Published Online
on August 14, 2008

A more recent version of this article appeared on November 1, 2008

This Article Full Text (PDF) All Versions of this Article: 39/11/3083    most recent STROKEAHA.108.521807v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gouw, A. A. Search for Related Content PubMed PubMed Citation Articles by Gouw, A. A. Related Collections Cerebrovascular disease/stroke CT and MRI Cerebral Lacunes Related Article

Submitted on March 31, 2008
Accepted on April 16, 2008

On the Etiology of Incident Brain Lacunes. Longitudinal Observations From the LADIS Study

Alida A. Gouw MD^*; Wiesje M. van der Flier PhD; Leonardo Pantoni MD, PhD; Domenico Inzitari MD; Timo Erkinjuntti MD, PhD; Lars O. Wahlund MD, PhD; Gunhild Waldemar MD, DMSc; Reinhold Schmidt MD; Franz Fazekas MD; Philip Scheltens MD, PhD; Frederik Barkhof MD, PhD; on behalf of the LADIS Study Group

From the Alzheimer Center (A.A.G., W.M.v.d.F., P.S., F.B.), and the Department of Neurology (A.A.G., W.M.v.d.F., P.S.), the Department of Radiology (F.B.), Image Analysis Center (A.A.G., F.B.), Vrije Universiteit Medical Center, Amsterdam, The Netherlands; the Department of Neurological and Psychiatric Sciences (L.P., D.I.), University of Florence, Italy; Memory Research Unit, Department of Clinical Neurosciences (T.E.), Helsinki University, Finland; the Karolinska Institutet, Department of Neurobiology (L.O.W.), Care Sciences and Society, Karolinska University Hospital Huddinge, Sweden; the Memory Disorders Research Unit, Department of Neurology (G.W.), Copenhagen University Hospital, Denmark; and the Department of Neurology and MRI Institute (R.S., F.F.), Medical University, Graz, Austria.

^* To whom correspondence should be addressed. E-mail: AA.Gouw{at}vumc.nl.

Background and Purpose—We investigated regional differences in MRI characteristics and risk factor profiles of incident lacunes over a 3-year period.

Methods—Baseline and 3-year follow-up MRI were collected within the LADIS study (n=358). Incident lacunes were characterized with respect to brain region, their appearance within pre-existent white matter hyperintensities (WMH), surrounding WMH size, and risk factors.

Results—106 incident lacunes were observed in 62 patients (58 subcortical white matter [WM], 35 basal ganglia, and 13 infratentorial). Incident subcortical WM lacunes occurred more often within preexisting WMH (P=0.01) and were mostly accompanied by new and expanded WMH (P<0.001), compared to incident basal ganglia and infratentorial lacunes. Risk factors for incident subcortical WM lacunes were history of hypertension and stroke, whereas atrial fibrillation predicted incident basal ganglia/infratentorial lacunes.

Conclusion—Differences in relation to WMH and risk factor profiles may suggest that incident lacunes in the subcortical WM have a different pathogenesis than those in the basal ganglia and infratentorial region.

Key words: lacunes • white matter hyperintensities • MRI

Related Article:

What Is a Lacune?

Joanna M. Wardlaw
Stroke 2008 39: 2921-2922. [Extract] [Full Text] [PDF]