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Lai PMR, Ryu JY, Park SC, Gross BA, Dickinson LD, Dagen S, Aziz-Sultan MA, Boulos AS, Barrow DL, Batjer HH, Blackburn S, Chang EF, Chen PR, Colby GP, Cosgrove GR, David CA, Day AL, Frerichs KU, Niemela M, Ojemann SG, Patel NJ, Shi X, Valle-Giler EP, Wang AC, Welch BG, Zusman EE, Weiss ST, Du R. Somatic Variants in SVIL in Cerebral Aneurysms. Neurol Genet 2022; 8:e200040. [PMID: 36475054 PMCID: PMC9720733 DOI: 10.1212/nxg.0000000000200040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Abstract
Background and ObjectivesWhile somatic mutations have been well-studied in cancer, their roles in other complex traits are much less understood. Our goal is to identify somatic variants that may contribute to the formation of saccular cerebral aneurysms.MethodsWe performed whole-exome sequencing on aneurysm tissues and paired peripheral blood. RNA sequencing and the CRISPR/Cas9 system were then used to perform functional validation of our results.ResultsSomatic variants involved in supervillin (SVIL) or its regulation were found in 17% of aneurysm tissues. In the presence of a mutation in theSVILgene, the expression level of SVIL was downregulated in the aneurysm tissue compared with normal control vessels. Downstream signaling pathways that were induced by knockdown ofSVILvia the CRISPR/Cas9 system in vascular smooth muscle cells (vSMCs) were determined by evaluating changes in gene expression and protein kinase phosphorylation. We found thatSVILregulated the phenotypic modulation of vSMCs to the synthetic phenotype via Krüppel-like factor 4 and platelet-derived growth factor and affected cell migration of vSMCs via the RhoA/ROCK pathway.DiscussionWe propose that somatic variants form a novel mechanism for the development of cerebral aneurysms. Specifically, somatic variants inSVILresult in the phenotypic modulation of vSMCs, which increases the susceptibility to aneurysm formation. This finding suggests a new avenue for the therapeutic intervention and prevention of cerebral aneurysms.
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Affiliation(s)
- Pui Man Rosalind Lai
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jee-Yeon Ryu
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sang-Cheol Park
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Bradley A Gross
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Lawrence D Dickinson
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sarajune Dagen
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mohammad Ali Aziz-Sultan
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alan S Boulos
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Daniel L Barrow
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - H Hunt Batjer
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Spiros Blackburn
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Edward F Chang
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - P Roc Chen
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Geoffrey P Colby
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Garth Rees Cosgrove
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Carlos A David
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Arthur L Day
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Kai U Frerichs
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mika Niemela
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Steven G Ojemann
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nirav J Patel
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Xiangen Shi
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Edison P Valle-Giler
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Anthony C Wang
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Babu G Welch
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Edie E Zusman
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Scott T Weiss
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Rose Du
- Department of Neurosurgery (P.M.R.L., J.-Y.R., S.-C.P., S.D., M.A.A.-S., G.R.C., K.U.F., N.J.P., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Artificial Intelligence and Robotics Laboratory (S.-C.P.), Myongji Hospital, Goyang, Korea; Department of Neurosurgery (B.A.G.), University of Pittsburgh, PA; Department of Neurosurgery (L.D.D., E.E.Z.), Sutter Health, Danville, CA; Department of Neurosurgery (A.S.B.), Albany Medical Center, NY; Department of Neurosurgery (D.L.B.), Emory University, Atlanta, GA; Department of Neurosurgery (H.H.B., B.G.W.), University of Texas Southwestern, Dallas, TX; Department of Neurosurgery (S.B., P.R.C., A.L.D.), University of Texas Health Science Center, Houston; Department of Neurosurgery (E.F.C.), University of California San Francisco, CA; Department of Neurosurgery (G.P.C., A.C.W.), University of California Los Angeles; Department of Neurosurgery (C.A.D.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurosurgery (M.N.), Helsinki University and Helsinki University Hospital, Finland; Department of Neurosurgery (S.G.O.), University of Colorado, Denver; Department of Neurosurgery (X.S.), Affiliated Fuxing Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery (E.P.V.-G.), Ochsner Medical Center, New Orleans, LA; and Channing Division of Network Medicine (S.T.W., R.D.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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