DeCure for Developmental and epileptic encephalopathy, 61
DeCure's autonomous Neuro AI scientist is researching a drug-repurposing hypothesis for developmental and epileptic encephalopathy, 61 — screening already-approved drugs against its 1-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleDevelopmental and epileptic encephalopathy, 61 maps to a 1-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 developmental and epileptic encephalopathy, 61 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
ADAM metallopeptidase domain 22 (ADAM22) — ADAM22 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 apo structuredrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 3G5C · 2.36 Å · ligand none (apo structure). Experimental structure, not a prediction.
What the evidence adds up to
The term developmental and epileptic encephalopathy (DEE) describes a condition in which cognitive function is influenced by both seizure activity and the underlying neurobiological process causing the epilepsy, with onset typically in early childhood and many cases linked to gene variants. A 2021 review distinguishes DEE from developmental encephalopathy (DE), where epileptiform activity has minimal effect on function, and from epileptic encephalopathy (EE), where cognition is directly impacted by epileptic activity and can often revert to near normal baseline with appropriate intervention. The review states that patients with DE are unlikely to gain from aggressive antiseizure medication, while those with EE will gain; patients with DEE might benefit from a precision medicine approach to reduce the overall burden of epilepsy. A 2015 review notes that cognitive and developmental outcomes in epileptic encephalopathy are hypothesised to result from an interplay between the underlying epileptic pathologic substrate and the acquired consequences of frequent seizures and discharges, but presents this as an assumption requiring further evidence.
A 2023 review of childhood epilepsy categorises syndromes into a self-limited group with good prognosis and high prevalence, and a pharmacoresistant group with poor prognosis despite low prevalence. It states that many children develop pharmacoresistant epilepsy beginning in early infancy and progress to DEE, which is associated with intellectual, behavioural, or motor disabilities. These children do not show remission in epilepsy and are transitioned to adult services, requiring comprehensive medical care. No abstract reports any specific drug trial, response rate, survival data, or sample size for any treatment in DEE.
What is missing is any controlled trial data for a repurposed drug in this specific population, funding for such trials, and a validated method to stratify patients by whether their encephalopathy is primarily developmental or epileptic, since the distinction determines whether aggressive antiseizure treatment is likely to help.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Epileptic Disorders · 2021 · 126 citations · open access
Developmental and epileptic encephalopathies: recognition and approaches to care
AbstractThe term "developmental and epileptic encephalopathy" (DEE) refers to when cognitive functions are influenced by both seizure and interictal epileptiform activity and the neurobiological process behind the epilepsy. Many DEEs are related to gene variants and the onset is typically during early childhood. In this setting, neurocognition, whilst not improved by seizure control, may benefit from some precision therapies. In patients with non-progressive diseases with cognitive impairment and co-existing epilepsy, in whom the epileptiform activity does not affect or has minimal effect on function, the term "developmental encephalopathy" (DE) can be used. In contrast, for those patients with direct impact on cognition due to epileptic or epileptiform activity, the term "epileptic encephalopathy" (EE) is preferred, as most can revert to their normal or near normal baseline cognitive state with appropriate intervention. These children need aggressive treatment. Clinicians must tailor care towards individual needs and realistic expectations for each affected person; those with DE are unlikely to gain from aggressive antiseizure medication whilst those with EE will gain. Patients with DEE might benefit from a precision medicine approach in order to reduce the overall burden of epilepsy.
Epileptic encephalopathies: Optimizing seizure control and developmental outcome
AbstractCognitive and developmental outcomes in patients with epileptic encephalopathy are hypothesized to result from an interplay between the underlying epileptic pathologic substrate and the acquired consequences of frequent and repetitive seizures and epileptiform discharges that often straddle the interictal and ictal boundaries. This article briefly reviews the evidence related to this assumption, presents critical questions that need to be answered to clarify this relationship, and advances a set of concrete steps that may help improve developmental patient outcomes.
