Skip to main content

Frequency of white matter lesions and silent lacunar infarcts

  • Conference paper
Ageing and Dementia Current and Future Concepts

Part of the book series: Journal of Neural Transmission. Supplementa ((NEURAL SUPPL,volume 62))

Abstract

White matter lesions and silent lacunar infarcts are related to andmay result from cerebral small vessel disease. Reported frequencies of theselesions vary largely among studies. Differences in imaging techniques, ratingscales, cut-off points in lesion severity grading and study populations contribute to the variation, in addition to differences in risk factor profiles acrossstudies.

In this paper, we will firstly discuss general methodological issues that may influence reported frequencies of white matter lesions and silent lacunar infarctions, and then review published data. We will focus on the results from population-based studies and only briefly comment on patient series fo stroke and dementia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Barber R, Scheltens P, Gholkar A, Ballard C, McKeith I, Ince P et al. (1999) White matterlesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer’sdisease, vascular dementia, and normal aging. J Neurol Neurosurg Psychiatry 67: 66–72

    Article  CAS  PubMed  Google Scholar 

  • Bogousslavsky J, Regli F, Uske A (1987) Leukoencephalopathy in patients with ischemicstroke. Stroke 18: 896–899

    Article  CAS  PubMed  Google Scholar 

  • Boiten J, Lodder J, Kessels F (1993) Two clinically distinct lacunar infarct entities? Ahypothesis. Stroke 24: 652¡ª656

    Google Scholar 

  • Bokura H, Kobayashi S, Yamaguchi S (1998) Distinguishing silent lacunar infarctionfrom enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathologi-cal study. J Neurol 245: 116–122

    Article  CAS  PubMed  Google Scholar 

  • Boon A, Lodder J, Heuts-van Raak L, Kessels F (1994) Silent brain infarcts in 755consecutive patients with a first-ever supratentorial ischemic stroke. Relationshipwith index-stroke subtype, vascular risk factors, and mortality. Stroke 25: 2384–2390

    Article  CAS  PubMed  Google Scholar 

  • Breteler MM, van Swieten JC, Bots ML, Grobbee DE, Claus JJ, van den Hout JH, et al.(1994) Cerebral white matter lesions, vascular risk factors, and cognitive function ina population-based study: the Rotterdam Study. Neurology 44: 1246–1252

    Article  CAS  PubMed  Google Scholar 

  • Briley DP, Haroon S, Sergent SM, Thomas S (2000) Does leukoaraiosis predict morbidityand mortality? Neurology 54: 90–94

    Article  CAS  PubMed  Google Scholar 

  • Bryan RN, Wells SW, Miller TJ, Elster AD, Jungreis CA, Poirier VC, et al. (1997)Infarctlike lesions in the brain: prevalence and anatomic characteristics at MR imaging of the elderly-data from the Cardiovascular Health Study. Radiology 202: 47–54

    CAS  PubMed  Google Scholar 

  • Bryan RN, Cai J, Burke G, Hutchinson RG, Liao D, Toole JF, et al. (1999) Prevalenceand anatomic characteristics of infarct-like lesions on MR images of middle-agedadults: the atherosclerosis risk in communitiesstudy. AJNR Am J Neuroradiol 20:1273–1280

    CAS  PubMed  Google Scholar 

  • Frequency of white matter lesions and silent lacunar infarcts 37deGroot JC, de Leeuw

    Google Scholar 

  • FE.OudkerkM,van Gijn J, Hofman A, Jolles J, et al. (2000)Cerebral white matter lesions and cognitive function:the Rotterdam Scan Study. AnnNeurol 47: 145–151

    Google Scholar 

  • de Leeuw FE, de Groot JC, Achten E, Oudkerk M, Ramos LM, Heijboer R, et al. (2001)Prevalence of cerebral white matter lesions in elderly people: a population basedmagnetic resonance imaging study. The Rotterdam Scan Study. J Neurol NeurosurgPsychiatry 70: 9–14

