunit genes of the neuronal nicotinic acetylcholine receptor (nAChR). Some of these mutations seem to increase the risk for additional neurologic symptoms. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books ).
Nocturnal Frontal Lobe Epilepsy: There is Bad, Good, and Very Good News!
AbstractSurgical Treatment of Drug-Resistant Nocturnal Frontal Lobe Epilepsy. Nobili L, Francione S, Mai R, Cardinale F, Castana L, Tassi L, Sartori I, Didato G, Citterio A, Colombo N, Galli C, Lo Russo G, Cossu M. Brain 2007;130(Pt 2):561–573. Of the cases with nocturnal frontal lobe epilepsy (NFLE) 30% are refractory to antiepileptic medication, with several patients suffering from the effects of both ongoing seizures and disrupted sleep. From a consecutive series of 522 patients operated on for drug-resistant focal epilepsy, 21 cases (4%), whose frontal lobe seizures occurred almost exclusively (>90%) during sleep, were selected. All patients underwent a comprehensive pre-surgical evaluation, which included history, interictal EEG, scalp video-EEG monitoring, high-resolution MRI and, when indicated, invasive recording by stereo-EEG (SEEG). There were 11 males and 10 females, whose mean age at seizure onset was 6.2 years, mean age at surgery was 24.7 years and seizure frequency ranged from <20/month to >300/month. Nine patients reported excessive daytime sleepiness (EDS). Prevalent ictal clinical signs were represented by asymmetric posturing (6 cases), hyperkinetic automatisms (10 cases), combined tonic posturing and hyperkinetic automatisms (4 cases) and mimetic automatisms (1 case). All patients reported some kind of subjective manifestations. Interictal and ictal EEG provided lateralizing or localizing information in most patients. MRI was unrevealing in 10 cases and it showed a focal anatomical abnormality in one frontal lobe in 11 cases. Eighteen patients underwent a SEEG evaluation to better define the epileptogenic zone (EZ). All patients received a microsurgical resection in one frontal lobe, tailored according to pre-surgical evaluations. Two patients were operated on twice owing to poor results after the first resection. Histology demonstrated a Taylor-type focal cortical dysplasia (FCD) in 16 patients and an architectural FCD in 4. In one case no histological change was found. After a post-operative follow-up of at least 12 months (mean 42.5 months) all the 16 patients with a Taylor's FCD were in Engel's Class Ia and the other 5 patients were in Engel's Classes II or III. After 6 months post-surgery EDS had disappeared in the 9 patients who presented this complaint pre-operatively. It is concluded that patients with drug-resistant, disabling sleep-related seizures of frontal lobe origin should be considered for resective surgery, which may provide excellent results both on seizures and on epilepsy-related sleep disturbances. An accurate pre-surgical evaluation, which often requires invasive EEG recording, is mandatory to define the EZ. Further investigation is needed to explain the possible causal relationships between FCD, particularly Taylor-type, and sleep-related seizures, as observed in this cohort of NFLE patients.
Neurologia i Neurochirurgia Polska · 2011 · 2 citations
Zaburzenia czynności kanałów jonowych w patogenezie padaczek idiopatycznych
AbstractPomimo postępów diagnostyki nadal u ok. 60–65% chorych nie można jednoznacznie ustalić przyczyny padaczki. W tej grupie chorych główną rolę odgrywają przypuszczalnie czynniki genetyczne. Uważa się, że u ok. 40% pacjentów predyspozycja genetyczna odpowiada za występowanie padaczek, określanych mianem „idiopatycznych”. Podłoże genetyczne padaczki potwierdzają liczne przykłady rodzinnie występujących zespołów padaczkowych. Należą do nich dziedziczona autosomalnie dominująco padaczka czołowa z napadami nocnymi oraz młodzieńcza padaczka miokloniczna. Obydwie formy padaczek uwarunkowane są mutacjami genów dla podjednostek neuronalnego receptora nikotynowego dla acetylocholiny. Postęp genetyki stworzył szansę dokładniejszego zrozumienia epileptogenezy na poziomie molekularnym, co ułatwia rozpoznanie oraz stwarza bardziej racjonalne podstawy leczenia i zapobiegania tej postaci padaczki. Despite advances in diagnostics, the cause of epilepsy has still not been unequivocally determined in 60-65% of patients. In this group of patients, genetic factors probably play the main role. It is thought that genetic predisposition is responsible for the occurrence of so-called “idiopathic” forms of epilepsy in about 40% of patients. The genetic basis of epilepsy has been substantiated by numerous examples of familial forms of epileptic syndromes. Among these, autosomal dominant nocturnal frontal lobe epilepsy and juvenile myoclonic epilepsy can be mentioned. Mutations in the neuronal nicotinic acetylcholine receptor subunit genes are responsible for both these epilepsies. Recent advances in molecular genetics have provided the means for better understanding of human epileptogenesis at a molecular level, which facilitates clinical diagnosis and provides a more rational basis for therapy and prevention of this form of epilepsy.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
