Increased prevalence of microangiopathic brain lesions among siblings of patients with lacunar stroke. A prospective multicenter study.
BACKGROUND
Family and twin studies suggest predisposing genetic factors in stroke. Lacunar infarcts represent a homogeneous phenotype, which is a prerequisite for genetic analyses. Applying an affected sib -pair analysis, we prospectively assessed the prevalence of microangiopathic brain lesions (MBL) and associated risk factors among siblings of patients with lacunar stroke.


METHODS
Index patients fulfilled clinical criteria of a lacunar stroke in combination with a corresponding MBL on CT or MRI. Siblings were characterized as affected if MBL demonstrated on MRI. The prevalence of MBL was compared with population prevalence data extracted from other studies.


RESULTS
From 784 patients screened, 81 index patients with lacunar stroke and 97 siblings were recruited, of which 42% were identified as affected. Compared with data from unselected historical controls and stratified by age groups, prevalence was between 2 and 5 times higher.


CONCLUSIONS
Our results indicate that genetic stroke studies are feasible even in subtypes of ischemic stroke. The high prevalence of MBL among siblings of patients with lacunar infarct might suggest a familial aggregation. However, due to the small sample size these results need to be interpreted with caution and require confirmation by planned genetic analyses.
Department of Neurology, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
Stefanie
S
Leistner
Norbert
N
Huebner
Andreas
A
Faulstich
Daniela
D
Ludwig
Maren
M
Rees
Peter
P
Marx
Bettina
B
Langer
Alexandrina
A
Nikolova
Andreas
A
Hartmann
Hans-Christian
HC
Koennecke
D000368:Aged; D020520:Brain Infarction / Q000453:epidemiology / Q000235:genetics / Q000473:pathology; D002533:Cerebral Angiography / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D035781:Siblings; D020521:Stroke / Q000150:complications* / Q000453:epidemiology / Q000235:genetics*; D014057:Tomography, X-Ray Computed