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Wolfe GI, Kaminski HJ, Aban IB, Minisman G, Kuo HC, Marx A, Ströbel P, Mazia C, Oger J, Cea JG, Heckmann JM, Evoli A, Nix W, Ciafaloni E, Antonini G, Witoonpanich R, King JO, Beydoun SR, Chalk CH, Barboi AC, Amato AA, Shaibani AI, Katirji B, Lecky BRF, Buckley C, Vincent A, Dias-Tosta E, Yoshikawa H, Waddington-Cruz M, Pulley MT, Rivner MH, Kostera-Pruszczyk A, Pascuzzi RM, Jackson CE, Garcia Ramos GS, Verschuuren JJGM, Massey JM, Kissel JT, Werneck LC, Benatar M, Barohn RJ, Tandan R, Mozaffar T, Conwit R, Odenkirchen J, Sonett JR, Jaretzki A, Newsom-Davis J, Cutter GR. Randomized Trial of Thymectomy in Myasthenia Gravis. N Engl J Med 2016; 375:511-22. [PMID: 27509100 PMCID: PMC5189669 DOI: 10.1056/nejmoa1602489] [Citation(s) in RCA: 513] [Impact Index Per Article: 64.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Thymectomy has been a mainstay in the treatment of myasthenia gravis, but there is no conclusive evidence of its benefit. We conducted a multicenter, randomized trial comparing thymectomy plus prednisone with prednisone alone. METHODS We compared extended transsternal thymectomy plus alternate-day prednisone with alternate-day prednisone alone. Patients 18 to 65 years of age who had generalized nonthymomatous myasthenia gravis with a disease duration of less than 5 years were included if they had Myasthenia Gravis Foundation of America clinical class II to IV disease (on a scale from I to V, with higher classes indicating more severe disease) and elevated circulating concentrations of acetylcholine-receptor antibody. The primary outcomes were the time-weighted average Quantitative Myasthenia Gravis score (on a scale from 0 to 39, with higher scores indicating more severe disease) over a 3-year period, as assessed by means of blinded rating, and the time-weighted average required dose of prednisone over a 3-year period. RESULTS A total of 126 patients underwent randomization between 2006 and 2012 at 36 sites. Patients who underwent thymectomy had a lower time-weighted average Quantitative Myasthenia Gravis score over a 3-year period than those who received prednisone alone (6.15 vs. 8.99, P<0.001); patients in the thymectomy group also had a lower average requirement for alternate-day prednisone (44 mg vs. 60 mg, P<0.001). Fewer patients in the thymectomy group than in the prednisone-only group required immunosuppression with azathioprine (17% vs. 48%, P<0.001) or were hospitalized for exacerbations (9% vs. 37%, P<0.001). The number of patients with treatment-associated complications did not differ significantly between groups (P=0.73), but patients in the thymectomy group had fewer treatment-associated symptoms related to immunosuppressive medications (P<0.001) and lower distress levels related to symptoms (P=0.003). CONCLUSIONS Thymectomy improved clinical outcomes over a 3-year period in patients with nonthymomatous myasthenia gravis. (Funded by the National Institute of Neurological Disorders and Stroke and others; MGTX ClinicalTrials.gov number, NCT00294658.).
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Affiliation(s)
- Gil I Wolfe
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Henry J Kaminski
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Inmaculada B Aban
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Greg Minisman
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Hui-Chien Kuo
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Alexander Marx
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Philipp Ströbel
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Claudio Mazia
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Joel Oger
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - J Gabriel Cea
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Jeannine M Heckmann
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Amelia Evoli
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Wilfred Nix
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Emma Ciafaloni
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Giovanni Antonini
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Rawiphan Witoonpanich
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - John O King
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Said R Beydoun
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Colin H Chalk
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Alexandru C Barboi
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Anthony A Amato
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Aziz I Shaibani
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Bashar Katirji
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Bryan R F Lecky
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Camilla Buckley
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Angela Vincent
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Elza Dias-Tosta
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Hiroaki Yoshikawa
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Márcia Waddington-Cruz
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Michael T Pulley
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Michael H Rivner
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Anna Kostera-Pruszczyk
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Robert M Pascuzzi
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Carlayne E Jackson
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Guillermo S Garcia Ramos
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Jan J G M Verschuuren
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Janice M Massey
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - John T Kissel
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Lineu C Werneck
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Michael Benatar
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Richard J Barohn
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Rup Tandan
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Tahseen Mozaffar
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Robin Conwit
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Joanne Odenkirchen
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Joshua R Sonett
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Alfred Jaretzki
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - John Newsom-Davis
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
| | - Gary R Cutter
- From the Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo (G.I.W.), the Department of Neurology, University of Rochester Medical Center, Rochester (E.C.), and the Section of General Thoracic Surgery, Columbia University Medical Center, New York (J.R.S., A.J.) - all in New York; the Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC (H.J.K.); the Department of Biostatistics, University of Alabama at Birmingham, Birmingham (I.B.A., G.M., H.-C.K., G.R.C.); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim (A.M.), the Institute of Pathology, University of Göttingen, Göttingen (P.S.), and the Department of Neurology, Johannes Gutenberg University, Mainz (W.N.) - all in Germany; the Department of Neurology, University of Buenos Aires, Buenos Aires (C.M.); the Division of Neurology, University of British Columbia, Vancouver (J. Oger), and the Department of Neurology, McGill University, Montreal (C.H.C.) - both in Canada; the Department of Neurology, University of Chile, Santiago (J.G.C.); the Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (J.M.H.); the Department of Neurology, Catholic University (A.E.), and the Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome (G.A.) - both in Rome; the Division of Neurology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (R.W.); the Department of Neurology, University of Melbourne, Melbourne, VIC, Australia (J.O.K.); the Department of Neurology, University of Southern California, Los Angeles (S.R.B.), and the Department of Neurology, University of California Irvine Medical Center, Orange (T.M.) - both in California; the Department of Neurology, Medical College of Wisconsin, Milwaukee (A.C.B.); the Department of Neurology, Harvard Medical School, Boston (A.A.A.); Nerve and M
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