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Kim BJ, Han MK, Park TH, Park SS, Lee KB, Lee BC, Yu KH, Oh MS, Cha JK, Kim DH, Lee J, Lee SJ, Ko Y, Park JM, Kang K, Cho YJ, Hong KS, Kim JT, Choi JC, Kim DE, Shin DI, Kim WJ, Lee J, Lee JS, Yoon BW, Gorelick PB, Bae HJ. Low-Versus Standard-Dose Alteplase for Ischemic Strokes Within 4.5 Hours: A Comparative Effectiveness and Safety Study. Stroke 2015; 46:2541-8. [PMID: 26243232 DOI: 10.1161/strokeaha.115.010180] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/30/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The low-dose (0.6 mg/kg) alteplase strategy to treat acute ischemic stroke patients became widespread in East Asian countries, without rigorous testing against standard-dose (0.9 mg/kg) alteplase treatment. Our aim was to investigate the comparative effectiveness and safety of the low-dose versus standard-dose intravenous alteplase strategy. METHODS A total of 1526 acute ischemic stroke patients who qualified for intravenous alteplase and treated within 4.5 hours were identified from a prospective, multicenter, and nationwide stroke registry database. Primary outcomes were a modified Rankin scale score of 0 to 1 at 3 months after stroke and occurrence of symptomatic hemorrhagic transformation. Inverse probability of low-dose alteplase weighting by propensity scores was used to remove baseline imbalances between the 2 groups, and variation among centers were also accounted using generalized linear mixed models with a random intercept. RESULTS Low-dose intravenous alteplase was given to 450 patients (29.5%) and standard-dose intravenous alteplase to 1076 patients (70.5%). Low-dose alteplase treatment was comparable to standard-dose therapy according to the following adjusted outcomes and odds ratios (95% confidence intervals): modified Rankin scale score 0 to 1 at 3 months and 0.95 (0.68-1.32); modified Rankin scale 0 to 2 at 3 months and 0.84 (0.62-1.15); symptomatic hemorrhagic transformation and 1.05 (0.65-1.70); and 3-month mortality and 0.54 (0.35-0.83). The associations were unchanged when the analysis was limited to those without endovascular recanalization. CONCLUSIONS The low-dose alteplase strategy was comparable to the standard-dose treatment in terms of the effectiveness and safety.
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Affiliation(s)
- Beom Joon Kim
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Moon-Ku Han
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Tai Hwan Park
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Sang-Soon Park
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Kyung Bok Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Byung-Chul Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Kyung-Ho Yu
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Mi Sun Oh
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Jae Kwan Cha
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Dae-Hyun Kim
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Jun Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Soo Joo Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Youngchai Ko
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Jong-Moo Park
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Kyusik Kang
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Yong-Jin Cho
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Keun-Sik Hong
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Joon-Tae Kim
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Jay Chol Choi
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Dong-Eog Kim
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Dong-Ick Shin
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Wook-Joo Kim
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Juneyoung Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Ji Sung Lee
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Byung-Woo Yoon
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Philip B Gorelick
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
| | - Hee-Joon Bae
- From the Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea (T.H.P., S.-S.P.); Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang-si Republic of Korea (B.-C.L., K.-H.Y., M.S.O.); Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea (J.K.C., D.-H.K.); Department of Neurology, Yeungnam University Medical Center, Daegu, Republic of Korea (J.L.); Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.L., Y.K.); Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea (J.-M.P., K.K.); Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea (J.-T.K.); Department of Neurology, Jeju National University, Jeju, Republic of Korea (J.C.C.); Department of Neurology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea (D.-E.K.); Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Republic of Korea (D.-I.S.); Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea (W.-J.K.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.); Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea (B.-W.Y.); and Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, and Mercy Health Hauenstein Neuroscienc
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