RCDP Natural History Study

Condition(s) studied

Study summary

A prospective, longitudinal observational trial in patients with RCDP. Study participants will be evaluated at baseline and approximately every 6 months by the study team. Quality of life, physiologic and functional measurements will be performed. In addition, audiologic recordings and other surveys will be completed at home by parents beginning at baseline and every 3-6 months thereafter.

Eligibility

Primary outcome measure(s)

• Medical History — 18 months
  History collection will be obtained from parents/caretakers and medical records which will be provided or subsequently obtained in a HIPAA compliant manner.
• Body Temperature — 18 months
  Temperature will be recorded using standard clinical methodology and reported in degrees Celsius.
• Respiratory Rate — 18 months
  Respiratory rate will be determined by counting number of breaths per minute
• Heart Rate — 18 months
  Heart rate will be reported as beats per minute
• Blood pressure — 18 months
  Systolic and diastolic pressure will be reported in mmHG
• Physical Examination: General Appearance — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Head, Eyes, Ears, Nose and Throat — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Cardiovascular — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Dermatologic — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Lymphatic — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Respiratory — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Gastrointestinal — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Genitourinary — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: Neurologic System — 18 months
  Reported as "Normal, Abnormal or Not Done". If abnormal, comments will be provided.
• Physical Examination: FLACC Behavioural Scale — 18 months
  The standardized FLACC (Faces, Legs, Activity, Consolability) questionnaire will be performed and the score reported.
• Anthropometric Measurement: Length/Height — 18 months
  Height (Length) will be reported in centimetres
• Anthropometric Measurement: Weight — 18 months
  Weight will be reported in kg
• Anthropometric Measurement: Head Circumference — 18 months
  Head Circumference will be reported in cm
• Anthropometric Measurement: Chest Circumference — 18 months
  Chest Circumference will be reported in cm
• Anthropometric Measurement: Abdominal Circumference — 18 months
  Abdominal Circumference will be reported in cm
• Observational pain assessment — 18 months
  Frequency and severity of patient exhibited pain symptoms will be evaluated with two parent-completed questionnaires, The Non-Communicating Children's Pain Checklist- Revised (NCCPC-R) and the Pediatric Pain Scale (PPS)19 (Appendix G). The NCCPC-R is a 7 domain questionnaire that is validated for assessment of pain in children aged 3-18 years who have cognitive and communication impairments. The PPS has 20 domains with a rating scale for each which is also designed to assess symptoms of pain in individuals with communication impairment. Both questionnaires will be completed during the study visits 2 hours after the end of the first morning feed. In addition, the NCCPC-R will be completed by the family 3 months after each visit at the same time interval after the first morning feed.
• Musculoskeletal system assessment — 18 months
  Musculoskeletal evaluations will be done together by a physiatrist and physical therapy. These assessments will include: assessments of strength, endurance, functional movement and control of extremities, head/neck and trunk. Assessment of muscle tone and passive and active joint range of motion will be made both qualitative and quantitatively for each major joint. Assessment of cognitive engagement will also be made. To assess the motor function and its changes over time, we propose to use Gross Motor Function Measures (GMFM-88), which is a freely available tool validated to evaluate motor skills in cerebral palsy and Down syndrome.
• Nerve conduction — 18 months
  Patients will be placed in a supine position and electrodes will be placed over the hypothenar eminence, 5th digit and dorsal hand. Stimulations will be done at the wrist and above and below the elbow. These electrodes will be connected to the Natus UltraPro S100 machine. This unit will measure nerve conduction for motor and sensory components. The evaluation will assess nerve latencies, compound motor unit and sensory nerve action potential amplitudes and nerve conduction velocities. These values will be compared to age adjusted normal values for the ulnar nerve.
• Pulmonary function — 18 months
  A combination of Impulse oscillometry system (IOS), Pneumotachography (PNT) and Respiratory Inductance Plethysmography (RIP) will be used to derive pulmonary indices comparable to spirometry.
• Seizure status by EEG — 18 months
  Assessments of brain electrical and seizure activity will take place through electroencephalograms (EEGs) at each study visit. Each EEG will last 4 hours and will be scheduled to optimally include both awake and sleep phases. Using the 10-20 International System, the patient's head will be measured and marked for proper electrode placement. Heart rate and rhythm are monitored throughout the EEG by placement of two electrocardiogram electrodes. Electrical activity is then recorded along with a video feed using the Nicolet NicOne acquisition and Xltek brain monitor machines.
• Bone Density and Body Composition by DEXA — 18 months
  The DEXA scans will be performed in the Medical Imaging Department of Nemours/A.I. duPont Hospital for Children on a Hologic Discovery A QDR bone densitometer (Hologic, Inc., Bedford, MA). Subjects will remove all clothing with metal components prior to DEXA scan to eliminate any possible imaging artifacts; a hospital gown will be provided to the subjects. Standard positioning techniques will be used to acquire the scans. Body sites measured will include the whole body, lumbar spine, and lateral distal femurs of both legs. The following variables will be collected from each scan: bone mineral density (BMD), bone mineral content (BMC), and bone area.
• Plasmalogen Level — 18 months
  A 100 ul aliquot of the separated serum will be stored at -80 °C and subsequently shipped to Med-Life Discoveries by priority overnight shipment in dry ice. Analyses will include levels of phosphoethanolamines, vinylacylglycerol (VAG), alkylacylglycerol (AAG) and results reported as quantitative concentrations for each metabolite.
• Clinical Chemistry — 18 months
  Serum will be processed locally for complete blood count (CBC) and standard comprehensive metabolic profile with phosphorus (CMP with PO4).
• Fatigue status — 18 months
• Gastrointestinal and Feeding status — 18 months
  To assess level of dysfunction in swallowing, a parent report measure, the Pediatric Assessment Scale for Severe Feeding Problems, designed to assess progress in the development of oral eating skills for children who need prolonged tube feeding will be used. The total score will be used as a quantifiable measure. This questionnaire will be completed during each study visit as well as at home 3 months after each visit. This 13 question interview provides a total score which indicates the level of GI symptom burden.

Trial sites (1)