Neurological and Behavioral Outcomes Center
Neurological and Behavioral Outcomes Center investigators at University Hospitals Cleveland Medical Center is devoted to studying outcomes for patients with neurological and neuropsychiatric conditions and has developed a reputation for novel methodologies and approaches that have the potential to improve health outcomes for patients.
The center collaborates with faculty from Case Western Reserve University School of Medicine and School of Arts and Sciences, the Francis Payne Bolton School of Nursing, the Veterans Health Administration, MetroHealth Medical Center, the Case Western Reserve University Prevention Research Center and the Cleveland Clinic, along with multiple other domestic and international Universities.
Recent Neurological and Behavioral Outcomes Center highlights include implementation of a Minority Advisory Board (MAB) that is intended to help support a successful grant submission to establish a Cleveland-wide Alzheimer's Disease Research Center in collaboration with the Case Brain Health Collaborative.
Cleveland Alzheimer's Disease Research Center (CADRC)
The Cleveland Alzheimer's Disease Research Center, supported by a two-year NIH grant, will bring together top researchers and clinicians from University Hospitals, Case Western Reserve University, Cleveland Clinic, Louis Stokes Cleveland VA Medical Center and the MetroHealth System. CADRC focuses on accelerating research for Alzheimer's disease and related dementias.
Particular areas of focus for the center will be atypical Alzheimer's disease (e.g. "rapidly progressive"), Lewy body dementia, healthy individuals at risk for developing dementia, and underserved populations. In addition to community outreach, the center will develop infrastructure and support for promising new investigators and promote the translation of findings from the laboratory to new therapeutics for these devastating diseases.
International Society for Bipolar Disorders (ISBD)
A three-year, $600,000 ISBD grant will fund a first-of-its-kind multi-national database that can be used to help researchers address questions about bipolar disorder throughout the adult lifespan.
Under the grant, investigators will aggregate and standardize data from more than 1,000 bipolar patients worldwide who have been previously studied. But most findings from these studies are based on research samples of no more than 50 participants from a relatively narrow geographic and age representation. By creating a single comprehensive data set, the scientific team aims to overcome these shortfalls and increase knowledge about bipolar disorder, its symptoms, and changes in behavior at different stages of life.
This one-year project, done as a partnership between Case Western Reserve University and Taipei Medical University (TMU) will enroll individuals with serious mental illness and conduct a cross-sectional analysis to evaluate the relationship between brain alteration, inflammatory markers and clinical features. The psychiatric sample will be compared to a sample of approximately 60 age- and sex-matched healthy controls. Data collection and analysis will be conducted at TMU. Findings are expected to inform future collaborative research efforts between investigators at TMU and Case Western Reserve University.
Adolescent Bipolar Disorder
The most common onset of bipolar disorder (BD) is during late adolescence and early adulthood. While pharmacotherapy is effective for BD symptoms in adolescents and young adults (AYA), poor adherence occurs in more than 65 percent of AYAs and is associated with low rates of recovery, high rates of relapse and a 5.2 fold increase in suicide risk. Poor adherence is a critical yet modifiable risk factor of poor outcomes in AYAs with BD. AYAs are an ideal BD subgroup to target and test adherence interventions given the potential impact of enhanced adherence on social, educational and occupational goals during this critical developmental period which can lay the foundation for lifelong BD self-management skills. To date, there are no interventions that specifically target adherence in AYAs with BD.
The proposed three-phase project will identify relevant characteristics of AYAs and needed refinements to CAE (Phase 1) and standardize the intervention using iterative refinements based on patient feedback (Phase 2). Phases 1 and 2 will be completed over a 12-month time period. In Phase 3 (months 13-36) we will test the feasibility, acceptability and preliminary efficacy of the adapted approach using a randomized controlled trial (RCT) design in a high-risk, high-need group: AYAs ages 16-21 with BD who are poorly adherent with prescribed BD medications. If proven effective, the proposed trial will pave the way for a rigorous efficacy trial of CAE-AYA.
In spite of advances in biological therapies, many people with epilepsy have poor outcomes including negative health events (NHEs) such as frequent seizures, accidents and emergency department visits, and low quality of life. Risk factors for poorly controlled epilepsy include limited social supports, poor medication adherence, and comorbidities like mental illnesses. People with epilepsy who live in rural or under-served communities face additional challenges such as social isolation, limited access to care and low levels of epilepsy awareness. The Managing Epilepsy Well (MEW) Network has been a national leader in developing, testing and disseminating evidence-based epilepsy self-management programs. One of these, Self-management for people with epilepsy and a history of negative health events (SMART) is an online, group-format program that has been demonstrated to reduce NHEs and improve quality of life and physical and mental health functioning in individuals with epilepsy.
This two-site, five-year prospective randomized controlled trial (RCT) will investigate the effects of the SMART program among people with epilepsy who have had recent NHEs vs. a six-month wait-list control. The RCT will be conducted in Ohio and in Iowa, led by a team from Case Western Reserve University in Cleveland and from the University of Iowa, in Iowa City, Iowa, in collaboration with local and regional epilepsy care stakeholders and partners. Key foci of the study are to replicate the efficacy findings of the original SMART study and to obtain new information on how SMART is perceived among people with epilepsy, their families, clinicians and other stakeholders in rural and underserved communities.
Stroke Risk Reduction in African-American Men
African-Americans (AA) have substantially higher stroke rates, compared to any other racial-ethnic group. Racial disparities in stroke outcomes are particularly high among AA men. The proposed project will test a nurse and patient co-led curriculum-guided self-management support approach, Targeted Management (TEAM) focused specifically on AA men at high risk for stroke. If previously conducted pilot results can be confirmed, TEAM represents a practical approach suitable for broad scale-up, with the potential to reverse the unacceptably high morbidity seen in AA men due to stroke.