    Article  Google Scholar 

  • DeCarli C, Miller BL, Swan GE, Reed T, Wolf PA, Garner J, et al. (1999) Predictors ofbrain morphology for the men of the NHLBI twin study. Stroke 30: 529–536

    Article  CAS  PubMed  Google Scholar 

  • Erkinjuntti T, Ostbye T, Steenhuis R, Hachinski V (1997) The effect of different diagnos-tic criteria on the prevalence of dementia. N Engl J Med 337: 1667–1674

    Article  CAS  PubMed  Google Scholar 

  • Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, et al.(1993)Pathologic correlates of incidental MRI white matter signal hyperintensities. Neuro-logy 43: 1683–1689

    Article  CAS  Google Scholar 

  • Fazekas F, Kapeller P, Schmidt R, Offenbacher H, Payer F, Fazekas G (1996) Therelation of cerebral magnetic resonance signal hyperintensities to Alzheimer’s disease.J Neurol Sci 142:121–125

    Article  CAS  PubMed  Google Scholar 

  • Furuta A,Ishii N, Nishihara Y,Horie A (1991) Medullary arteries in aging and dementia.Stroke 22: 442–446

    Google Scholar 

  • Herderschee D, Hijdra A, Algra A, Koudstaal PJ, Kappelle LJ, van Gijn J (1992) Silentstroke in patients with transient ischemic attack or minor ischemic stroke. The DutchTIA Trial Study Group. Stroke 23: 1220–1224

    Article  CAS  PubMed  Google Scholar 

  • Hijdra A,Verbeeten B Jr,Verhulst JA (1990) Relation ofleukoaraiosis to lesion type instroke patients. Stroke 21: 890–894

    Article  CAS  PubMed  Google Scholar 

  • Hirono N, Kitagaki H, Kazui H, Hashimoto M, Mori E (2000) Impact of white matterchanges on clinical manifestation of Alzheimer’s disease: a quantitative study. Stroke31: 2182–2188

    Article  Google Scholar 

  • Inzitari D, Giordano GP, Ancona AL, Pracucci G, Mascalchi M, Amaducci L,(1990)Leukoaraiosis, intracerebral hemorrhage, and arterial hypertension. Stroke 21: 1419–1423

    Article  CAS  PubMed  Google Scholar 

  • Inzitari D, Cadelo M, Marranci ML, Pracucci G, Pantoni L (1997) Vascular deaths inelderly neurological patients with leukoaraiosis. J Neurol Neurosurg Psychiatry 62:177–181

    Article  CAS  PubMed  Google Scholar 

  • Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS (1995) Leukoaraiosis in strokepatients. The Copenhagen Stroke Study. Stroke 26: 588–592

    Article  CAS  PubMed  Google Scholar 

  • Jungreis CA, Kanal E, Hirsch WL, Martinez AJ, Moossy J (1998) Normal perivascularspaces mimicking lacunar infarction: MR imaging. Radiology 169: 101–104

    Google Scholar 

  • Kase CS, Wolf PA, Chodosh EH, Zacker HB, Kelly-Hayes M, Kannel WB, et al. (1989)Prevalence of silent stroke in patients presenting with initial stroke: the FraminghamStudy. Stroke 20: 850–852

    Article  CAS  PubMed  Google Scholar 

  • Kobayashi S, Okada K, Koide H, Bokura H, Yamaguchi S (1997) Subcortical silent braininfarction as a risk factor for clinical stroke. Stroke 28: 1932–1939

    Article  CAS  PubMed  Google Scholar 

  • Lammie GA, Brannan F, Slattery J, Warlow C (1997) Nonhypertensive cerebral small-vessel disease. An autopsy study. Stroke 28: 2222–2229

    Article  CAS  PubMed  Google Scholar 

  • Herderschee D, Hijdra A, Algra A, Koudstaal PJ, Kappelle LJ, van Gijn J (1992) Silentstroke in patients with transient ischemic attack or minor ischemic stroke. The DutchTIA Trial Study Group.Stroke 23: 1220–1224

