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Metabolic & Lysosomal

Leigh Syndrome Clinical Trials and Treatments

Also called Leigh syndrome, Leigh disease, Subacute necrotizing encephalomyelopathy, Leigh syndrome spectrum, MT-ATP6 Leigh syndrome, SURF1 deficiency, Mitochondrial Leigh syndrome

Mitochondria turn food and oxygen into the energy every cell runs on, and the brain uses more of it than any other organ. In Leigh syndrome a genetic fault in one of the energy-making steps, most often complex I or complex IV of the respiratory chain, or the pyruvate dehydrogenase enzyme, leaves nerve cells in the basal ganglia and brainstem starved of energy.

In plain words, Leigh syndrome is a rare inherited condition where the tiny energy makers inside cells cannot give the brain enough energy. Damage builds up in deep parts of the brain that control movement, swallowing and breathing, often getting worse in sudden steps after an illness.

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Leigh Syndrome

Where treatments stand, from ClinicalTrials.gov and FDA labels

Also 5 studies with no phase, like observational studies.

FDA review0

No decision pending. FDA calendar

FDA-approved medicines0

No medicine's current FDA label names Leigh Syndrome yet.

Leigh Syndrome has no FDA-approved medicines, 6 open or active clinical trials (5 recruiting), and no pending FDA decision.

Labels checked October 21, 2026.Download the data

More about Leigh Syndrome

Those regions control movement, swallowing, eye movement and breathing, which is why the disease looks the way it does. On a brain MRI the damage shows up as matching bright spots on both sides of those structures, and lactate is often raised in the blood or spinal fluid, especially during an illness.

Keep reading about Leigh Syndrome

The course is usually stepwise rather than steady. A child does well for a stretch, then an infection or fever triggers a sudden decline, followed by partial recovery to a new, lower baseline. Most children have at least one of these sudden declines, which may require hospitalization, and up to half die before age 3, most often from breathing or heart failure.

Some children have stable periods lasting years, and outcomes vary widely: very early onset, brainstem involvement, the MT-ATP6 m.8993T>G change and MT-ND5 changes have been linked to more severe disease, published reports on SURF1 conflict, and a small number of subtypes, such as the thiamine transporter gene SLC19A3, respond to high-dose vitamins if caught early.

Diagnosis today rests on genetic testing, usually a nuclear gene panel or whole-exome sequencing plus mitochondrial DNA sequencing that measures the mutant load, rather than the muscle biopsy or autopsy that defined the disease for decades. Care is supportive: nutrition (often by feeding tube), seizure control, avoiding the drug valproate and other metabolic stressors, and a vitamin and cofactor mix that many specialists prescribe despite limited trial evidence.

What are the symptoms of Leigh Syndrome?

These are common symptoms of Leigh Syndrome, and how strong they are varies from person to person.

  • Vomiting, diarrhea, trouble swallowing and poor weight gain, often the first signs
  • Loss of skills a child had already learned, with floppy muscle tone
  • Stiff or twisting postures (dystonia), unsteady balance and tremor
  • Irregular breathing, with pauses or unusually fast or slow breaths, from damage to the brainstem
  • Weak eye muscles, jerky eye movements and vision loss from optic nerve damage
  • Seizures, and in some children a thickened heart muscle, hearing loss, or liver or kidney problems

Who gets Leigh Syndrome?

Symptoms usually begin in the first year of life, often appearing or sharply worsening during a fever or infection.

More than 130 genes can cause it (over 120 in the nuclear DNA and 15 in the mitochondrial DNA): about 70-80% of cases come from nuclear genes, usually inherited from both parents (autosomal recessive, a 1 in 4 chance in each pregnancy), and roughly 20-30% from mitochondrial DNA, which is inherited only through the mother, though some changes arise new in the child.

In mitochondrial DNA cases, the share of mutated copies (heteroplasmy) can influence severity, most clearly for the MT-ATP6 m.8993 changes. A few genes, such as PDHA1, are X-linked. A minority of people first develop symptoms as teenagers or adults, with ataxia, nerve damage or psychiatric symptoms.

