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Park TH, Lee JK, Park MS, Park SS, Hong KS, Ryu WS, Kim DE, Park MS, Choi KH, Kim JT, Kang J, Kim BJ, Han MK, Lee J, Cha JK, Kim DH, Kim JG, Lee SJ, Cho YJ, Kwon JH, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee JS, Choi JC, Kim WJ, Lee BC, Yu KH, Oh MS, Park JM, Kang K, Lee KB, Lee J, Gorelick PB, Bae HJ. Neurologic deterioration in patients with acute ischemic stroke or transient ischemic attack. Neurology 2020; 95:e2178-e2191. [PMID: 32817184 DOI: 10.1212/wnl.0000000000010603] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 04/27/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To improve epidemiologic knowledge of neurologic deterioration (ND) in patients with acute ischemic stroke (AIS). METHODS In this prospective observational study, we captured ND prospectively in 29,446 patients with AIS admitted to 15 hospitals in Korea within 7 days of stroke onset. ND was defined as an increase in NIH Stroke Scale (NIHSS) score ≥2 (total), or ≥1 (motor or consciousness), or any new neurologic symptoms. Change in incidence rate after stroke onset, causes, factors associated with ND, modified Rankin Scale (mRS) score at 3 months and 1 year, and a composite of stroke, myocardial infarction, and all-cause death at 1 year were assessed. RESULTS ND occurred in 4,299 (14.6%) patients. The highest rate, 6.95 per 1,000 person-hours incidence, was within the first 6 hours, which decreased to 2.09 within 24-48 hours, and 0.66 within 72-96 hours after stroke onset. Old age, female sex, diabetes, early arrival, large artery atherosclerosis as a stroke subtype, high NIHSS scores, glucose level, systolic blood pressure, leukocytosis at admission, recanalization therapy, TIA without a relevant lesion, and steno-occlusion of relevant arteries were associated with ND. The causes were stroke progression (71.8%) followed by recurrence (8.5%). Adjusted relative risks (95% CI) for poor outcome (mRS 3-6) at 3 months and 1 year were 1.75 (1.70-1.80) and 1.70 (1.65-1.75), respectively. The adjusted hazard ratio (95% CI) for the composite event was 1.59 (1.45-1.74). CONCLUSIONS ND should be taken into consideration as a factor that may influence the outcome in acute ischemic stroke.
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Affiliation(s)
- Tai Hwan Park
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jeong-Kon Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Moo-Seok Park
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Sang-Soon Park
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Keun-Sik Hong
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Wi-Sun Ryu
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Dong-Eog Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Man Seok Park
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Kang-Ho Choi
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Joon-Tae Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jihoon Kang
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Beom Joon Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Moon-Ku Han
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jun Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jae-Kwan Cha
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Dae-Hyun Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jae Guk Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Soo Joo Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Yong-Jin Cho
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jee-Hyun Kwon
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Dong-Ick Shin
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Min-Ju Yeo
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Sung Il Sohn
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jeong-Ho Hong
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Ji Sung Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jay Chol Choi
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Wook-Joo Kim
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Byung-Chul Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Kyung-Ho Yu
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Mi-Sun Oh
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Jong-Moo Park
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Kyusik Kang
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Kyung Bok Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Juneyoung Lee
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Philip B Gorelick
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL
| | - Hee-Joon Bae
- From the Department of Neurology (T.H.P., M.-S.P., S.-S.P.), Seoul Medical Center; Department of Neurology, Cerebrovascular Center (J.-K.L., J.K., B.J.K., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (W.-S.R., D.-E.K.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (M.S.P., K.-H.C., J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Department of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (J.G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University College of Medicine; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (B.-C.L., K.-H.Y., M.-S.O.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Eulji University, Seoul; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; and Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Davee, Chicago, IL.
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