Evaluating Treatment Outcomes for Teens Experiencing Suicidal Thoughts

Our child and adolescent forensic research team developed a protocol funded by PCORI to explore treatment outcomes for adolescents experiencing suicidal thoughts. Cincinnati Children's is the home base of this multi-site study that collaborates with Nationwide Children’s in Columbus, UT Southwestern in Dallas, and Northwell Health in New York. START, Suicide Treatment Alternatives for Teens, seeks to build an understanding of standard of care for suicidal thoughts through a comparison of inpatient treatment with the emerging intervention of outpatient crisis intervention clinics, such as the Bridge clinic at Cincinnati Children's. Over the past year, the research team worked closely with the PIRC and emergency departments to implement the randomized trial among patients who come for a mental health evaluation in the emergency department. Eligible patients are 12-18 years of age and presented with a chief complaint of suicidal ideation. After enrollment, we follow patients for six months and complete surveys every two weeks to evaluate treatment outcomes and safety. The emergence of telehealth as a primary source of services led the research team to identify a need to explore the safety and efficacy of this treatment with the suicidal adolescent population. The research team was recently awarded additional funding on an adjunct protocol to explore treatment outcomes for inpatient treatment, Outpatient Crisis Intervention Clinics and Telehealth Crisis Intervention Services.

Translational, Neurophysiological, and Next-generation Treatment Studies in Fragile X Syndrome

Fragile X syndrome (FXS) is the most common inherited form of intellectual disability and autism worldwide. Division of Psychiatry faculty Craig Erickson, MD; Kelli Dominick, MD, PhD; Martine Lamy, MD, PhD; and Ernest Pedapati, MD, from both the Divisions of Psychiatry and Neurology; along with collaborators from the Division of Developmental and Behavior Pediatrics members Rebecca Shaffer, PsyD, and Lauren Schmitt, PhD; Division of Neurology member Christina Gross, PhD; and Division of Behavioral Medicine and Clinical Psychology member Elizabeth Smith, PhD, are spearheading a nationwide collaborative to understand brain mechanisms and pioneer new treatments in FXS. Individual with FXS suffer from heightened irritation from sounds and other sensory experiences believed caused by heightened neuronal excitability. By studying how the FXS brain responds to sensory inputs, we may better understand how the FXS brain may more generally work in autism and intellectual disability.

Cincinnati Children's is the primary human research site for two large NIH funded research programs with basic science collaborators at UT Southwestern, UCLA and UC Riverside. Collaborators are taking a multilevel, integrated approach that tests mechanisms of sensory neocortical dysfunction in FXS and pharmacological approaches to reduce the deficits. Participants, and their families from around the country, take part in this research program which includes evaluation of brain activity with electroencephalography, eye tracking and novel blood biomarkers. Other neuroimaging programs are also supported including functional magnetic imaging (fMRI) and near infrared spectroscopy (NIRS). The research with federal research programs supports EEG studies of cognition and transcranial magnetic stimulation-based biomarkers of brain functioning in FXS.

Cincinnati Children's is highly involved in translational research including one of two fragile X mouse EEG research programs in the country. Team involvement in cutting edge treatment trials for novel pharmaceutical agents for treatment of the core symptoms of FXS, for which no cure exists, includes federally and industry sponsored clinical trials across pediatric and adult populations. Most recently, Cincinnati Children's announced a next-generation gene therapy program to ultimately address the fundamental deficit in FXS, which is a single dysfunctional gene. With generous divisional investment and institutional support, the FXS program at Cincinnati Children's receives tremendous recognition for both research and clinical care and is well-positioned to make breakthroughs in the field.