Natural History Database
Implemented in 2006, the TSC Natural History Database captures clinical data to document the impact of the disease on a person’s health over his or her lifetime. More than 2,000 people with TSC are enrolled in the project among 18 U.S.-based clinical sites. The TS Alliance provides funding to participating clinics to perform data entry, monitors the integrity of the database, and makes data available to investigators to answer specific research questions and identify potential participants for clinical trials and studies.
Participating TSC Clinics
- Minnesota Epilepsy Group, P.A., St. Paul, MN (Michael Frost, MD)
- Texas Scottish Rite Hospital for Children, Dallas, TX (Steven Sparagana, MD)
- New York University Medical Center, New York, NY (Orrin Devinsky, MD to 2015, Josiane LaJoie, MD)
- Massachusetts General Hospital, Boston, MA (Elizabeth Thiele, MD, PhD)
- Children’s National Medical Center, Fairfax, VA (William McClintock, MD)
- University of Chicago, Chicago, IL (Michael Kohrman, MD to 2016, Patricia Ogden, APN, FNP, NP-C)
- Oakland Children’s Hospital, Oakland, CA (Candida Brown, MD to 2010, Rachel Kuperman, MD)
- UCLA Medical Center, Los Angeles, CA (Joyce T. Wu, MD)
- University of Texas, Houston (Hope Northrup, MD)
- University of Alabama, Birmingham (E. Martina Bebin, MD, MPA & Bruce Korf, MD, PhD)
- The Cleveland Clinic Foundation, Cleveland, OH (Ajay Gupta, MD)
- University of Colorado, Denver (Paul Levisohn, MD to 2011 & Susan Koh, MD)
- Miami Children’s Hospital, Miami, FL (Ian O’Neil Miller, MD & Michael Duchowny, MD)
- Loma Linda University Medical Center, Loma Linda, CA (Stephen Ashwal, MD)
- Pennsylvania Medical Center, Philadelphia, PA (Peter Crino, MD, PhD to 2012 & Katherine Nathanson, MD)
- Boston Children’s Hospital, Boston, MA (Mustafa Sahin, MD, PhD)
- Cincinnati Children’s Hospital, Cincinnati, OH (Darcy Krueger, MD, PhD)
- Washington University St. Louis, MO (Michael Wong, MD, PhD)
Since 2010, researchers have published seven articles in well-regarded, peer-reviewed biomedical journals using data from the TSC Natural History Database. This published research has contributed to our understanding of TSC in a number of relevant fields, including neurology, psychiatry, and ophthalmology. Several papers have found correlations between gene mutations and specific TSC symptoms, as well as correlations between different kinds of symptoms. This type of work is helping us understand why and how different individuals with TSC experience the disease differently.
Please see the TS Alliance Mendeley group for more information on these papers, as well as other articles produced with the help of TS Alliance grants, data, and biosamples.
CNS and TAND
- Jeong A, Wong M. Systemic disease manifestations associated with epilepsy in tuberous sclerosis complex. Epilepsia. 2016;57(9):1443-1449. doi: 10.1111/epi.13467.The authors confirmed their hypothesis that systemic disease manifestations such as cardiac rhabdomyomas, renal and skin tumors were associated with the presence of epilepsy or infantile spasms.
- Kothare SV, Singh K, Hochman T, Chalifoux JR, Staley BA, Weiner HL, Menzer K, Devinsky O. Genotype/phenotype in tuberous sclerosis complex: Associations with clinical and radiologic manifestations. Epilepsia. 2014;55(7):1020-1024. doi: 10.1111/epi.12627.The authors evaluated the associations between the presence of SEGAs and neuropsychiatric disorders in a retrospective review of 916 patients enrolled in the TSC Natural History Database Project.
- Kothare SV, Singh K, Chalifoux JR, Staley BA, Weiner HL, Menzer K, Devinsky O. Severity of manifestations in tuberous sclerosis complex in relation to genotype. Epilepsia. 2014;55(7):1025-1029. doi: 10.1111/epi.12680.The authors evaluated the association of the TSC1 and TSC2 gene mutations with patient and disease characteristics in a review of clinical data collected from 919 individuals who were enrolled in the TSC Natural History Database.
- van Eeghen AM, Nellist M, van Eeghen EE, Thiele EA. Central TSC2 missense mutations are associated with a reduced risk of infantile spasms. Epilepsy Res. 2013;103(1):83-87. doi:10.1016/j.eplepsyres.2012.07.007.This paper reports on the analysis of epilepsy and DNA data from the TS Alliance TSC database and the database of the Carol and James Herscot Center for Children and Adults with Tuberous Sclerosis Complex at Massachusetts General Hospital. The findings suggest that identifying distinct epilepsy characteristics for specific mutation subgroups may help identify relevant biomarkers (indicators), which will assist healthcare providers in making treatment decisions.
- Ehninger D, Sano Y, de Vries PJ, Dies K, Franz D, Geschwind DH, Kaur M , Lee YS , Li W, Lowe JK, Nakagawa JA, Sahin M, Smith K, Whittemore V, Silva AJ. Gestational immune activation and Tsc2 haploinsufficiency cooperate to disrupt fetal survival and may perturb social behavior in adult mice. Mol Psychiatry. 2012;17(1):62-70. doi: 10.1038/mp.2010.115.This paper (the first to use information from the TSC Natural History Database) raises the possibility that exposure to viral infection may increase the risk of autism spectrum disorder in TSC.
- Aronow ME, Nakagawa JA, Gupta A, Traboulsi EI, Singh AD. Tuberous sclerosis complex: genotype/phenotype correlation of retinal findings. Ophthalmology. 2012;119(9):1917-1923. doi: 10.1016/j.ophtha.2012.03.020.This paper evaluates the genetic and clinical feature correlations in individuals with astrocytic hamartoma and retinal achromatic patch in TSC.
- Swallow E, King S, Song J, Peeples M, Signorovitch JE, Liu Z, Prestifilippo J, Frost M, Kohrman M, Korf B, Krueger D, Sparagana S. Patterns of disease monitoring and treatment among patients with tuberous sclerosis complex-related angiomyolipomas. Urology. 2017;0(0). doi: 10.1016/j.urology.2017.02.036.This paper reports that the use of MRIs increased between 2000 and 2012 among patients with TSC-AML. The majority of TSC-AML patients did not receive treatment for angiomyolipoma. Use of nephrectomy decreased over the study period and was particularly rare in patients who initiated an mTOR inhibitor.