    Article  CAS  PubMed  Google Scholar 

  • Hijdra A, Verbeeten B Jr, Verhulst JA (1990) Relation of leukoaraiosis to lesion type instroke patients. Stroke 21: 890–894

    Article  CAS  PubMed  Google Scholar 

  • Hirono N, Kitagaki H, Kazui H, Hashimoto M, Mori E (2000) Impact of white matterchanges on clinical manifestation of Alzheimer’s disease: a quantitative study. Stroke31: 2182–2188

    Article  CAS  PubMed  Google Scholar 

  • Inzitari D, Giordano GP, Ancona AL, Pracucci G, Mascalchi M, Amaducci L (1990)Leukoaraiosis, intracerebral hemorrhage, and arterial hypertension. Stroke 21: 1419–1423

    Article  CAS  PubMed  Google Scholar 

  • Inzitari D, Cadelo M, Marranci ML, Pracucci G, Pantoni L (1997) Vascular deaths inelderly neurological patients with leukoaraiosis. J Neurol Neurosurg Psychiatry 62:177–181

    Article  CAS  PubMed  Google Scholar 

  • Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS (1995) Leukoaraiosis in strokepatients. The Copenhagen Stroke Study. Stroke 26: 588–592

    Article  CAS  PubMed  Google Scholar 

  • Jungreis CA, Kanal E, Hirsch WL, Martinez AJ, Moossy J (1998) Normal perivascularspaces mimicking lacunar infarction: MR imaging. Radiology 169: 101–104

    Google Scholar 

  • Kase CS, Wolf PA, Chodosh EH, Zacker HB, Kelly-Hayes M, Kannel WB, et al. (1989)Prevalence of silent stroke in patients presenting with initial stroke: the FraminghamStudy. Stroke 20: 850–852

    Article  CAS  PubMed  Google Scholar 

  • Kobayashi S, Okada K, Koide H, Bokura H, Yamaguchi S (1997) Subcortical silent braininfarction as a risk factor for clinical stroke. Stroke 28: 1932–1939

    Article  CAS  PubMed  Google Scholar 

  • Lammie GA, Brannan F, Slattery J, Warlow C (1997) Nonhypertensive cerebral small-vessel disease. An autopsy study. Stroke 28: 2222–222938

    Google Scholar 

  • van Dijk E.1,et al.Liao D,Cooper L, Cai J,Toole J,Bryan N,Burke G (1997) The prevalence andseverity of white matter lesions,their relationship with age,ethnicity,gender,andcardiovascular disease risk factors:the ARIC Study.Neuroepidemiology 16:149–162

    Google Scholar 

  • Lindgren A, Roijer A, Rudling 0, Norrving B, Larsson EM, Eskilsson J, et al. (1994)Cerebral lesions on magnetic resonance imaging, heart disease, and vascular riskfactors in subjects without stroke. A population-based study. Stroke 25: 929–934

    Article  CAS  PubMed  Google Scholar 

  • Longstreth WT, Jr., Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, et al.(1996) Clinical correlates of white matter findings on cranial magnetic resonanceimaging of 3,301 elderly people. The Cardiovascular Health Study. Stroke 27: 1274–1282

    Article  PubMed  Google Scholar 

  • Longstreth WT, Jr., Bernick C, Manolio TA, Bryan N, Jungreis CA, Price TR (1998)Lacunar infarcts defined by magnetic resonance imaging of 3,660 elderly people: theCardiovascular Health Study. Arch Neurol 55: 1217–1225

    Article  PubMed  Google Scholar 

  • Mantyla R, Erkinjuntti T, Salonen 0, Aronen HJ, Peltonen T, Pohjasvaara T, et al. (1997)Variable agreement between visual rating scales for white matter hyperintensities onMRI. Comparison of 13 rating scales in a poststroke cohort. Stroke 28: 1614– 1623

