Knottnerus et al. [36] found significantly lower t-PA levels (and significantly higher PAI-1 levels) in 43 lacunar stroke patients with an isolated infarct versus 53 lacunar stroke patients with concurrent extensive WMH, hypothesizing that patients with extensive WMH lack the protective effect of PAI-1 in t-PA-induced tissue damage. Here, SERPINE1 is linked to infarction.