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Rutten-Jacobs LCA, Traylor M, Adib-Samii P, Thijs V, Sudlow C, Rothwell PM, Boncoraglio G, Dichgans M, Meschia J, Maguire J, Levi C, Rost NS, Rosand J, Hassan A, Bevan S, Markus HS. Association of MTHFR C677T Genotype With Ischemic Stroke Is Confined to Cerebral Small Vessel Disease Subtype. Stroke 2016; 47:646-51. [PMID: 26839351 PMCID: PMC4760380 DOI: 10.1161/strokeaha.115.011545] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/31/2015] [Indexed: 12/31/2022]
Abstract
Supplemental Digital Content is available in the text. Elevated plasma homocysteine levels are associated with stroke. However, this might be a reflection of bias or confounding because trials have failed to demonstrate an effect from homocysteine lowering in stroke patients, although a possible benefit has been suggested in lacunar stroke. Genetic studies could potentially overcome these issues because genetic variants are inherited randomly and are fixed at conception. Therefore, we tested the homocysteine levels–associated genetic variant MTHFR C677T for association with magnetic resonance imaging–confirmed lacunar stroke and compared this with associations with large artery and cardioembolic stroke subtypes.
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Affiliation(s)
- Loes C A Rutten-Jacobs
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.).
| | - Matthew Traylor
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Poneh Adib-Samii
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Vincent Thijs
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Cathie Sudlow
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Peter M Rothwell
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Giorgio Boncoraglio
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Martin Dichgans
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - James Meschia
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Jane Maguire
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Christopher Levi
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Natalia S Rost
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Jonathan Rosand
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Ahamad Hassan
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Steve Bevan
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
| | - Hugh S Markus
- From the Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (L.C.A.R.-J., M.T., H.S.M.); Department of Medical & Molecular Genetics, King's College London, London, UK (M.T.); Stroke and Dementia Research Centre, Department of Clinical Neuroscience, St George's University of London, London, UK (P.A.-S.); KULeuven Department of Experimental Neurology and Leuven Research Institute for Neuroscience and Disease, University of Leuven, and Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium and Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia (V.T.); Division of Clinical Neurosciences, Neuroimaging Sciences and Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK (C.S.); Stroke Prevention Research Unit, Nuffield Department of Neuroscience, University of Oxford, UK (P.M.R.); Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy (G.B.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich and Munich Cluster of Systems Neurology, SyNergy, Munich, Germany (M.D.); Department of Neurology, Mayo Clinic, Jacksonville (J.M.); School of Nursing and Midwifery (J.M.) and Hunter Medical Research Institute (J.M., C.L.), University of Newcastle, NSW, Australia; Center for Human Genetic Research and Department of Neurology, Massachusetts General Hospital, Boston (N.S.R., J.R.); Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK (A.H.); and School of Life Science, University of Lincoln, Lincoln, UK (S.B.)
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