    Article  CAS  PubMed  Google Scholar 

  • Mantyla R, Aronen HJ, Salonen 0, Korpelainen M, Peltonen T, Standertskjold-Nordenstam C, et al. (1999a) The prevalence and distribution of white-matterchanges on different MRI pulse sequences in a post-stroke cohort. Neuroradiology 41: 657–665

    Google Scholar 

  • Mantyla R, Aronen HJ, Salonen 0, Pohjasvaara T, Korpelainen M, Peltonen T, et al.(1999b) Magnetic resonance imaging white matter hyperintensities and mechanism ofischemic stroke. Stroke 30: 2053–2058

    Article  CAS  PubMed  Google Scholar 

  • Miyao S, Takano A, Teramoto J, Takahashi A (1992) Leukoaraiosis in relation to prog-nosis for patients with lacunar infarction. Stroke 23: 1434–1438

    Article  CAS  PubMed  Google Scholar 

  • O’Brien J, Desmond P, Ames D, Schweitzer I, Harrigan S, Tress B (1996) A magneticresonance imaging study of white matter lesions in depression andAlzheimer’sdisease. Br J Psychiatry 168: 477– 485

    Article  Google Scholar 

  • Offenbacher H, Fazekas F, Schmidt R, Koch M, Fazekas G, Kapeller P (1996) MR ofcerebral abnormalities concomitant with primary intracerebral hematomas. AJNRAm J Neuroradiol17: 573–578

    Google Scholar 

  • Pantoni L, Garcia JH (1995) The significance of cerebral white matter abnormalities 100years after Binswanger’s report. A review. Stroke 26: 1293–1301

    Article  CAS  PubMed  Google Scholar 

  • Pantoni L, Garcia JH (1997) Pathogenesis of leukoaraiosis: a review. Stroke 28: 652–659

    Article  CAS  PubMed  Google Scholar 

  • Pohjasvaara T, Mantyla R, Ylikoski R, Kaste M, Erkinjuntti T (2000) Comparison ofdifferent clinical criteria (DSM-III, ADDTC, ICD-10, NINDS-AlREN, DSM-IV) forthe diagnosis of vascular dementia. National Institute of Neurological Disorders andStroke-Association Internationale pour la Recherche et l’Enseignement en Neuro-sciences. Stroke 31: 2952–2957

    Article  CAS  PubMed  Google Scholar 

  • Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH et al.(1993) Vascular dementia: diagnostic criteria for research studies. Report of theNINDS-AIREN International Workshop. Neurology 43: 250–260

    Article  CAS  PubMed  Google Scholar 

  • Scheltens P, Barkhof F, Valk J, Algra PR, van der Hoop RG, Nauta J et al. (1992) Whitematter lesions on magnetic resonance imaging in clinically diagnosed Alzheimer’sdisease. Evidence for heterogeneity. Brain 115: 735–748

    Article  PubMed  Google Scholar 

  • Scheltens P, Erkinjunti T, Leys D, Wahlund LO, Inzitari D, del Ser T et aI. (1998) Whitematter changes on CT and MRI: an overview of visual rating scales. European TaskForce on Age-Related White Matter Changes. Eur Neurol 39: 8D-89

    Article  Google Scholar 

  • Schmidt R, Fazekas F, Kleinert G, Offenbacher H, Gindl K, Payer F et al. (1992)Magnetic resonance imaging signal hyperintensities in the deep and subcortical whitematter. A comparative study between stroke patients and normal volunteers. ArchNeurol 49: 825–827

    CAS  Google Scholar 

  • Schmidt R, Hayn M, Fazekas F, Kapeller P, Esterbauer H (1996) Magnetic resonanceimaging white matter hyperintensities in clinically normal elderly individuals. Corre-Frequency of white matter lesions and silent lacunar infarcts 39lations with plasma concentrations of naturally occurring antioxidants. Stroke 27:2043–2047

    Article  CAS  PubMed  Google Scholar 

  • Schmidt R, Fazekas F, Hayn M, Schmidt H, Kapeller P, Roob G, et al. (1997) Risk factorsfor microangiopathy-related cerebral damage in the Austrian stroke preventionstudy. J Neurol Sci 152: 15–21

