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To the Editor.—
In their recent article, Dupont et al stressed the importance of small focal white matter hyperintensities in bipolar disorder; these were absent in their control group but present in half of their patients. Although these focal abnormalities may reflect some disease, we wish to caution against the idea that they are not present in apparently healthy controls. As part of a magnetic resonance imaging study of schizophrenia, we collected data on 36 healthy controls and found similar small discrete abnormalities in seven people. These controls were matched to the patients by being taken from a similar parental social class, as well as being matched for age, sex, and race. All controls were younger than 50 years of age and had no history of neurologic or major psychiatric disorders, treated hypertension, systemic illness, or head injuries requiring hospital admission. The mean alcohol intake was less than 8 units
Harvey I, Ron M, Boulay GD, Murray R, Lewis S. White Matter Abnormalities on Magnetic Resonance Imaging in Bipolar Patients. Arch Gen Psychiatry. 1990;47(12):1172–1173. doi:10.1001/archpsyc.1990.01810240092016