Dravet syndrome (SCN1A; NaV1.1 loss-of-function, GABAergic-interneuron haploinsufficiency) OMIM 607208

In Dravet syndrome (SCN1A, OMIM 607208), the master switch sits on the ↓ DOWN branch ([F] forced below); the healthy state is the ON well. The forced corrective direction is to raise s toward ON branch (polarity: supply). Classification: ○ Novel direction-only lead. Direction only — no dose, no efficacy magnitude.

The disease maps to an R19 double-well whose corrective lever is read straight off the cusp (barrier 0.3875, γ 1.2450, spinodal 0.5347). The corrective direction is forced [F]; the agent names below are direction-concordant labels at grade [O] (no dose, no efficacy or safety magnitude). This is a research hypothesis offered to experts, not medical advice.

The emergence switch

The switch for Dravet syndrome is an R19 double-well emerged from the real proximal-promoter DNA of SCN1A. Its geometry is fixed by measured stiffness γ (never fitted); the numbers below are read directly off that cusp.

emergent axis
↓ DOWN [F]
healthy branch
ON
lesion
LOF_null
γ (stiffness)
1.2450
barrier
0.3875
spinodal
0.5347
s_on / s_off
1.1158 / -1.1158
fragility
1.00
corrective polarity
supply
forced direction
raise s toward ON branch

Chemistry feasibility (DIRECTION only [O]). small-molecule recrossing of the fold is geometrically plausible (barrier 0.3875 at neutral drive; lower barrier = smaller drive to supply). [O] -- no affinity/potency/dose/efficacy asserted.

The derived corrective lever

The cusp forces a corrective direction: raise s toward ON branch. This is the load-bearing output of the framework — it is [F] forced, and it is falsifiable. 2 lever families are derived; the lead is h-restore (drive modulator).

h-restore (drive modulator)sign: increasegeometric rank 1.00
Mechanism. supply / restore the positive drive (replace-or-agonise the missing competence)
Applies to. allele-agnostic (downstream/environmental tilt)
favoured when the switch is fragile -- a small drive shift recrosses the fold
Falsifier. If supplying/agonising SCN1A (raising the switch drive) does NOT move the DOWN [F] switch toward the healthy branch in a SCN1A-deficient model, the h-restore(supply) lever is refuted for this axis.
gamma-restore (stabiliser / chaperone)sign: Nonegeometric rank 0.00
Mechanism. N/A
Applies to. none (honest exclusion)
EXCLUDED: null allele -- no product to stiffen
Falsifier. If a folding-stabiliser/chaperone does NOT re-deepen the healthy well for a residual SCN1A allele (no rescue that a null allele lacks), the gamma-restore lever is refuted; null alleles are excluded by construction.

Agents mapped onto the lever

Existing agents whose known action is direction-concordant with the derived lever (status as pinned in the corpus; no dose, no efficacy magnitude).
agent (class)dir.statusphasemap
SCN1A-upregulating antisense oligonucleotide (zorevunersen / STK-001, TANGO)
Han 2020 Sci Transl Med 12:eaaz6100 (TANGO ASO upregulates Scn1a, reduces seizures / SUDEP in Dravet mice); Stoke Therapeutics zorevunersen / STK-001 Phase 1-3 programme
increaseinvestigational2◇ in trials
interneuron-targeted SCN1A gene replacement (dual-AAV split-intein NaV1.1; DLX2.0-SCN1A enhancer)
Tanenhaus 2022 Hum Gene Ther 33:579 (eTF-SCN1A endogenous upregulation); Mich 2025 Sci Transl Med (DLX2.0-SCN1A dual-AAV interneuron gene replacement in Dravet mice)
increaseinvestigational2◇ in trials
⚠ Mechanism-direction only — do not self-administer; no dose (unvalidated; set by a physician / national authority); not an approved use.

Direction-only candidate leads (corpus join)

Each lead is surfaced only because its known mechanism points the same way as the derived lever, and each comes with a source and a falsifier. None is a treatment.

zorevunersen○ novel leaddir: increase · investigational
Class. antisense oligonucleotide (TANGO) upregulating productive SCN1A transcript
Mechanism. An investigational antisense oligonucleotide that redirects SCN1A splicing to increase productive mRNA and Nav1.1 protein in inhibitory interneurons, supplying the haploinsufficient channel function. Direction on the disease axis: increase -- supply the lost SCN1A competence. Engaged node: SCN1A (unique among the 113). Allele scope: haploinsufficiency-directed (augments the productive allele). Categorically distinct from the approved Dravet anticonvulsants (stiripentol, cannabidiol, fenfluramine), which are symptomatic and do NOT supply Nav1.1, hence are not direction-matched and are not catalogued. Sodium-channel BLOCKERS remain contraindicated in Dravet; this is an SCN1A-RAISING lever, the opposite action. INVESTIGATIONAL direction-only hypothesis (no efficacy/approval/availability claim); status per training knowledge to Jan 2026 -- confirm current development.
Prior-art. Direction-only hypothesis: the geometry derives an increase (supply the haploinsufficient channel) for SCN1A; the investigational TANGO antisense zorevunersen upregulates productive SCN1A/Nav1.1, a matched increase. Distinct from approved symptomatic anticonvulsants (stiripentol/cannabidiol/fenfluramine), which do not supply Nav1.1; sodium-channel blockers remain contraindicated, this is the opposite (channel-raising) action. Investigational; confirm current status. No efficacy/availability claim.
Safety (qualitative; no magnitude). investigational intrathecal antisense oligonucleotide; CSF-delivery considerations (qualitative; no magnitude); confirm current development status
Falsifier. If zorevunersen (a gene-specific supply/increase agent) does NOT move the DOWN [F] switch toward the healthy branch in a SCN1A-deficient model, the h-restore(supply) direction is refuted for zorevunersen here.
Source: Zorevunersen (TANGO antisense) investigational SCN1A-upregulating programme in Dravet syndrome
⚠ Mechanism-direction only — do not self-administer; no dose (unvalidated; set by a physician / national authority); not an approved use.

Evidence & provenance

What is reproduced vs. cited for this page.
elementgradebasis
R19 switch & cusp geometry (this page)[V] verifiedemerged from measured promoter γ of SCN1A; deterministic, 2×sha256 identical
corrective direction[F] forcedforced by the cusp sign; falsifiable (see lever falsifiers)
mapped agents / leads[O] opendirection-concordance only; corpus-pinned (2026-06-21); no dose, no efficacy/safety magnitude

Reading the agent column. VALIDATION SIGNAL -- the agent is already approved / established standard for this disease, so the direction logic recovered known clinical practice. Not a new claim by this kit. GENUINE HYPOTHESIS -- no approved indication for this disease; the direction match is a direction-only, untested [O] lead. Basis field grades the evidence (investigational here / in a related condition / off-label / speculative).