Seasonal changes in clinical status in bipolar disorder: a prospective study in 1000 STEP-BD patients.

OBJECTIVE: To investigate seasonal and regional effects on bipolar I and II patients. METHOD: The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) patients were prospectively examined for monthly change in prevalence rates of depressed and recovered clinical status over the year. General Estimating Equation modeling was used to assess the effect of season on prevalence rates. Additionally, patients were stratified by bipolar subtype and by region. RESULTS: A significantly higher prevalence rate of depression is observed in the northern sites, a significant prevalence by month effect is found only in the bipolar II patients. CONCLUSION: The prevalence of depression is greater in patients from the northern vs. southern STEP-BD sites. Seasonal peak prevalence rates of depression differ by region. Bipolar II patients were more ill year-round and demonstrated greater monthly fluctuation in prevalence rates of being ill than did bipolar I patients. We conclude that seasonal effects upon bipolar patients vary by region and bipolar subtype.

Definition of neuronal circuitry controlling the activity of phrenic and abdominal motoneurons in the ferret using recombinant strains of pseudorabies virus.

During a number of behaviors, including vomiting and some postural adjustments, activity of both the diaphragm and abdominal muscles increases. Previous transneuronal tracing studies using injection of pseudorabies virus (PRV) into either the diaphragm or rectus abdominis (RA) of the ferret demonstrated that motoneurons innervating these muscles receive inputs from neurons in circumscribed regions of the spinal cord and brainstem, some of which have an overlapping distribution in the magnocellular part of the medullary reticular formation (MRF). This observation raises two possibilities: that two populations of MRF neurons provide independent inputs to inspiratory and expiratory motoneurons or that single MRF neurons have collateralized projections to both groups of motoneurons. The present study sought to distinguish between these prospects. For this purpose, recombinant isogenic strains of PRV were injected into these respiratory muscles in nine ferrets; the strain injected into the diaphragm expressed beta-galactosidase, whereas that injected into RA expressed green fluorescent protein. Immunofluorescence localization of the unique reporters of each virus revealed three populations of infected premotor neurons, two of which expressed only one virus and a third group that contained both viruses. Dual-infected neurons were predominantly located in the magnocellular part of the MRF, but were absent from both the dorsal and ventral respiratory cell groups. These data suggest that coactivation of inspiratory and expiratory muscles during behaviors such as emesis and some postural adjustments can be elicited through collateralized projections from a single group of brainstem neurons located in the MRF.

Transneuronal tracing of neural pathways controlling an abdominal muscle, rectus abdominis, in the ferret.

Abdominal muscles participate in generating a large number of behaviors and reflex responses, including expiration, coughing, sneezing, vomiting, postural control, production of speech, straining, facilitation of venous return to the heart, and reaction to vestibular stimulation. However, the only premotor neurons that have been conclusively shown to influence abdominal motoneurons are located in nucleus retroambiguus, the expiratory region of the caudal ventral respiratory group. In the present study, the neural circuitry controlling the activity of one abdominal muscle, rectus abdominis, was mapped using the transneuronal tracer pseudorabies virus (PRV) in the ferret. Injections of PRV into rectus abdominis labeled large presumed motoneurons in the ventral horn of T12-L4, and smaller presumed interneurons that were scattered in laminae VII, VIII, IX, and X of T4-L4. In addition, neurons in several areas of the medulla and caudal pons, including the retroambigual nucleus, medial and ventromedial reticular formation, nucleus prepositus hypoglossi, vestibular nuclei, and raphe nuclei, were infected by transynaptic passage of PRV from rectus abdominis motoneurons. Thus, the multifunctional roles of abdominal muscles appear to be coordinated by premotor neurons located in both the spinal cord and several regions of the brainstem.