Dr. Zachary Grinspan, Interim Division Chief of pediatric neurology at Weill Cornell Medicine and Director of the Pediatric Epilepsy Program, has been awarded an R01 from the National Institute of Neurological Disorders and Stroke for his study, “NS-PEACE Neonatal Seizures -Predicting Epilepsy and Assessing Comparative Effectiveness.” The study aims to improve the care of newborns who experience seizures and their subsequent outcomes and predict and prevent epilepsy in high-risk individuals.
Neonatal seizures occur once per 1000 live births and are associated with the subsequent development of epilepsy, cerebral palsy, and intellectual disability. This study will address three questions related to the management of acute symptomatic neonatal seizures. First, it will compare the effectiveness of two anti-seizure medications, levetiracetam and phenytoin/fosphenytoin, to determine which is the best second-line medication. Second, it will examine whether the use of certain medications, like oxcarbazepine, affects the risk of infantile spasms syndrome. Finally, it will validate a published epilepsy prediction rule to determine which infants will develop epilepsy after leaving the neonatal intensive care unit.
The study will utilize the Pediatric Epilepsy Learning Health System (PELHS), a consortium of US academic pediatric epilepsy programs that work collaboratively to improve outcomes for children with epilepsy through cycles of electronic health record collection and analysis. The PEHLS data coordinating center resides at Weill Cornell Medicine where Dr. Grinspan is also the principal investigator.
Dr. Grinspan will work in collaboration with investigators across the country, including Dr. Hannah Glass and Dr. Nilika Singhal of the University of California San Francisco, Dr. Renée Shellhaas of Washington University St. Louis, and other investigators from eighteen pediatric epilepsy programs to provide the much-needed evidence to support treatment decisions in this vulnerable population, and to lay the foundation for future epilepsy prevention trials.
“Our team is so excited to lead this collaborative, multi-center research project. Neonatal seizures can be so scary for new parents — this project will teach us how to optimize care for these vulnerable newborns," says Dr. Grinspan.
At Weill Cornell Medicine, the study will involve collaboration among pediatric neurologists, neonatologists (Dr. Vivien Yap), neuroradiologists (Dr. Elizabeth Weidman), clinical informatics experts (Dr. Mark Weiner), and statisticians (Dr. Iván Díaz, now at NYU) in the Departments of Pediatrics, Neurology, Radiology, and Population Health Sciences, as well as with Imaging Data Evaluation & Analysis Laboratory (IDEAL) and Architecture for Research Computing in Health (ARCH).