Similar rhythms of seasonal conceptions in neural tube defects and schizophrenia: a hypothesis of oxidant stress and the photoperiod.
BACKGROUND: Numerous studies have found that people with schizophrenia tend to be born most often in late winter and least often in late summer. The same rhythm appears in the birth of children with neural tube defects (NTDs). In the northern hemisphere, both disorders thus show a conception peak in May-June and a trough around November-December. The senior author found the same May-June conception peak among left-handed American baseball players and the opposite effect (a November-December peak) among extreme right-handed players. A similar rhythm appeared with respect to characteristics related to artistic as opposed to scientific modes of thought. DISCUSSION: Schizophrenia has been proposed to involve a deficit in the establishment of lateral asymmetry, as does left-handedness. The artist-scientist dichotomy is also believed to involve cerebral dominance. Thus, the similarity of seasonal variation in month of conception between NTDs, schizophrenia, left-handedness, and artistic intuition suggests that these four conditions may share some factor affecting the cellular processes involved in both neural tube closure and asymmetry development during the early-fourth week, neural-fold stages of embryogenesis. We propose that maternal oxidant stress, which can rise with exposure to intense solar radiation, may interfere with both neural tube closure and asymmetry development. The June and December extremes of sunlight would thus explain the peak times of the seasonal fluctuations. Moreover, regardless of mechanisms, the parallel between the two conception rhythms suggests that the same periconceptional folate regimens found effective in preventing NTDs may also lower the risk of schizophrenia. This paper reviews some of the clinical and experimental evidence supporting this hypothesis.