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Lim JS, Boon CS, Oguejiofor K, Ramkumar S, Boon IS. National Institute for Health and Care Excellence and Royal College of Radiologists' Fractionation Guideline for Metastatic Spinal Cord Compression. Clin Oncol (R Coll Radiol) 2024; 36:e114. [PMID: 38395637 DOI: 10.1016/j.clon.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Affiliation(s)
- J S Lim
- University of Southampton School of Medicine, Southampton, UK
| | - C S Boon
- Department of Clinical Oncology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - K Oguejiofor
- Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Ramkumar
- Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - I S Boon
- Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Coenen M, de Kort FAS, Weaver NA, Kuijf HJ, Aben HP, Bae HJ, Bordet R, Chen CL, Dewenter A, Doeven T, Dondaine T, Duering M, Fang R, van der Giessen RS, Kim J, Kim BJ, de Kort PLM, Koudstaal P, Lee M, Lim JS, Lopes R, van Oostenbrugge RJ, Staals J, Yu KH, Biessels GJ, Biesbroek JM. Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment: a multicenter study in 1568 stroke patients. Int J Stroke 2024:17474930241252530. [PMID: 38651756 DOI: 10.1177/17474930241252530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Post-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear. AIM We determined if WMH in strategic white matter tracts explain cognitive performance after stroke. METHODS Individual patient data from 9 ischemic stroke cohorts with MRI were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major and left inferior fronto-occipital fasciculus. RESULTS The total study sample consisted of 1568 patients (39.9% female, mean age: 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed, and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume. CONCLUSIONS These results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH. DATA AVAILABILITY The Meta VCI Map consortium is dedicated to data sharing, following our guidelines.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
- contributed equally
| | - Floor A S de Kort
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
- contributed equally
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hugo Paul Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Régis Bordet
- Lille Neuroscience & Cognition (LilNCog)- U1172, Université Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Christopher Lh Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
| | - Thomas Doeven
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Thibaut Dondaine
- 5Lille Neuroscience & Cognition (LilNCog)- U1172, Université Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Marco Duering
- 8Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Rong Fang
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
| | | | - Jonguk Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Paul L M de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Peter Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Renaud Lopes
- Lille Neuroscience & Cognition (LilNCog)- U1172, Université Lille, Inserm, CHU Lille, F-59000 Lille, France
| | | | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
- contributed equally
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Kwon HS, Sung W, Park KU, Kim SH, Koh SH, Lim JS, Choi H. Impact of the COVID-19 pandemic on mortality and loss to follow-up among patients with dementia receiving anti-dementia medications. Sci Rep 2024; 14:7986. [PMID: 38575660 PMCID: PMC10994909 DOI: 10.1038/s41598-024-58316-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted vulnerable groups, such as patients with dementia. We examined changes in mortality and loss to follow-up in patients with dementia using data from the Korean National Health Insurance Service research database. Patients with dementia who visited a medical institution with a recorded dementia-related diagnostic code, including Alzheimer's disease, and who received anti-dementia medication between February 2018 and January 2020 were included in this study. We divided patients with dementia receiving anti-dementia medications into two cohorts: those newly diagnosed with dementia between February 2018 and January 2019 (n = 62,631) and those diagnosed between February 2019 and January 2020 (n = 54,494). Then, we conducted a one-year follow-up of their records, tracking the cohort diagnosed between February 2018 and January 2019 from February 2019 to January 2020, as well as the cohort diagnosed between February 2019 and January 2020 from February 2020 to January 2021. There was a significant increase in follow-up loss among patients newly diagnosed with dementia during the COVID-19 outbreak, from 42.04% in 2019 to 45.89% in 2020. Female sex, younger age, fewer comorbidities, diagnosis of dementia at the Department of Neurology or Psychiatry, and higher income were associated with decreased follow-up loss and mortality. This study highlights the importance of paying extra attention to patients with dementia receiving anti-dementia medications, particularly during pandemics, given their increased risk of loss to follow-up.
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Affiliation(s)
- Hyuk Sung Kwon
- Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Wonjae Sung
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Keun U Park
- Claim Data Analyst, Seoul, Republic of Korea
| | - Seung Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Seong-Ho Koh
- Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, 88 Olympic-ro 43-gil Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Hojin Choi
- Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
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Heo H, Park HY, Suh CH, Shim WH, Lim JS, Lee JH, Kim SJ. Development of statistical auto-segmentation method for diffusion restriction gray matter lesions in patients with newly diagnosed sporadic Creutzfeldt-Jakob disease. Sci Rep 2024; 14:4215. [PMID: 38378772 PMCID: PMC10879176 DOI: 10.1038/s41598-024-51927-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
Quantification of diffusion restriction lesions in sporadic Creutzfeldt-Jakob disease (sCJD) may provide information of the disease burden. We aim to develop an automatic segmentation model for sCJD and to evaluate the volume of disease extent as a prognostic marker for overall survival. Fifty-six patients (mean age ± SD, 61.2 ± 9.9 years) were included from February 2000 to July 2020. A threshold-based segmentation was used to obtain abnormal signal intensity masks. Segmented volumes were compared with the visual grade. The Dice similarity coefficient was calculated to measure the similarity between the automatic vs. manual segmentation. Cox proportional hazards regression analysis was performed to evaluate the volume of disease extent as a prognostic marker. The automatic segmentation showed good correlation with the visual grading. The cortical lesion volumes significantly increased as the visual grade aggravated (extensive: 112.9 ± 73.2; moderate: 45.4 ± 30.4; minimal involvement: 29.6 ± 18.1 mm3) (P < 0.001). The deep gray matter lesion volumes were significantly higher for positive than for negative involvement of the deep gray matter (5.6 ± 4.6 mm3 vs. 1.0 ± 1.3 mm3, P < 0.001). The mean Dice similarity coefficients were 0.90 and 0.94 for cortical and deep gray matter lesions, respectively. However, the volume of disease extent was not associated with worse overall survival (cortical extent: P = 0.07; deep gray matter extent: P = 0.12).
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Affiliation(s)
- Hwon Heo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
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Best JG, Ambler G, Wilson D, Du H, Lee KJ, Lim JS, Teo KC, Mak H, Kim YD, Song TJ, Selcuk Demirelli D, Nishihara M, Yoshikawa M, Kubacka M, Zietz A, Al-Shahi Salman R, Jäger HR, Lip GYH, Panos L, Goeldlin MB, Slater LA, Karayiannis CC, Phan TG, Bellut M, Abrigo J, Cheng C, Leung TW, Chu W, Chappell F, Makin SDJ, van Dam-Nolen DHK, Kooi ME, Köhler S, Staals J, Kuchcinski G, Bordet R, Dubost F, Wardlaw JM, Soo YOY, Fluri F, Srikanth VK, Jung S, Peters N, Hara H, Yakushiji Y, Necioglu Orken D, Heo JH, Lau GKK, Bae HJ, Werring DJ. Clinical Associations and Prognostic Value of MRI-Visible Perivascular Spaces in Patients With Ischemic Stroke or TIA: A Pooled Analysis. Neurology 2024; 102:e207795. [PMID: 38165371 PMCID: PMC10834118 DOI: 10.1212/wnl.0000000000207795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Visible perivascular spaces are an MRI marker of cerebral small vessel disease and might predict future stroke. However, results from existing studies vary. We aimed to clarify this through a large collaborative multicenter analysis. METHODS We pooled individual patient data from a consortium of prospective cohort studies. Participants had recent ischemic stroke or transient ischemic attack (TIA), underwent baseline MRI, and were followed up for ischemic stroke and symptomatic intracranial hemorrhage (ICH). Perivascular spaces in the basal ganglia (BGPVS) and perivascular spaces in the centrum semiovale (CSOPVS) were rated locally using a validated visual scale. We investigated clinical and radiologic associations cross-sectionally using multinomial logistic regression and prospective associations with ischemic stroke and ICH using Cox regression. RESULTS We included 7,778 participants (mean age 70.6 years; 42.7% female) from 16 studies, followed up for a median of 1.44 years. Eighty ICH and 424 ischemic strokes occurred. BGPVS were associated with increasing age, hypertension, previous ischemic stroke, previous ICH, lacunes, cerebral microbleeds, and white matter hyperintensities. CSOPVS showed consistently weaker associations. Prospectively, after adjusting for potential confounders including cerebral microbleeds, increasing BGPVS burden was independently associated with future ischemic stroke (versus 0-10 BGPVS, 11-20 BGPVS: HR 1.19, 95% CI 0.93-1.53; 21+ BGPVS: HR 1.50, 95% CI 1.10-2.06; p = 0.040). Higher BGPVS burden was associated with increased ICH risk in univariable analysis, but not in adjusted analyses. CSOPVS were not significantly associated with either outcome. DISCUSSION In patients with ischemic stroke or TIA, increasing BGPVS burden is associated with more severe cerebral small vessel disease and higher ischemic stroke risk. Neither BGPVS nor CSOPVS were independently associated with future ICH.
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Affiliation(s)
- Jonathan G Best
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Gareth Ambler
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Duncan Wilson
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Houwei Du
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Keon-Joo Lee
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jae-Sung Lim
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kay Cheong Teo
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Henry Mak
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Young Dae Kim
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Tae-Jin Song
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Derya Selcuk Demirelli
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Masashi Nishihara
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Masaaki Yoshikawa
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Marta Kubacka
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Annaelle Zietz
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Rustam Al-Shahi Salman
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hans Rolf Jäger
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Gregory Y H Lip
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Leonidas Panos
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Martina B Goeldlin
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Lee-Anne Slater
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Christopher Charles Karayiannis
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Thanh G Phan
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Maximilian Bellut
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jill Abrigo
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Cyrus Cheng
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Thomas W Leung
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Winnie Chu
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Francesca Chappell
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Stephen D J Makin
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Dianne H K van Dam-Nolen
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - M Eline Kooi
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sebastian Köhler
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Julie Staals
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Grégory Kuchcinski
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Régis Bordet
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Florian Dubost
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Joanna M Wardlaw
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Yannie O Y Soo
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Felix Fluri
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Velandai K Srikanth
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Simon Jung
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Nils Peters
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hideo Hara
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Yusuke Yakushiji
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Dilek Necioglu Orken
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Ji-Hoe Heo
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Gary Kui Kai Lau
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hee-Joon Bae
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - David J Werring
- From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Research Centre (H.D.), Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China; Department of Neurology (K.-J.L.), Korea University Guro Hospital, Seoul; Department of Neurology (J.-S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Neurology, Department of Medicine (K.C.T., G.K.K.L.) and Department of Diagnostic Radiology (H.M.), The University of Hong Kong; Department of Neurology (Y.D.K., J.-H.H.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Neurology (D.S.D.), Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Turkey; Department of Radiology (M.N.), Saga University Faculty of Medicine; Division of Neurology (M.Y., H.H.), Department of Internal Medicine, Saga University Faculty of Medicine, Japan; Stroke Center Klinik Hirslanden Zürich (M.K., N.P.); University of Basel (M.K.); Department of Neurology and Stroke Center University Hospital and University of Basel (A.Z.), Switzerland; Centre for Clinical Brain Sciences (R.A.-S.S., F.C., J.M.W.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science at University of Liverpool (G.Y.H.L.), Liverpool John Moores University and Liverpool Heart & Chest Hospital, United Kingdom; Department of Neurology (L.P., M.B.G., S.J.), Inselspital, Bern University Hospital, Switzerland; Department of Imaging, School of Clinical Sciences at Monash Health (L.-A.S.), Peninsula Clinical School, Peninsula Health (C.C.K.), and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health (T.G.P.), Monash University, Melbourne, Australia; Department of Neurology (M.B., F.F.), University Hospital of Würzburg, Germany; Department of Imaging and Interventional Radiology (J.A., W.C.) and Division of Neurology, Department of Medicine and Therapeutics (C.C., T.W.L., Y.O.Y.S.), Prince of Wales Hospital, The Chinese University of Hong Kong; Institute of Applied Health Sciences (S.D.J.M.), University of Aberdeen, United Kingdom; Biomedical Imaging Group Rotterdam (F.D.), Department of Radiology and Nuclear Medicine (D.H.K.D.-N.), Erasmus University Medical Centre, Rotterdam, The Netherlands; Departments of Radiology and Nuclear Medicine (M.E.K.) and Neurology (J.S.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre; Department of Psychiatry and Neuropsychology (S.K.), School for Mental Health and Neuroscience, Maastricht University, The Netherlands; University of Lille (G.K., R.B.), Inserm, CHU de Lille, Lille Neuroscience & Cognition, France; National Centre for Healthy Ageing (V.K.S.), Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology (Y.Y.), Kansai Medical University, Osaka, Japan; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey; and Department of Neurology (H.-J.B.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
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Na S, Kang DW, Kim GH, Kim KW, Kim Y, Kim HJ, Park KH, Park YH, Byeon G, Suh J, Shin JH, Shim Y, Yang Y, Um YH, Oh SI, Wang SM, Yoon B, Yoon HJ, Lee SM, Lee J, Lee JS, Rhee HY, Lim JS, Jung YH, Chin J, Hong YJ, Jang H, Choi H, Choi M, Jang JW. The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis. Dement Neurocogn Disord 2024; 23:54-66. [PMID: 38362056 PMCID: PMC10864694 DOI: 10.12779/dnd.2024.23.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Background and Purpose Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. Results From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jeewon Suh
- Department of Neurology, National Medical Center, Seoul, Korea
| | | | - YongSoo Shim
- Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YoungSoon Yang
- Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong-il Oh
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sun Min Lee
- Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myungji Hospital, Goyang, Korea
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Hyemin Jang
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
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Lee S, Lim JS, Cheong EN, Lee Y, Kim JW, Kim YE, Jo S, Kim HJ, Shim WH, Lee JH. Relationship between disproportionately enlarged subarachnoid-space hydrocephalus and white matter tract integrity in normal pressure hydrocephalus. Sci Rep 2023; 13:21328. [PMID: 38044360 PMCID: PMC10694135 DOI: 10.1038/s41598-023-48940-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/01/2023] [Indexed: 12/05/2023] Open
Abstract
Normal pressure hydrocephalus (NPH) patients had altered white matter tract integrities on diffusion tensor imaging (DTI). Previous studies suggested disproportionately enlarged subarachnoid space hydrocephalus (DESH) as a prognostic sign of NPH. We examined DTI indices in NPH subgroups by DESH severity and clinical symptoms. This retrospective case-control study included 33 NPH patients and 33 age-, sex-, and education-matched controls. The NPH grading scales (0-12) were used to rate neurological symptoms. Patients with NPH were categorized into two subgroups, high-DESH and low-DESH groups, by the average value of the DESH scale. DTI indices, including fractional anisotropy, were compared across 14 regions of interest (ROIs). The high-DESH group had increased axial diffusivity in the lateral side of corona radiata (1.43 ± 0.25 vs. 1.72 ± 0.25, p = 0.04), and showed decreased fractional anisotropy and increased mean, and radial diffusivity in the anterior and lateral sides of corona radiata and the periventricular white matter surrounding the anterior horn of lateral ventricle. In patients with a high NPH grading scale, fractional anisotropy in the white matter surrounding the anterior horn of the lateral ventricle was significantly reduced (0.36 ± 0.08 vs. 0.26 ± 0.06, p = 0.03). These data show that DESH may be a biomarker for DTI-detected microstructural alterations and clinical symptom severity.
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Affiliation(s)
- Sunju Lee
- Department of Neurology, Seosan Jungang General Hospital, Seosan-si, Chungcheongnam-do, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea
| | - E-Nae Cheong
- Department of Medical Science and Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoojin Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea
| | - Jae Woo Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea
| | - Ye Eun Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea
| | - Sungyang Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea
| | - Hyung-Ji Kim
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Woo Hyun Shim
- Department of Medical Science and Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul, 05505, Republic of Korea.
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de Kort FA, Coenen M, Weaver NA, Kuijf HJ, Aben HP, Bae HJ, Bordet R, Cammà G, Chen CP, Dewenter A, Duering M, Fang R, van der Giessen RS, Hamilton OK, Hilal S, Huenges Wajer IM, Kan CN, Kim J, Kim BJ, Köhler S, de Kort PL, Koudstaal PJ, Lim JS, Lopes R, Mok VC, Staals J, Venketasubramanian N, Verhagen CM, Verhey FR, Wardlaw JM, Xu X, Yu KH, Biesbroek JM, Biessels GJ. White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies. Stroke 2023; 54:3021-3029. [PMID: 37901947 PMCID: PMC10664782 DOI: 10.1161/strokeaha.123.044297] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts. METHODS We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (www.metavcimap.org). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning (Z scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect. RESULTS In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from -0.09 [SE, 0.04, P=0.01] for verbal memory to -0.19 [SE, 0.03, P<0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type. CONCLUSIONS In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.
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Affiliation(s)
- Floor A.S. de Kort
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
| | - Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
| | - Nick A. Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
| | - Hugo J. Kuijf
- Image Sciences Institute, University Medical Center Utrecht, the Netherlands (H.J.K.)
| | - Hugo P. Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands (H.P.A., P.L.M.d.K.)
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - Régis Bordet
- Lille Neuroscience & Cognition (LilNCog) U1172, Université Lille, Inserm, CHU Lille, France (R.B., R.L.)
| | - Guido Cammà
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
| | - Christopher P.L.H. Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany (A.D., M.D., R.F.)
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany (A.D., M.D., R.F.)
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Switzerland (M.D.)
| | - Rong Fang
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany (A.D., M.D., R.F.)
| | - Ruben S. van der Giessen
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands (R.S.v.d.G., P.J.K.)
| | - Olivia K.L. Hamilton
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.)
- UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.)
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, United Kingdom (O.K.L.H.)
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (S.H.)
| | - Irene M.C. Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
- Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands (I.M.C.H.W.)
| | - Cheuk Ni Kan
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
| | - Jonguk Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K., F.R.J.V.)
| | - Paul L.M. de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands (H.P.A., P.L.M.d.K.)
| | - Peter J. Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands (R.S.v.d.G., P.J.K.)
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (J.-S.L.)
| | - Renaud Lopes
- Lille Neuroscience & Cognition (LilNCog) U1172, Université Lille, Inserm, CHU Lille, France (R.B., R.L.)
| | - Vincent C.T. Mok
- Division of Neurology, Department of Medicine and Therapeutics (V.C.T.M.), The Chinese University of Hong Kong
- Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese, Li Ka Shing Institute of Health Sciences, Gerald Choa Neuroscience Institute, Lui Chi Woo Institute of Innovative Medicine (V.C.T.M.), The Chinese University of Hong Kong
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, the Netherlands (J.S.)
| | | | - Charlotte M. Verhagen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
| | - Frans R.J. Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K., F.R.J.V.)
| | - Joanna M. Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.)
- UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.)
| | - Xin Xu
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore (C.P.L.H.C., S.H., C.N.K., X.X.)
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea (K.-H.Y.)
| | - J. Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands (J.M.B.)
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.)
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9
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Lee M, Lim JS, Kim Y, Park SH, Lee SH, Kim C, Lee BC, Yu KH, Lee JJ, Oh MS. High ApoB/ApoA-I Ratio Predicts Post-Stroke Cognitive Impairment in Acute Ischemic Stroke Patients with Large Artery Atherosclerosis. Nutrients 2023; 15:4670. [PMID: 37960323 PMCID: PMC10648714 DOI: 10.3390/nu15214670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND We aimed to investigate the association between the ApoB/ApoA-I ratio and post-stroke cognitive impairment (PSCI) in patients with acute stroke of large artery atherosclerosis etiology. METHODS Prospective stroke registry data were used to consecutively enroll patients with acute ischemic stroke due to large artery atherosclerosis. Cognitive function assessments were conducted 3 to 6 months after stroke. PSCI was defined as a z-score of less than -2 standard deviations from age, sex, and education-adjusted means in at least one cognitive domain. The ApoB/ApoA-I ratio was calculated, and patients were categorized into five groups according to quintiles of the ratio. Logistic regression analyses were performed to assess the association between quintiles of the ApoB/ApoA-I ratio and PSCI. RESULTS A total of 263 patients were included, with a mean age of 65.9 ± 11.6 years. The median NIHSS score and ApoB/ApoA-I ratio upon admission were 2 (IQR, 1-5) and 0.81 (IQR, 0.76-0.88), respectively. PSCI was observed in 91 (34.6%) patients. The highest quintile (Q5) of the ApoB/ApoA-I ratio was a significant predictor of PSCI compared to the lowest quintile (Q1) (adjusted OR, 3.16; 95% CI, 1.19-8.41; p-value = 0.021) after adjusting for relevant confounders. Patients in the Q5 group exhibited significantly worse performance in the frontal domain. CONCLUSIONS The ApoB/ApoA-I ratio in the acute stage of stroke independently predicted the development of PSCI at 3-6 months after stroke due to large artery atherosclerosis. Further, a high ApoB/ApoA-I ratio was specifically associated with frontal domain dysfunction.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (M.L.); (B.-C.L.); (K.-H.Y.)
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea;
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Republic of Korea;
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 24252, Republic of Korea; (Y.K.); (S.H.P.)
| | - Soo Hyun Park
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 24252, Republic of Korea; (Y.K.); (S.H.P.)
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea; (S.-H.L.); (C.K.)
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea; (S.-H.L.); (C.K.)
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (M.L.); (B.-C.L.); (K.-H.Y.)
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (M.L.); (B.-C.L.); (K.-H.Y.)
| | - Jae-Jun Lee
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea;
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (M.L.); (B.-C.L.); (K.-H.Y.)
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Park HY, Shim WH, Suh CH, Heo H, Oh HW, Kim J, Sung J, Lim JS, Lee JH, Kim HS, Kim SJ. Development and validation of an automatic classification algorithm for the diagnosis of Alzheimer's disease using a high-performance interpretable deep learning network. Eur Radiol 2023; 33:7992-8001. [PMID: 37170031 DOI: 10.1007/s00330-023-09708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/01/2023] [Accepted: 03/18/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES To develop and validate an automatic classification algorithm for diagnosing Alzheimer's disease (AD) or mild cognitive impairment (MCI). METHODS AND MATERIALS This study evaluated a high-performance interpretable network algorithm (TabNet) and compared its performance with that of XGBoost, a widely used classifier. Brain segmentation was performed using a commercially approved software. TabNet and XGBoost were trained on the volumes or radiomics features of 102 segmented regions for classifying subjects into AD, MCI, or cognitively normal (CN) groups. The diagnostic performances of the two algorithms were compared using areas under the curves (AUCs). Additionally, 20 deep learning-based AD signature areas were investigated. RESULTS Between December 2014 and March 2017, 161 AD, 153 MCI, and 306 CN cases were enrolled. Another 120 AD, 90 MCI, and 141 CN cases were included for the internal validation. Public datasets were used for external validation. TabNet with volume features had an AUC of 0.951 (95% confidence interval [CI], 0.947-0.955) for AD vs CN, which was similar to that of XGBoost (0.953 [95% CI, 0.951-0.955], p = 0.41). External validation revealed the similar performances of two classifiers using volume features (0.871 vs. 0.871, p = 0.86). Likewise, two algorithms showed similar performances with one another in classifying MCI. The addition of radiomics data did not improve the performance of TabNet. TabNet and XGBoost focused on the same 13/20 regions of interest, including the hippocampus, inferior lateral ventricle, and entorhinal cortex. CONCLUSIONS TabNet shows high performance in AD classification and detailed interpretation of the selected regions. CLINICAL RELEVANCE STATEMENT Using a high-performance interpretable deep learning network, the automatic classification algorithm assisted in accurate Alzheimer's disease detection using 3D T1-weighted brain MRI and detailed interpretation of the selected regions. KEY POINTS • MR volumetry data revealed that TabNet had a high diagnostic performance in differentiating Alzheimer's disease (AD) from cognitive normal cases, which was comparable with that of XGBoost. • The addition of radiomics data to the volume data did not improve the diagnostic performance of TabNet. • Both TabNet and XGBoost selected the clinically meaningful regions of interest in AD, including the hippocampus, inferior lateral ventricle, and entorhinal cortex.
