Skip to main content
Evidence-Based Supplement Research
Evidence-Based Supplement Research
Pillser
Search
Sign UpLog In

Potential benefits of l-serine in children with GRIN2B loss-of-function variants: Randomized n-of-1 trials.

  • 2025-12
  • Molecular genetics and metabolism 146(4)
    • Bibiche den Hollander
    • Marieke Rothuizen-Lindenschot
    • Hoang Lan Le
    • Jennifer R Ramautar
    • Annelieke R Müller
    • Lisa Geertjens
    • Frédéric M Vaz
    • Agnies M van Eeghen
    • Martina C Cornel
    • Bart A W Jacobs
    • Hilgo Bruining
    • Peter M van de Ven
    • Marion M Brands
    • Clara D van Karnebeek

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 3
Population
4 children with GRIN2B LoF variants
Methods
Double-blind, randomized, placebo-controlled, one-year n-of-1 trials consisting of 2 cycles of 6 months
Blinding
Double-blind
Duration
1 year
Funding
Unclear

Background

GRIN2B-neurodevelopmental disorder (GRIN2B-NDD) is a rare genetic disorder caused by pathogenic variants in GRIN2B, leading to impaired N-methyl d-aspartate receptor (NMDAR) function. l-serine, a precursor to d-serine that modulates NMDAR activity, has shown therapeutic potential for GRIN2B loss-of-function (LoF) variants.

Methods

The efficacy of oral l-serine supplementation in 4 children with GRIN2B LoF variants were evaluated in the first double-blind, randomized, placebo-controlled, one-year n-of-1 trials. The trial consisted of 2 cycles of 6 months.

Results

The Perceive, Recall, Plan, and Perform Assessment (PRPP-A) showed a significant improvement in Performance Mastery at 1.5 months (p = 0.0373), while 11 of 14 other PRPP-A measures showed mean differences that were numerically in the same direction toward a positive l-serine effect (not significant). Secondary outcomes varied across patients, for those with statistical group analysis, no significant difference were observed. Individual improvements were noted in information processing/adaptive function (n = 3/4), quality of life (n = 3/4), sleep (n = 1/2), irritability (n = 2/4), and language (n = 1/3), based on objective assessments and anecdotal parent reports.

Conclusion

These pioneering n-of-1 trials provide insights into l-serine's potential for GRIN2B-NDD, with improvements in two of four patients, though no clear distinguishing responder-characteristics were identified. Future trials should focus on refining patient selection, the use of multiple baseline designs, establishing a core outcome set and pooling treatment data to better understand patient-specific responses.

Research Insights

  • L-Serine→Improved Performance Mastery

    The Perceive, Recall, Plan, and Perform Assessment (PRPP-A) showed a significant improvement in Performance Mastery at 1.5 months (p = 0.0373)

    Effect
    Beneficial
    Effect size
    Small
Back to top