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Side effects people have reported to the FDA

Side effects people have reported to the FDA

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Diagnosis and genetic testing

Genetic testing for Leigh Syndrome

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Leigh Syndrome resources

Reputable organizations and medical references for learning more about Leigh Syndrome, including disease registries, foundation resources, and clinical guidelines.

Active clinical trials for Leigh Syndrome

Use this Leigh Syndrome clinical trial finder to see the 5 studies recruiting patients and 1 not yet recruiting in the United States and worldwide, with eligibility criteria in plain English. Of these, 1 tests a treatment and 5 are observational studies or registries; each card says which. Every trial comes from ClinicalTrials.gov.

Jump to the trial list, the site map or the pipeline timeline.

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

6 active trials worldwide
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RecruitingObservational study, no treatment givenRecently updatedNCT01780168

The NIH MINI Study: Metabolism, Infection, and Immunity in Inborn Errors of Metabolism

Sponsor: National Human Genome Research Institute (NHGRI)

The Metabolism, Infection and Immunity (MINI) Study is a longitudinal natural history study at the National Institutes of Health (NIH) that aims to define the relationship between infection, immunity and clinical decline in individuals with mitochondrial disease. Mitochondrial di...

Ages 4 Weeks to 115 Years1 location
Started Dec 2012Updated 2 weeks agoEst. Dec 2099 (~73y 2m)
RecruitingPatient registry covering many conditionsRecently updatedNCT01793168

Rare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford

Sponsor: Sanford Health

The Coordination of Rare Diseases at Sanford (CoRDS) is an international patient registry that serves as a centralized resource for rare disease research. Individuals affected by rare diseases, undiagnosed conditions, and disorders of unknown prevalence may voluntarily contribute...

Ages not specified1 location
Started Jul 2010Updated 2 weeks agoEst. Dec 2100 (~74y 2m)
RecruitingObservational study, no treatment givenUpdated a few months agoNCT05554835

Global Registry and Natural History Study for Mitochondrial Disorders

Sponsor: LMU Klinikum

The main goal of the project is provision of a global registry for mitochondrial disorders to harmonize previous national registries, enable world-wide participation and facilitate natural history studies, definition of outcome measures and conduction of clinical trials.

Ages not specified
Started Feb 2009Updated 3 months agoEst. Dec 2040 (~14y 1m)
Not yet recruitingTreatment trialPhase 2Updated a few months agoNCT06990984

A Dose-ranging Study of TTI-0102 in Adults and Children With Leigh Syndrome Spectrum (LSS)

Intervention: TTI-0102: cysteamine-pantetheine disulfide, D-Mannitol

Sponsor: Thiogenesis Therapeutics, Inc.

The goal of this clinical trial is to investigate oral TTI-0102 to evaluate its pharmacokinetics, safety, and preliminary efficacy in patients with Leigh syndrome spectrum, in three sequences. First sequence will be placebo-controlled and include 12 adolescents and adults weighin...

Ages 5 Years to 55 Years
Expected to start Oct 2026Updated 3 months agoEst. Jun 2027 (~7 months)
RecruitingObservational study, no treatment givenHasn't posted an update in over a yearNCT06967831

Drug Repurposing for Mitochondrial Disorders Using iPSCs Derived Neural Cells

Intervention: skin biopsy, generation of iPSCs, blood drawing, off-label compassionate drug use

Sponsor: Charite University, Berlin, Germany

In this project, the investigators are using iPSC lines derived from patients with Leigh syndrome that carry mutations in the mitochondrial (mtDNA) and in the nuclear DNA (nDNA) to reprogram them into neural progenitor cells and into dopaminergic neurons. The researchers are usin...

Ages not specified2 locations
Started Mar 2020Updated 1 year agoEst. Feb 2030 (~3y 3m)
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Active trial locations3 cities in the US
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Trial Pipeline

Jan 2021 to Nov 2031
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Phase 2
Observational
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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
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Leigh Syndrome patient communities

Facebook groups, Reddit communities and YouTube channels where Leigh Syndrome patients, caregivers and advocacy groups talk.

Companies developing Leigh Syndrome treatments

Drugmakers that list Leigh Syndrome in their rare disease portfolio, 2 in all.

Questions people ask about Leigh Syndrome