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Affiliation(s)
- Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwon Heo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | | | | | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lee M, Hong Y, An S, Park U, Shin J, Lee J, Oh MS, Lee BC, Yu KH, Lim JS, Kang SW. Machine learning-based prediction of post-stroke cognitive status using electroencephalography-derived brain network attributes. Front Aging Neurosci 2023; 15:1238274. [PMID: 37842126 PMCID: PMC10568623 DOI: 10.3389/fnagi.2023.1238274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives More than half of patients with acute ischemic stroke develop post-stroke cognitive impairment (PSCI), a significant barrier to future neurological recovery. Thus, predicting cognitive trajectories post-AIS is crucial. Our primary objective is to determine whether brain network properties from electroencephalography (EEG) can predict post-stroke cognitive function using machine learning approach. Methods We enrolled consecutive stroke patients who underwent both EEG during the acute stroke phase and cognitive assessments 3 months post-stroke. We preprocessed acute stroke EEG data to eliminate low-quality epochs, then performed independent component analysis and quantified network characteristics using iSyncBrain®. Cognitive function was evaluated using the Montreal cognitive assessment (MoCA). We initially categorized participants based on the lateralization of their lesions and then developed machine learning models to predict cognitive status in the left and right hemisphere lesion groups. Results Eighty-seven patients were included, and the accuracy of lesion laterality prediction using EEG attributes was 97.0%. In the left hemispheric lesion group, the network attributes of the theta band were significantly correlated with MoCA scores, and higher global efficiency, clustering coefficient, and lower characteristic path length were associated with higher MoCA scores. Most features related to cognitive scores were selected from the frontal lobe. The predictive powers (R-squared) were 0.76 and 0.65 for the left and right stroke groups, respectively. Conclusion Estimating EEG-based network properties in the acute phase of ischemic stroke through a machine learning model has a potential to predict cognitive outcomes after ischemic stroke.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | | | - Sungsik An
- Department of Neurology, Hwahong Hospital, Suwon, Republic of Korea
| | - Ukeob Park
- iMedisync, Inc., Seoul, Republic of Korea
| | | | - Jeongjae Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Hartwigsen G, Lim JS, Bae HJ, Yu KH, Kuijf HJ, Weaver NA, Biesbroek JM, Kopal J, Bzdok D. Bayesian modeling disentangles language versus executive control disruption in stroke. bioRxiv 2023:2023.08.06.552147. [PMID: 37609325 PMCID: PMC10441359 DOI: 10.1101/2023.08.06.552147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Stroke is the leading cause of long-term disability worldwide. Incurred brain damage disrupts cognition, often with persisting deficits in language and executive capacities. Despite their clinical relevance, the commonalities, and differences of language versus executive control impairments remain under-specified. We tailored a Bayesian hierarchical modeling solution in a largest-of-its-kind cohort (1080 stroke patients) to deconvolve language and executive control in the brain substrates of stroke insults. Four cognitive factors distinguished left- and right-hemispheric contributions to ischemic tissue lesion. One factor delineated language and general cognitive performance and was mainly associated with damage to left-hemispheric brain regions in the frontal and temporal cortex. A factor for executive control summarized control and visual-constructional abilities. This factor was strongly related to right-hemispheric brain damage of posterior regions in the occipital cortex. The interplay of language and executive control was reflected in two factors: executive speech functions and verbal memory. Impairments on both were mainly linked to left-hemispheric lesions. These findings shed light onto the causal implications of hemispheric specialization for cognition; and make steps towards subgroup-specific treatment protocols after stroke.
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Suh PS, Jung W, Suh CH, Kim J, Oh J, Heo H, Shim WH, Lim JS, Lee JH, Kim HS, Kim SJ. Development and validation of a deep learning-based automatic segmentation model for assessing intracranial volume: comparison with NeuroQuant, FreeSurfer, and SynthSeg. Front Neurol 2023; 14:1221892. [PMID: 37719763 PMCID: PMC10503131 DOI: 10.3389/fneur.2023.1221892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023] Open
Abstract
Background and purpose To develop and validate a deep learning-based automatic segmentation model for assessing intracranial volume (ICV) and to compare the accuracy determined by NeuroQuant (NQ), FreeSurfer (FS), and SynthSeg. Materials and methods This retrospective study included 60 subjects [30 Alzheimer's disease (AD), 21 mild cognitive impairment (MCI), 9 cognitively normal (CN)] from a single tertiary hospital for the training and validation group (50:10). The test group included 40 subjects (20 AD, 10 MCI, 10 CN) from the ADNI dataset. We propose a robust ICV segmentation model based on the foundational 2D UNet architecture trained with four types of input images (both single and multimodality using scaled or unscaled T1-weighted and T2-FLAIR MR images). To compare with our model, NQ, FS, and SynthSeg were also utilized in the test group. We evaluated the model performance by measuring the Dice similarity coefficient (DSC) and average volume difference. Results The single-modality model trained with scaled T1-weighted images showed excellent performance with a DSC of 0.989 ± 0.002 and an average volume difference of 0.46% ± 0.38%. Our multimodality model trained with both unscaled T1-weighted and T2-FLAIR images showed similar performance with a DSC of 0.988 ± 0.002 and an average volume difference of 0.47% ± 0.35%. The overall average volume difference with our model showed relatively higher accuracy than NQ (2.15% ± 1.72%), FS (3.69% ± 2.93%), and SynthSeg (1.88% ± 1.18%). Furthermore, our model outperformed the three others in each subgroup of patients with AD, MCI, and CN subjects. Conclusion Our deep learning-based automatic ICV segmentation model showed excellent performance for the automatic evaluation of ICV.
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Affiliation(s)
- Pae Sun Suh
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | | | - Chong Hyun Suh
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | | | - Jio Oh
- R&D Center, VUNO, Seoul, Republic of Korea
| | - Hwon Heo
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
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Yun SY, Choi KS, Suh CH, Kim SC, Heo H, Shim WH, Jo S, Chung SJ, Lim JS, Lee JH, Kim D, Kim SO, Jung W, Kim HS, Kim SJ, Kim JH. Risk estimation for idiopathic normal-pressure hydrocephalus: development and validation of a brain morphometry-based nomogram. Eur Radiol 2023; 33:6145-6156. [PMID: 37059905 DOI: 10.1007/s00330-023-09612-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/10/2023] [Accepted: 03/09/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To develop and validate a nomogram based on MRI features for predicting iNPH. METHODS Patients aged ≥ 60 years (clinically diagnosed with iNPH, Parkinson's disease, or Alzheimer's disease or healthy controls) who underwent MRI including three-dimensional T1-weighted volumetric MRI were retrospectively identified from two tertiary referral hospitals (one hospital for derivation set and the other for validation set). Clinical and imaging features for iNPH were assessed. Deep learning-based brain segmentation software was used for 3D volumetry. A prediction model was developed using logistic regression and transformed into a nomogram. The performance of the nomogram was assessed with respect to discrimination and calibration abilities. The nomogram was internally and externally validated. RESULTS A total of 452 patients (mean age ± SD, 73.2 ± 6.5 years; 200 men) were evaluated as the derivation set. One hundred eleven and 341 patients were categorized into the iNPH and non-iNPH groups, respectively. In multivariable analysis, high-convexity tightness (odds ratio [OR], 35.1; 95% CI: 4.5, 275.5), callosal angle < 90° (OR, 12.5; 95% CI: 3.1, 50.0), and normalized lateral ventricle volume (OR, 4.2; 95% CI: 2.7, 6.7) were associated with iNPH. The nomogram combining these three variables showed an area under the curve of 0.995 (95% CI: 0.991, 0.999) in the study sample, 0.994 (95% CI: 0.990, 0.998) in the internal validation sample, and 0.969 (95% CI: 0.940, 0.997) in the external validation sample. CONCLUSION A brain morphometry-based nomogram including high-convexity tightness, callosal angle < 90°, and normalized lateral ventricle volume can help accurately estimate the probability of iNPH. KEY POINTS • The nomogram with MRI findings (high-convexity tightness, callosal angle, and normalized lateral ventricle volume) helped in predicting the probability of idiopathic normal-pressure hydrocephalus. • The nomogram may facilitate the prediction of idiopathic normal-pressure hydrocephalus and consequently avoid unnecessary invasive procedures such as the cerebrospinal fluid tap test, drainage test, and cerebrospinal fluid shunt surgery.