    Article  CAS  PubMed  Google Scholar 

  • Schmidt R, Fazekas F, Kapeller P, Schmidt H, Hartung HP (1999) MRI white matterhyperintensities: three-year follow-up of the Austrian Stroke Prevention Study.Neurology 53: 132–139

    Article  Google Scholar 

  • Shimada K, Kawamoto A, Matsubayashi K, Ozawa T (1990) Silent cerebrovasculardisease in the elderly. Correlation with ambulatory pressure. Hypertension 16: 692–699

    Article  CAS  PubMed  Google Scholar 

  • Tarvonen-Schroder S, Kurki T, Raiha I, Sourander L (1995) Leukoaraiosis and cause ofdeath: a five year follow up. J Neurol Neurosurg Psychiatry 58: 586–589

    Article  CAS  PubMed  Google Scholar 

  • van Swieten JC, van den Hout JH, van Ketel BA, Hijdra A, Wokke JH, van Gijn J (1991)Periventricular lesions in the white matter on magnetic resonance imaging in theelderly. A morphometric correlation with arteriolosclerosis and dilated perivascularspaces. Brain 114: 761–774

    Article  PubMed  Google Scholar 

  • van Swieten JC, Kappelle LJ, Algra A, van Latum JC, Koudstaal PJ, van Gijn J (1992)Hypodensity of the cerebral white matter in patients with transient ischemic attackor minor stroke: influence on the rate of subsequent stroke. Dutch TIA Trial StudyGroup. Ann Neurol 32: 177–183

    Article  PubMed  Google Scholar 

  • van Zagten M, Boiten J, Kessels F, Lodder J (1996) Significant progression of whitematter lesions and small deep (lacunar) infarcts in patients with stroke. Arch Neurol53: 650– 655

    Google Scholar 

  • Vermeer SE, Koudstaal PJ, Oudkerk M, Hofman A, BretelerMM (2002) Prevalence andrisk factors of silent brain infarcts in the population-based Rotterdam Scan Study.Stroke 33: 21–25

    Google Scholar 

  • WaWund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjogren M et al. (2001) Anew rating scale for age-related white matter changes applicable to MRI and CT.Stroke 32: 1318–1322

    Article  Google Scholar 

  • Waldemar G, Christiansen P, Larsson HB, Hogh P, Laursen H, Lassen NA et al. (1994)White matter magnetic resonance hyperintensities in dementia of the Alzheimertype: morphological and regional cerebral blood flow correlates. J Neurol NeurosurgPsychiatry 57: 1458–1465

    Article  CAS  Google Scholar 

  • Whitman GT, Tang T, Lin A, Baloh RW (2001) A prospective study of cerebral whitematter abnormalities in older people with gait dysfunction. Neurology 57: 990–994

    Article  CAS  PubMed  Google Scholar 

  • Wiszniewska M, Devuyst G, Bogousslavsky J, Ghika J, van Melle G (2000) What is thesignificance of leukoaraiosis in patients with acute ischemic stroke? Arch Neurol57:967–973

    Article  Google Scholar 

  • Ylikoski A, Erkinjuntti T, Raininko R, Sarna S, Sulkava R, Tilvis R (1995) White matterhyperintensities on MRI in the neurologically nondiseased elderly. Analysis ofcohorts of consecutive subjects aged 55 to 85 years living at home. Stroke 26: 1171–1177

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Wien

About this paper

Cite this paper

van Dijk, E.J., Prins, N.D., Vermeer, S.E., Koudstaaf, P.J., Breteler, M.M.B. (2002). Frequency of white matter lesions and silent lacunar infarcts. In: Jellinger, K.A., Schmidt, R., Windisch, M. (eds) Ageing and Dementia Current and Future Concepts. Journal of Neural Transmission. Supplementa, vol 62. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6139-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-6139-5_2

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-83796-2

  • Online ISBN: 978-3-7091-6139-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics