DEEP
WHITE MATTER ABNORMALITIES ON MRI ARE LINKED TO WINTER BIRTHS IN
BIPOLAR PATIENTS
P.B. Moore*, A.
H. Young, I.N. Ferrier. Department Psychiatry, Newcastle
University, Newcastle Upon Tyne, United Kingdom
Introduction: Recently it
has been established that bipolar patients, show winter/early
spring birth excess. Although white matter abnormalities are
found three times more frequently in bipolars than controls, the
neuropathology and clinical correlates of the abnormalities
remain poorly understood.
Method: 7mm thick axial T2
weighted (TR=2300, TE=25, 100ms) and proton
density scans were examined from 79 bipolar patients (DSM IV; 15
males, 64 females, age 35.4±8.6yrs)
for the presence of deep subcortical (DWML) and periventricular
white matter lesions( PVWML). The birth season of patients
showing DWMLs or PVWMLs were compared with those of the general
population.
RESULTS: Thirteen subjects
exhibited DWMLs, of whom 9 were born in the months Jan-March, a
frequency significantly different from the normal population (c 2=14.49,
DF=3, p=0.003) and from bipolars without DWMLs ((c 2=10.77,
DF=3, p=0.014). Seven of these patients had remained symptomatic
for 2 years despite adequate therapy.
COMMENT: Birth season,
illness outcome and DWMLs appear to be closely linked. DWMLs may
represent a marker of an in-utero toxic or infective insult.