title: On the etiology of incident brain lacunes: longitudinal observations from the LADIS study.
abstract: 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.
authors.affiliation: Alzheimer Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. AA.Gouw@vumc.nl
authors.forename: Alida A
authors.initials: AA
authors.lastname: Gouw
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: Lars O
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
mesh_terms: 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