A Phase 1 interventional study of donepezil in Fragile X Syndrome, sponsored by Stanford University. Completed at 1 site in United States. Open to participants aged 14 Years and older. Per ClinicalTrials.gov, last updated 2012-12-13.
Sponsored by Stanford University · Phase 1, Interventional, and Treatment
Fragile X syndrome is the most common known inherited cause of neurodevelopmental disability. Functional magnetic resonance imaging (fMRI) studies from our laboratory indicate that specific brain regions using the neurochemical, acetylcholine, show significantly reduced activation during learning. Since donepezil is a medication that enhances acetylcholine function in the brain, the purpose of this study is to determine if donepezil has any beneficial effect on behavior or cognition in subjects with fragile X syndrome.
Fragile X syndrome is the most common genetically inherited cause of neurodevelopmental disability in humans, affecting approximately 1:2000 to 4000 live births. Affected individuals have significant, long-term problems with learning, and often with behavior as well. The disorder is caused by the presence of a greatly expanded CGG repeat within the FMR1 gene on the long arm of the X chromosome. Abnormal methylation of this repeat, and adjacent areas within the FMR1 gene impedes transcription, ultimately resulting in reduced production of the FMR1 protein (FMRP). This protein is expressed in neurons, with particularly high levels of gene transcription occurring in the nucleus basalis (basal forebrain) and hippocampus. A recent functional imaging study from our group showed girls with fragile X to have greatly reduced levels of brain activation in the basal forebrain and hippocampal activation during a memory task. The nucleus basalis, is a cholinergic nucleus with widespread connections to the neocortex. It is critical to visuospatial attention in rodents and primates and is presumed to play a similar role in humans. The finding of decreased basal forebrain activation in girls with fragile X, considered in light of histological evidence showing high transcription levels of FMR1 in healthy nucleus basalis, suggests the possibility of a functional cholinergic deficit in fragile X syndrome.
Donepezil is an acetylcholinesterase inhibitor which slows the degradation of synaptic acetylcholine thereby increasing its availability. It is approved for the treatment of mild-moderate Alzheimer's disease. It has been studied in several other neurologic disorders--including vascular dementia, Lewy Body dementia, and Down's syndrome (with and without dementia)--where it has shown varying degrees of efficacy but consistently high degrees of safety and tolerability. The goal of the proposed study is to determine if enhancing cholinergic activity with donepezil has beneficial effects on behavior or cognition in subjects with fragile X syndrome.
110 studies on the registry are indexed under Fragile X Syndrome; 23 are open to participants now.
This study's enrollment of 10 is below the median of 58 across 88 interventional studies indexed under Fragile X Syndrome.
Browse Fragile X Syndrome studies →Stanford University is the lead sponsor of 2,117 studies on the registry; 425 are open to participants now.
Of its 259 completed or terminated interventional studies of FDA-regulated products, 197 (76%) have results posted.
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Inclusion Criteria:1. Confirmed genetic diagnosis of fragile X syndrome
open donepezil
Drug: donepezil
donepezil 5 mg daily for 3 weeks (days 1-21); 10 mg daily for 3 weeks (days 22-42)
Also known as: Aricept, donepezil hydrochloride
Scores on learning tests at baseline
Time frame: baseline, day 21, day 42
score on test of attention
Time frame: baseline, day 21, day 42
score on measures of behavior
Time frame: baseline, day 21, day 42
scores on learning tests
Time frame: baseline, day 21, day 42
scores on working memory tests
Time frame: baseline, day 21, day 42
This study is completed, as verified in Dec 2012. You cannot join it, but the record below documents what was studied.
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