Meet Dr. Leigh Sepeta & Dr. Elizabeth Wells

October 11, 2022

Dr. Leigh Sepeta & Dr. Elizabeth Wells (Children’s National Hospital, Washington DC, USA) were awarded a 2022 AEA Community Seed Grant to investigate the Predictors of Cognitive Outcomes in Children with Anti-NMDA Receptor Encephalitis. Learn more about their research and how it will impact those affected with autoimmune encephalitis. The start date for the award is September 1, 2022.

You have been awarded the AEA seed Grant, can you tell us more about the study you plan to do?

Executive functioning (EF) and memory are the primary cognitive concerns following NMDAR encephalitis in adults and children. A primary clinical question is what variables predict the severity of the cognitive impairment. Predictors of cognitive outcome are variable; for adults, a delay in treatment is predictive of worse outcome; however, this has not been found for pediatric populations. No other clear variables have been significant in predicting cognitive outcome for children; however, few have been studied. We propose to address this gap in knowledge by finding predictors of cognition for children with NMDAR encephalitis. First, we will examine predictors from clinical evaluations, such as treatment variables and disease-related factors at admission (e.g., abnormal MRI findings). Second, we propose to assay putative biomarkers of neuronal loss and inflammation in NMDAR encephalitis using CSF.

How will your study help patients and families affected by AE?

Autoimmune Encephalitis often affects previously healthy, typically developing children and sets families on an unexpected path of supporting a child with new challenges in learning and life. In particular, the memory difficulties and learning difficulties can require significant support in school and at home, and parents often ask their child’s doctors what to expect in the future. Children with autoimmune encephalitis do not necessarily follow the trajectory of brain injury and lasting damage seen in children with other brain diseases or injuries. Some children with autoimmune encephalitis have experienced remarkable recoveries through treatments, rehabilitation and learning support. Other children have had significant recovery in some domains of brain function but are left with lasting residual effects especially with memory, attention and planning. Families and doctors recognize that brain recovery in pediatrics is complex and there will always be a range out of outcomes. Nevertheless, we hope that this research study will help identify new lab tests to predict better or worse neurocognitive function in children who have autoimmune encephalitis. The goal is to help families better understand the path ahead and aid doctors, therapists, teachers and parents in their work to achieve the best outcome for each child.

Tell us more about yourself and your affiliation?

Leigh N. Sepeta, PhD. I am an assistant professor (tenure track) at George Washington University and clinical neuropsychologist at Children’s National Hospital (Children’s National) specializing in pediatric and adult epilepsy, and a recipient of NINDs K23 Grant, the Avery Translational Research Career Development award at Children’s National, the Susan S. Spencer Research Clinical Research Training Fellowship through the American Academy of Neurology (AAN), Epilepsy Foundation of America (EFA), and the American Epilepsy Society (AES). I have also received the National Institutes of Health (NIH) Post-Doctoral Research Fellowship (T32) in Clinical Developmental Neuroscience at Children’s National and the Epilepsy Foundation of America’s Research and Training Fellowship for Clinicians. My work has spanned both basic research and clinical practice, with a focus on functional magnetic resonance imaging (fMRI) for language and memory mapping in epilepsy.  From my extensive clinical and research experience in pediatric and adult neuropsychology, I am intent on pursuing the research and clinical study of neurological disorders. I am increasingly interested in following a multidisciplinary approach to studying the neurobiological basis of cognitive networks, memory in particular. My research program aims to provide important insights regarding development of executive functioning and memory, and their neural underpinnings.

Elizabeth Wells, MD. Dr. Elizabeth Wells, M.D. is Vice President of the Neuroscience and Behavioral Medicine Center at Children’s National Hospital. Dr. Wells is a graduate of Harvard University and the George Washington University School of Medicine and Health Sciences. She holds a master’s in Health Science from the NIH/Duke Clinical Research Training Program. Dr. Wells completed her pediatrics and neurology training at Children’s National and has been on staff as a pediatric neurologist within the Brain Tumor Institute and the Division of Neurology for the past 10 years.

In addition to her work in neuro-oncology, Dr. Wells has developed the multidisciplinary program in pediatric neuro-immunology at Children’s National. She serves on numerous national committees and receives national and international referrals for children with neuro-inflammatory disorders. She is a Principal Investigator for translational research studies and serves in a leadership role for the Clinical and Translational Science Institute at Children’s National and the District of Columbia Intellectual and Developmental Disabilities Research Center at Children’s National. Dr. Wells has been director of Inpatient Neurology since 2015, served as director of the Neuroscience Medical Unit from 2015-2021 and as President of the Medical Staff from July 2020 to 2022.

Thank you to the entire AE Alliance community for the commitment to changing the course of AE. Thank you to the researchers applying for the AEA Community Seed Grant program and to the AE Alliance community, friends and family members for donating to the AEA Research Network. It is your donations that allow us to fund research focused on improving the lives of people living with AE.

Together, we are changing the course of AE.