Open-label study comparing the efficacy and tolerability of aripiprazole and haloperidol in the treatment of pediatric tic disorders

Due to its unique pharmacodynamic properties of dopamine partial agonist activity, and its association with few and mild side effects, aripiprazole is a candidate atypical antipsychotic for patients with tic disorders. This open-label study compared the efficacy and tolerability of aripiprazole with haloperidol, a typical antipsychotic widely used to treat patients with tic disorders. Forty-eight children and adolescents with tic disorders were recruited from the outpatient clinic at South Korea and treated with aripiprazole (initial dose, 5.0 mg/d; maximum dose 20 mg/d) or haloperidol (initial dose, 0.75 mg/d; maximum dose, 4.5 mg/d) for 8 weeks. Treatment efficacy was measured using the yale global tic severity scale (YGTSS), and tolerability was measured using the extrapyramidal symptom rating scale (ESRS) and an adverse effects checklist. Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups. ESRS scores were significantly higher in the haloperidol group during the 4 weeks after commencement of medication (p < 0.05). These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders. Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients

Protective Efficacy of Serially Up-Ranked Subdominant CD8+ T Cell Epitopes against Virus Challenges

Immunodominance in T cell responses to complex antigens like viruses is still incompletely understood. Some data indicate that the dominant responses to viruses are not necessarily the most protective, while other data imply that dominant responses are the most important. The issue is of considerable importance to the rational design of vaccines, particularly against variable escaping viruses like human immunodeficiency virus type 1 and hepatitis C virus. Here, we showed that sequential inactivation of dominant epitopes up-ranks the remaining subdominant determinants. Importantly, we demonstrated that subdominant epitopes can induce robust responses and protect against whole viruses if they are allowed at least once in the vaccination regimen to locally or temporally dominate T cell induction. Therefore, refocusing T cell immune responses away from highly variable determinants recognized during natural virus infection towards subdominant, but conserved regions is possible and merits evaluation in humans

Neural Mechanisms of Positive Mood Induced Modulation of Reality Monitoring

This study investigates the neural mechanisms of mood induced modulation of cognition, specifically, on reality monitoring abilities. Reality monitoring is the ability to accurately distinguish the source of self-generated information from externally-presented contextual information. When participants were in a positive mood, compared to a neutral mood, they significantly improved their source memory identification abilities, particularly for self-generated information. However, being in a negative mood had no effect on reality monitoring abilities. Additionally, when participants were in a positive mood state, they showed activation in several regions that predisposed them to perform better at reality monitoring. Specifically, positive mood induced activity within the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) was associated with improvements in subsequent identification of self-generated information, and positive mood induced activation within the striatum (putamen) facilitated better identification of externally-presented information. These findings indicate that regions within mPFC, PCC and striatum are sensitive to positive mood-cognition enhancing effects that enable participants to be better prepared for subsequent reality monitoring decision-making

Neural Mechanisms of Positive Mood Induced Modulation of Reality Monitoring

Photo of interior Mary Doi's Fuji Tea House in Salt Lake City, Utah, in the 1970s