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Affiliation(s)
- Su Young Yun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Soo Chin Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hwon Heo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sungyang Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Donghyun Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
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Exalto LG, Weaver NA, Kuijf HJ, Aben HP, Bae HJ, Best JG, Bordet R, Chen CP, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OK, Hilal S, Huenges Wajer IM, Kim J, Kappelle LJ, Kim BJ, Köhler S, de Kort PL, Koudstaal PJ, Lim JS, Makin SD, Mok VC, van Oostenbrugge RJ, Roussel M, Staals J, Valdés-Hernández MDC, Venketasubramanian N, Verhey FR, Wardlaw JM, Werring DJ, Xu X, van Zandvoort MJ, Biesbroek JM, Chappell FM, Biessels GJ. Sex Differences in Poststroke Cognitive Impairment: A Multicenter Study in 2343 Patients With Acute Ischemic Stroke. Stroke 2023; 54:2296-2303. [PMID: 37551589 PMCID: PMC10453354 DOI: 10.1161/strokeaha.123.042507] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Poststroke cognitive impairment (PSCI) occurs in about half of stroke survivors. Cumulative evidence indicates that functional outcomes of stroke are worse in women than men. Yet it is unknown whether the occurrence and characteristics of PSCI differ between men and women. METHODS Individual patient data from 9 cohorts of patients with ischemic stroke were harmonized and pooled through the Meta-VCI-Map consortium (n=2343, 38% women). We included patients with visible symptomatic infarcts on computed tomography/magnetic resonance imaging and cognitive assessment within 15 months after stroke. PSCI was defined as impairment in ≥1 cognitive domains on neuropsychological assessment. Logistic regression analyses were performed to compare men to women, adjusted for study cohort, to obtain odds ratios for PSCI and individual cognitive domains. We also explored sensitivity and specificity of cognitive screening tools for detecting PSCI, according to sex (Mini-Mental State Examination, 4 cohorts, n=1814; Montreal Cognitive Assessment, 3 cohorts, n=278). RESULTS PSCI was found in 51% of both women and men. Men had a lower risk of impairment of attention and executive functioning (men: odds ratio, 0.76 [95% CI, 0.61-0.96]), and language (men: odds ratio, 0.67 [95% CI, 0.45-0.85]), but a higher risk of verbal memory impairment (men: odds ratio, 1.43 [95% CI, 1.17-1.75]). The sensitivity of Mini-Mental State Examination (<25) for PSCI was higher for women (0.53) than for men (0.27; P=0.02), with a lower specificity for women (0.80) than men (0.96; P=0.01). Sensitivity and specificity of Montreal Cognitive Assessment (<26.) for PSCI was comparable between women and men (0.91 versus 0.86; P=0.62 and 0.29 versus 0.28; P=0.86, respectively). CONCLUSIONS Sex was not associated with PSCI occurrence but affected domains differed between men and women. The latter may explain why sensitivity of the Mini-Mental State Examination for detecting PSCI was higher in women with a lower specificity compared with men. These sex differences need to be considered when screening for and diagnosing PSCI in clinical practice.
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Affiliation(s)
- Lieza G. Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
| | - Nick A. Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
| | - Hugo J. Kuijf
- Image Sciences Institute, University Medical Center Utrecht, the Netherlands (H.J.K.)
| | - Hugo P. Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands (H.P.A., P.L.M.d.K.)
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - Jonathan G. Best
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (J.G.B., D.J.W.)
| | - Régis Bordet
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-Lille, France (R.B.)
| | - Christopher P.L.H. Chen
- Department of Pharmacology, National University of Singapore (C.P.L.H.C., S.H., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore (C.P.L.H.C., B.G., S.H., X.X.)
| | - Ruben S. van der Giessen
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands (R.S.v.d.G., P.J.K.)
| | - Olivier Godefroy
- Department of Neurology, Amiens University hospital, Laboratory of Functional Neurosciences, Jules Verne Picardy University, France (O.G., M.R.)
| | - Bibek Gyanwali
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore (C.P.L.H.C., B.G., S.H., X.X.)
| | - Olivia K.L. Hamilton
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
- UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing (O.K.L.H.), University of Glasgow, United Kingdom
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore (C.P.L.H.C., S.H., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore (C.P.L.H.C., B.G., S.H., X.X.)
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (S.H.)
| | - Irene M.C. Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
- Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands (I.M.C.H.W., M.J.E.v.Z.)
| | - Jonguk Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - L. Jaap Kappelle
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.)
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K., F.R.J.V.)
| | - Paul L.M. de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands (H.P.A., P.L.M.d.K.)
| | - Peter J. Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands (R.S.v.d.G., P.J.K.)
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (J.-S.L.)
| | - Stephen D.J. Makin
- Centre For Rural Health, Institute of Applied Health Sciences, University of Aberdeen, United Kingdom (S.D.J.M.)
| | - Vincent C.T. Mok
- Division of Neurology, Department of Medicine and Therapeutics (V.C.T.M.), The Chinese University of Hong Kong
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre (V.C.T.M.), The Chinese University of Hong Kong
| | | | - Martine Roussel
- Department of Neurology, Amiens University hospital, Laboratory of Functional Neurosciences, Jules Verne Picardy University, France (O.G., M.R.)
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, the Netherlands (R.J.v.O., J.S.)
| | - Maria del C. Valdés-Hernández
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
- UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
| | | | - Frans R.J. Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K., F.R.J.V.)
| | - Joanna M. Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
- UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., M.d.C.V.-H., J.M.W.)
| | - David J. Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom (J.G.B., D.J.W.)
| | - Xin Xu
- Department of Pharmacology, National University of Singapore (C.P.L.H.C., S.H., X.X.)
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore (C.P.L.H.C., B.G., S.H., X.X.)
| | - Martine J.E. van Zandvoort
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
- Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands (I.M.C.H.W., M.J.E.v.Z.)
| | - J. Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands (J.M.B.)
| | - Francesca M. Chappell
- Social and Public Health Sciences Unit (F.M.C.), University of Glasgow, United Kingdom
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (L.G.E., N.A.W., I.M.C.H.W., L.J.K., M.J.E.v.Z., J.M.B., G.J.B.)
