In a Japanese study with 194 neurologically asymptomatic participants at a high risk of stroke, mean serum levels of IL-6 were higher in patients with lacunes visible on MRI than in those without, with one standard deviation increase in IL-6 leading to a nearly two-fold increased risk of having at least one visible lacune after adjusting for age, sex, vascular risk factors, medication use and carotid atherosclerosis [68]. This evidence concerns the gene IL6 and carotid atherosclerosis.