Deep white matter lesions on MRI, and not silent brain infarcts are related to headache and dizziness of non-specific cause in non-stroke Japanese subjects

Objective Silent or asymptomatic cerebrovascular disease is believed to be an important risk factor for symptomatic stroke and vascular dementia, Alth ough non-specific complaints such as mild to moderate headache and/or dizzi ness may also be caused by silent stroke, which remains a topic of controve rsy. Methods To investigate the relationship between silent brain infarcts and n on-specific complaints, we assessed findings on magnetic resonance images u sing a common protocol in the following three groups of subjects; Group 1: 78 subjects with non-specific complaints, Group 2: 47 subjects with vascula r risk factors, and Group 3: 75 normal subjects without any subjective comp laints or vascular risk factors. In addition to silent stroke, deep white m atter lesions on MRI were also evaluated. All subjects were recruited from 12 institutes of the study group located at various parts of Japan. Results Silent brain infarcts were demonstrated in 44%, 43%, and 20% of sub jects in Groups 1, 2, and 3, respectively. In Group 1, the average number o f infarcts per individual who had silent brain infarction was 1.8, which wa s significantly fewer than 3.8 in Group 2 or 3.5 in Group 3 (p<0.0167). Whi te matter lesions were found in 68%, 49%, and 11% in Groups 1, 2, and 3, re spectively, indicating that non-specific complaints are more closely relate d to deep white matter lesions than to silent infarct lesions. Such white m atter lesions were found more frequently in subjects with depressive state than in non-depressed subjects (67% vs. 39%, p=0.0155). Conclusion The present results suggest that deep white matter lesions, rath er than silent brain infarcts, appear to be important in producing headache and/or dizziness of non-specific cause and also to be related to the depre ssive state.