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Lee M, Yeo NY, Ahn HJ, Lim JS, Kim Y, Lee SH, Oh MS, Lee BC, Yu KH, Kim C. Prediction of post-stroke cognitive impairment after acute ischemic stroke using machine learning. Alzheimers Res Ther 2023; 15:147. [PMID: 37653560 PMCID: PMC10468853 DOI: 10.1186/s13195-023-01289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Post-stroke cognitive impairment (PSCI) occurs in up to 50% of patients with acute ischemic stroke (AIS). Thus, the prediction of cognitive outcomes in AIS may be useful for treatment decisions. This PSCI cohort study aimed to determine the applicability of a machine learning approach for predicting PSCI after stroke. METHODS This retrospective study used a prospective PSCI cohort of patients with AIS. Demographic features, clinical characteristics, and brain imaging variables previously known to be associated with PSCI were included in the analysis. The primary outcome was PSCI at 3-6 months, defined as an adjusted z-score of less than - 2.0 standard deviation in at least one of the four cognitive domains (memory, executive/frontal, visuospatial, and language), using the Korean version of the Vascular Cognitive Impairment Harmonization Standards-Neuropsychological Protocol (VCIHS-NP). We developed four machine learning models (logistic regression, support vector machine, extreme gradient boost, and artificial neural network) and compared their accuracies for outcome variables. RESULTS A total of 951 patients (mean age 65.7 ± 11.9; male 61.5%) with AIS were included in this study. The area under the curve for the extreme gradient boost and the artificial neural network was the highest (0.7919 and 0.7365, respectively) among the four models for predicting PSCI according to the VCIHS-NP definition. The most important features for predicting PSCI include the presence of cortical infarcts, mesial temporal lobe atrophy, initial stroke severity, stroke history, and strategic lesion infarcts. CONCLUSION Our findings indicate that machine-learning algorithms, particularly the extreme gradient boost and the artificial neural network models, can best predict cognitive outcomes after ischemic stroke.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Na-Young Yeo
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea
- Chuncheon Artificial Intelligence Center, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Hyo-Jeong Ahn
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea
- Chuncheon Artificial Intelligence Center, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University, Chuncheon, South Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea.
- Chuncheon Artificial Intelligence Center, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon, South Korea.
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Joo L, Suh CH, Shim WH, Kim SO, Lim JS, Lee JH, Kim HS, Kim SJ. Detection rate of contrast-enhanced brain magnetic resonance imaging in patients with cognitive impairment. PLoS One 2023; 18:e0289638. [PMID: 37549181 PMCID: PMC10406288 DOI: 10.1371/journal.pone.0289638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 07/22/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION The number of brain MRI with contrast media performed in patients with cognitive impairment has increased without universal agreement. We aimed to evaluate the detection rate of contrast-enhanced brain MRI in patients with cognitive impairment. MATERIALS AND METHODS This single-institution, retrospective study included 4,838 patients who attended outpatient clinics for cognitive impairment evaluation and underwent brain MRI with or without contrast enhancement from December 2015 to February 2020. Patients who tested positive for cognitive impairment were followed-up to confirm whether the result was true-positive and provide follow-up management. Detection rate was defined as the proportion of patients with true-positive results and was compared between groups with and without contrast enhancement. Individual matching in a 1:2 ratio according to age, sex, and year of test was performed. RESULTS The overall detection rates of brain MRI with and without contrast media were 4.7% (57/1,203; 95% CI: 3.6%-6.1%) and 1.8% (65/3,635; 95% CI: 1.4%-2.3%), respectively (P<0.001); individual matching demonstrated similar results (4.7% and 1.9%). Among 1,203 patients with contrast media, 3.6% was only detectable with the aid of contrast media. The proportion of patients who underwent follow-up imaging or treatment for the detected lesions were significantly higher in the group with contrast media (2.0% and 0.6%, P < .001). CONCLUSIONS Detection rate of brain MRI for lesions only detectable with contrast media in patients with cognitive impairment was not high enough and further study is needed to identify whom would truly benefit with contrast media.
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Affiliation(s)
- Leehi Joo
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Soo Y, Zietz A, Yiu B, Mok VCT, Polymeris AA, Seiffge D, Ambler G, Wilson D, Leung TWH, Tsang SF, Chu W, Abrigo J, Cheng C, Lee KJ, Lim JS, Shiozawa M, Koga M, Chabriat H, Hennerici M, Wong YK, Mak H, Collet R, Inamura S, Yoshifuji K, Arsava EM, Horstmann S, Purrucker J, Lam BYK, Wong A, Kim YD, Song TJ, Lemmens R, Eppinger S, Gattringer T, Uysal E, Demirelli DS, Bornstein NM, Assayag EB, Hallevi H, Molad J, Nishihara M, Tanaka J, Coutts SB, Kappelle LJ, Al-Shahi Salman R, Jager R, Lip GYH, Goeldlin MB, Panos LD, Mas JL, Legrand L, Karayiannis C, Phan T, Bellut M, Chappell F, Makin S, Hayden D, Williams D, van Dam-Nolen DHK, Nederkoorn PJ, Barbato C, Browning S, Wiegertjes K, Tuladhar AM, Mendyk AM, Köhler S, van Oostenburgge R, Zhou Y, Xu C, Hilal S, Gyanwali B, Chen C, Lou M, Staals J, Bordet R, Kandiah N, de Leeuw FE, Simister R, Hendrikse J, Wardlaw J, Kelly P, Fluri F, Srikanth V, Calvet D, Jung S, Kwa VIH, Smith EE, Hara H, Yakushiji Y, Orken DN, Fazekas F, Thijs V, Heo JH, Veltkamp R, Ay H, Imaizumi T, Lau KK, Jouvent E, Toyoda K, Yoshimura S, Bae HJ, Martí-Fàbregas J, Prats-Sánchez L, Lyrer P, Best J, Werring D, Engelter ST, Peters N. Impact of Cerebral Microbleeds in Stroke Patients with Atrial Fibrillation. Ann Neurol 2023; 94:61-74. [PMID: 36928609 DOI: 10.1002/ana.26642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate the risks of intracranial hemorrhage and ischemic stroke associated with microbleeds in patients with atrial fibrillation treated with vitamin K antagonists, direct oral anticoagulants, antiplatelets, and combination therapy (i.e. concurrent oral anticoagulant and antiplatelet). METHODS We included patients with documented atrial fibrillation from the pooled individual patient data analysis by the Microbleeds International Collaborative Network. Risks of subsequent intracranial hemorrhage and ischemic stroke were compared between patients with and without microbleeds, stratified by antithrombotic use. RESULTS A total of 7,839 patients were included. The presence of microbleeds was associated with an increased relative risk of intracranial hemorrhage (adjusted hazard ratio [aHR] = 2.74, 95% confidence interval = 1.76-4.26) and ischemic stroke (aHR = 1.29, 95% confidence interval = 1.04-1.59). For the entire cohort, the absolute incidence of ischemic stroke was higher than intracranial hemorrhage regardless of microbleed burden. However, for the subgroup of patients taking combination of anticoagulant and antiplatelet therapy, the absolute risk of intracranial hemorrhage exceeded that of ischemic stroke in those with 2 to 4 microbleeds (25 vs 12 per 1,000 patient-years) and ≥ 11 microbleeds (94 vs 48 per 1,000 patient-years). INTERPRETATION Patients with atrial fibrillation and high burden of microbleeds receiving combination therapy have a tendency of higher rate of intracranial hemorrhage than ischemic stroke, with potential for net harm. Further studies are needed to help optimize stroke preventive strategies in this high-risk group. ANN NEUROL 2023;94:61-74.
