Research

LIke ThisLIke ThisLIke This

Tobias  Loddenkemper, MD

Tobias Loddenkemper, MD
Department:
Neurology Research
Hospital Title:
Associate in Neurology; Director of Clinical Epilepsy Research
Academic Title:
Associate Professor of Neurology, Harvard Medical School
Research Focus Area:
EpilepsyClinical Neurophysiology
Contact Via Email
Send an email to SendYour Name*Your Email Address*Subject*Comments*

Research Overview

Tobias Loddenkemper's research is focused on identifying the factors that determine epileptic encephalopathies and status epilepticus as well as functional outcome later in life. Repetitive seizures and epileptic encephalopathy can impair development, plasticity and cognitive function of eloquent areas including language and memory. Seizure frequency reduction and seizure freedom, in particular after epilepsy surgery, has been shown to improve neurocognitive and developmental outcome. By identifying biomarkers that indicate predictors of cerebral damage and developmental outcome in epileptic encephalopathies and status epilepticus, we intend to reduce the occurrence of brain damage and later developmental disabilities and aim to identify novel therapeutic approaches.

Research Interests

What are we doing?

  • Comparative effectiveness and interventional clinical trials in pediatric status epilepticus and epileptic encephalopathies

How do we do it?

  • Inventing, evaluating and implementing clinically relevant biomarkers and treatment paradigms to assess and benchmark these based on clinical data, neurophysiology, imaging, pharmacogenomics and genetics, in collaboration with basic researcher locally, nationally, and internationally.
  • Developing and evaluating monitoring tools for clinical biomarkers to further clinical epilepsy outcome measures including seizure characterization, neuropsychological outcome assessment, and quality of life assessment by means of seizure sensors and electronic tools including ICISS, the RENCI seizure tracking and outcome prediction modeling software, and novel in- and outpatient monitoring devices and algorithms, and neurophysiological, biochemical and genetic periodicity markers and implement these techniques into clinical workflow.
  • Research networks and collaborations are essential for our work, like the pediatric status epilepticus research group (www.pserg.org), the Pediatric Epilepsy Research Consortium , the pediatric critical care epilepsy research group, the Critical Care EEG consortium, the pediatric neurocritical care research group and other consortia.

Selected Publications

A sample of epilepsy clinical studies enrolling at Boston Children’s Hospital

Advanced Seizure Tracking and Warning Systems

Seizures frequently are not noted by patients and families, and are rarely charted in seizure diaries. This trial tests novel, portable epilepsy monitoring sensors and tools that can detect seizures by means of autonomic nervous system features, patient movement and other vital signs and parameters. The devices allow for rescue measures and tracking of less severe seizures and treatment responses, and may help patients gain better control over seizures and avoid complications including sudden death in epilepsy. Patients with frequent generalized seizures may be eligible.
CONTACT: Francesca Coughlin, BA  

Cognitive Outcome in Children with Partial Epilepsy

Together with 16 centers nationally, this study is investigating the effects of lamotrigine, leve­tiracetam and oxcarbazepine on the cognitive function of children with newly diagnosed Localized Related Epilepsy. The study aims to establish whether these common anti-epileptic drugs preserve cognitive function or negatively impact behavior. Children will undergo cognitive testing. Children 6 to 12 with newly diagnosed Localized Related Epilepsy, including benign epilepsy syndromes, may be eligible.
CONTACT: Michele Jackson, BA

Epileptic Spasms Studies

Together with 22 centers nationally, the Pediatric Epilepsy Research Consortium is trying to learn more about children with new-onset epilepsy. The study seeks to identify causes, natural evolution and treatment responses in order to develop better management modalities. Children younger than 3 years with new-onset epilepsy and/or epileptic spasms may be eligible.
CONTACT: Afra Can, MD

TriVox Health Epilepsy Module

TriVox Health is a secure information sharing system currently in its beta test at Boston Children’s Epilepsy Center. Caregivers complete monthly questionnaires to monitor seizure type and frequency, medication changes and side effects, as well as quality of life scales including family functioning and comfort in self-management of epilepsy. Pre-visit questionnaires may also be completed in advance to eliminate paperwork in clinic. This robust documentation tool allows providers to closely monitor patients’ seizures and quality of life between visits, and spend more time with families in clinic discussing progress and treatment.
CONTACT: Julie Oppenheimer, BA

New-Onset Epilepsy and Chronotherapy: Treating Seizures by the Clock

Individual patients present with different seizure patterns at different times throughout the day or night. Medication may need to be dosed based on times of greatest seizure susceptibility. Analysis of differential timing in anti-epileptic treatment, combined with chronopharmacokinetic knowledge of epilepsy medications, can benefit patients with refractory seizures. Patients with seizure peaks at certain times may be eligible for this study.
CONTACT: Michele Jackson, BA

Role of Viral Infections in Patients with Epilepsy

Herpesvirus 6 infects almost all young children. In most cases, acute infection is asymptomatic or presents with a mild febrile illness that resolves spontaneously and is not treated. Acute infection with herpesvirus 6 has sometimes been associated with seizures in the short term and epilepsy in the long term, but it is unknown whether this association is causal (and potentially preventable). This study compares the rate of herpesvirus 6 infections in young children with first-time seizures and status epilepticus. Children 3 to 18 months presenting with first time complex febrile seizures may be eligible.
CONTACT: Fatemeh M. Touserkani, MD

Status Epilepticus in Children

This national study, organized by the Pediatric Status Epilepticus Research Group, aims to determine how children with status epilepticus are treated and their outcomes, adjusting for other clinical factors. The trial includes genetic testing to explore susceptibility factors and predictors of treatment response and outcome.
CONTACT: Michele Jackson, BA

Treatment Trial for Children with Epileptic Spasms

In collaboration with New York University Medical Center, this study is enrolling infants with epileptic spasms who have failed to respond to adrenocorticotrophic hormone, vigabatrin or both. The study will assess the safety and tolerability of rufinamide as an add-on therapy. English-speaking children 3 to 47 months of age who have a confirmed diagnosis of epileptic spasms and are currently on at least one additional anti-epileptic drug may be eligible.
CONTACT: Michele Jackson, BA

Treatment Trial for Adolescents and Adults with Cluster Seizures

This is a multi-center, open-label study of safety and tolerability of chronic intermittent usage of diazepam nasal spray in adolescent and adult patients with treatment-resistant cluster seizures. Patients will take the investigational product in response to a recognized bout of increased seizure activity (cluster). The treatment period is 12 months.
CONTACT: Francesca Coughlin, BA

Phase I Pharmacokinetic Study of Intranasal Midazolam in Children with Epilepsy

This study evaluates the single-dose pharmacokinetic, safety, and tolerability of intranasal Midazolam in male and female pediatric subjects with focal or generalized epilepsy. Children from ages 2 to 13 are eligible.
CONTACT: Francesca Coughlin, BA

Treatment Trial for Children 4 to 16 years of age with Partial Onset Seizures

This study is examining the efficacy and safety of Pregabalin adjunctive therapy in children from 4 to 16 years of age with partial onset seizures. Pregabalin is approved in more than 50 countries including the U.S. as an adjunctive treatment of adult patients with partial onset seizures. This study is assessing the safety and efficacy of pregabalin in pediatric subjects with epilepsy.
CONTACT: Michele Jackson, BA

Treatment Trial for Children 1 Month through <4 Years of Age with Partial Onset Seizures

This study is examining the efficacy and safety of Pregabalin adjunctive therapy in children from 1 month through <4 years of age with partial onset seizures. Pregabalin is approved in more than 50 countries including the U.S. as an adjunctive treatment of adult patients with partial onset seizures. This study is assessing the safety and efficacy of pregabalin in pediatric subjects with epilepsy. The primary objective of this study is to evaluate the efficacy of two dose levels of pregabalin compared to placebo as an adjunctive treatment in reducing the frequency of partial onset seizures in pediatric subjects 1 month through <4 years of age.
CONTACT: Michele Jackson, BA

Treatment Trial for Pediatric and Adult Patients with Primary Generalized Tonic-Clonic Seizures

This is a multi-center trial of pregabalin as adjunctive therapy in pediatric and adult subjects with primary generalized clonic seizures. This study is specifically evaluating the efficacy of 2 dose levels of pregabalin compared with placebo as adjunctive treatment in reducing the frequency of PGTC seizures in pediatric and adult subjects 5 to 65 years of age.
CONTACT: Michele Jackson, BA

12-Month Open-Label Study of Pregabalin as Adjunctive Therapy

In the US, pregabalin is indicated for the adjunctive treatment of adult patients with partial onset seizures. This study is one of several studies that will be conducted to assess the safety and efficacy of pregabalin in pediatric subjects with epilepsy and address post approval commitments to US authorities.
CONTACT: Michele Jackson, BA

Contacts

Julia Oppenheimer, BA
617-919-6988
Julia.Oppenheimer@childrens.harvard.edu

Michele Jackson, BA
617-919-8686
Epilepsytrials@childrens.harvard.edu

Francesca Coughlin, BA
617-919-6234
Epilepsytrials@childrens.harvard.edu

Fatemeh M. Touserkani, MD
617-919-6232
Fatemeh.touserkani@childrens.harvard.edu

Afra Can, MD
617-919-6230
Afra.can@childrens.harvard.edu

LIke ThisLIke ThisLIke This
Close