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Nicotine Use as a Possible Risk Factor for Subcortical Abnormalities

Richard S. Epstein, MD
Arch Gen Psychiatry. 1990;47(12):1172. doi:10.1001/archpsyc.1990.01810240092015.
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To the Editor.—  The findings of Dupont et al1 contribute to the efforts to understand the structural and neuropsy-chological correlates of affective disorder.The authors note that the subcortical signal hyperintensities in the magnetic resonance imaging scans of a subgroup of bipolar patients might also be found in patients with multiple sclerosis or Binswanger's disease. They did not feel that this was relevant in their study because the magnetic resonance imaging abnormalities were not found in similarly screened agematched controls. While these patients were screened for alcohol and drug abuse, no mention was made of nicotine use. Roman2 reviewed the white matter lesions in dementia of the Binswanger type and noted that smoking may be one of the risk factors leading to diminished blood flow in susceptible subcortical regions. If there was a differential use of nicotine between subjects with positive or negative scans in the


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