Dynamic electro‐clinical features in Guanidinoacetate N‐methyltransferase deficiency: A familial case series
AbstractGuanidinoacetate N-methyltransferase deficiency is an inborn error of creatine metabolism, responsible for the absent conversion of guanidinoacetic acid into creatine, resulting in cerebral creatine deficit. It could present a variety of symptoms such as neurodevelopmental delay, epilepsy, movement disorder (ataxia, dystonia, and chorea), and behavioral disturbances. After intellectual disability, epilepsy is the second most frequent expression of the disorder, usually arising during infancy with febrile seizures that are typically followed by generalized seizures and electroencephalographic anomalies. Herein, we describe three siblings with the same homozygous truncating variant in GAMT, all of whom showed significant global developmental delay during early infancy. The eldest two developed initially neglected atypical absences, preceded by focal motor seizures in the older brother, with complete remission with antiseizure medications and dietary treatment. Despite seizure freedom, during follow-up, both developed overt focal epileptiform discharges that have persisted after 2 years of creatine supplementation. Neither seizures nor electroencephalographic abnormalities were noted in the youngest brother who took advantage of an earlier diagnosis and treatment. The dynamic electroclinical pattern we observed has never been reported beforehand. Further studies are needed to assess the long-term prognosis of epilepsy in patients who have introduced dietary treatment after the seizure onset. PLAIN LANGUAGE SUMMARY: GAMT deficiency is a rare genetic disorder that prevents the brain from getting enough creatine, leading to developmental delay, seizures, movement disorders, and behavior problems. This condition often starts in infancy with seizures in fever and can be partially limited by creatine supplementation. In this paper, we present three siblings with the same mutation. The older two had seizures that improved with treatment, but their brain activity remained abnormal. The youngest, diagnosed and treated earlier with supplementation, did not develop epilepsy. More research is needed to understand electro-clinical features of this condition and the long-term effects of early or late dietary treatment.
AbstractChildhood epilepsy is characterized by specific epilepsy syndromes that occur during each developmental age. These "age-dependent" epilepsy syndromes are clinically categorized into a self-limited epilepsy group with good prognosis and high prevalence rate and a pharmacoresistant epilepsy group with poor prognosis despite low prevalence rates. Many children develop pharmacoresistant epilepsy beginning in early infancy and progress to developmental epileptic encephalopathy, which is associated with intellectual, behavioral, and/or motor disabilities. These children do not show remission in epilepsy and are transitioned to the adult service and require comprehensive medical care.
Sage Journals Data · 2023 · 0 citations · open access
Safety of Diazepam Nasal Spray in Pediatric Patients With Developmental Epileptic Encephalopathies: Results From a Long-term Phase 3 Safety Study
AbstractPediatric developmental epileptic encephalopathies are often refractory to treatment despite stable antiseizure therapy. The safety profile of diazepam nasal spray (Valtoco) as rescue therapy for seizure clusters was described in a long-term safety study. This post hoc analysis assessed safety and effectiveness within a subpopulation of patients with developmental epileptic encephalopathies. Of 163 treated patients, 64 were diagnosed with ≥1 pediatric developmental epileptic encephalopathy. Among the most common developmental epileptic encephalopathies were Rett syndrome (n = 16), Lennox-Gastaut syndrome (n = 9), and Dravet syndrome (n = 7). In the broad pediatric developmental epileptic encephalopathy group, 10.6% of seizure clusters were treated with a second dose, with similar proportions in the 3 individual encephalopathies. Across groups, treatment-emergent adverse event rates ranged from 66.7% to 100%. Only epistaxis (n = 2) was treatment-related and reported in >1 patient. In this long-term safety analysis in patients with developmental epileptic encephalopathies, diazepam nasal spray demonstrated a consistent safety profile, supporting its use in these hard-to-treat patients (ClinicalTrials.gov NCT02721069).
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.
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