On the etiology of incident brain lacunes: longitudinal observations from the LADIS study.
OBJECTIVE
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.


CONCLUSIONS
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.
Gouw
Alida A
AA
Alzheimer Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. AA.Gouw@vumc.nl
van der Flier
Wiesje M
WM
Pantoni
Leonardo
L
Inzitari
Domenico
D
Erkinjuntti
Timo
T
Wahlund
Lars O
LO
Waldemar
Gunhild
G
Schmidt
Reinhold
R
Fazekas
Franz
F
Scheltens
Philip
P
Barkhof
Frederik
F
D001479:Basal Ganglia / Q000473:pathology*; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D006801:Humans; D049292:Leukoaraiosis / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012307:Risk Factors