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Affiliation(s)
- Yannie Soo
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Annaelle Zietz
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Brian Yiu
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
- Gerald Choa Neuroscience Institute, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Science, Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Alexandros A Polymeris
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland
| | - David Seiffge
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, UK
| | - Duncan Wilson
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK, New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Thomas Wai Hong Leung
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Suk Fung Tsang
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Winnie Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Cyrus Cheng
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Masayuki Shiozawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hugues Chabriat
- APHP, Lariboisière Hospital, Translational Neurovascular Centre, F-75475 Paris, France, FHU NeuroVasc, Université de Paris and INSERM U1141, Paris, France
| | - Michael Hennerici
- Department of Neurology, University of Heidelberg/Mannheim Hospital, Mannheim, Germany
| | - Yuen Kwun Wong
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Henry Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Roger Collet
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Shigeru Inamura
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Kazuhisa Yoshifuji
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Ethem Murat Arsava
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Solveig Horstmann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Purrucker
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Bonnie Y K Lam
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
- Gerald Choa Neuroscience Institute, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Science, Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Adrian Wong
- Gerald Choa Neuroscience Institute, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, Li Ka Shing Institute of Health Science, Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Robin Lemmens
- Experimental Neurology, Department of Neurosciences, KU Leuven-University of Leuven, Leuven, Belgium
- VIB Center for Brain & Disease Research, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Sebastian Eppinger
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Ender Uysal
- Antalya Teaching and Research Hospital, Department of Radiology, University of Health Sciences Turkey, Antalya, Turkey
| | - Derya Selçuk Demirelli
- Sisli Hamidiye Etfal Teaching and Research Hospital, Department of Neurology, University of Health Sciences Turkey, Antalya, Turkey
| | - Natan M Bornstein
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Einor Ben Assayag
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Hen Hallevi
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jeremy Molad
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Masashi Nishihara
- Department of Radiology, Saga University Faculty of Medicine, Saga, Japan
| | - Jun Tanaka
- Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan
| | - Shelagh B Coutts
- Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, University Medical Centre Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, UK
| | - Rolf Jager
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martina B Goeldlin
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Leonidas D Panos
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Jean-Louis Mas
- GHU-Paris Psychiatrie et Neurosciences, Neurology Department and Stroke Unit, Sainte-Anne Hospital, and Université de Paris Cité, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Laurence Legrand
- GHU-Paris Psychiatrie et Neurosciences, Neuroradiology Department, Sainte-Anne Hospital, and Université Paris Cité, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Chris Karayiannis
- Peninsula Clinical School, Peninsula Health, Monash University, Melbourne, Australia
| | - Thanh Phan
- Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Maximilian Bellut
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Francesca Chappell
- Centre for Clinical Brain Sciences, Edinburgh Imaging, Edinburgh, UK
- UK Dementia Institute at the University of Edinburgh, Edinburgh, UK
| | - Stephen Makin
- Centre for Rural Health, Institute for Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Derek Hayden
- Acute Medical Unit and Department of Age-related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - David Williams
- Department of Geriatric and Stroke Medicine, RCSI University of Medicine and Health Sciences Dublin, Ireland and Beaumont Hospital Dublin, Dublin, Ireland
| | - Dianne H K van Dam-Nolen
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Paul J Nederkoorn
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Carmen Barbato
- Department of Neurology, University of Florence, Firenze, Italy
| | - Simone Browning
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
- Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil Man Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne-Marie Mendyk
- University of Lille, Inserm, CHU de Lille. Lille Neuroscience & Cognition, Lille, France
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Robert van Oostenburgge
- Department of Neurology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ying Zhou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Chao Xu
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Bibek Gyanwali
- Memory Aging & Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher Chen
- Memory Aging & Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Min Lou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Julie Staals
- Department of Neurology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Regis Bordet
- University of Lille, Inserm, CHU de Lille. Lille Neuroscience & Cognition, Lille, France
| | - Nagaendran Kandiah
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Singapore, Singapore
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert Simister
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
- Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Jeroen Hendrikse
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joanna Wardlaw
- Division of Neuroimaging Sciences, Edinburgh Imaging, Edinburgh, UK
- UK Dementia Research Institute, University of Edinburgh and NHS Lothian, Edinburgh, UK
| | - Peter Kelly
- The Neurovascular Research Unit and Health Research Board, Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland
| | - Felix Fluri
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Velandai Srikanth
- Peninsula Clinical School, Peninsula Health, Monash University, Melbourne, Australia, National Centre for Healthy Ageing, Melbourne, Australia
| | - David Calvet
- GHU-Paris Psychiatrie et Neurosciences, Neurology Department and Stroke Unit, Sainte-Anne Hospital, and Université de Paris Cité, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Simon Jung
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | | | - Eric E Smith
- Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Hideo Hara
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Yusuke Yakushiji
- Department of Neurology, Kansai Medical University, Hirakata, Japan
| | | | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Australia
- A.A. Martinos Center for Biomedical Imaging, Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ji-Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Roland Veltkamp
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neurology, Austin Health, Heidelberg, Australia
| | - Hakan Ay
- Department of Brain Sciences, Imperial College London, London, UK
| | - Toshio Imaizumi
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Shatin, Hong Kong
| | - Eric Jouvent
- Université de Paris-Assistance Publique Hôpitaux de Paris, Paris, France
- Département de Neurologie, Hôpital Lariboisière, FHU NeuroVasc, INSERM NeuroDiderot U1141, Paris, France
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Sohei Yoshimura
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Joan Martí-Fàbregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Luis Prats-Sánchez
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Philippe Lyrer
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jonathan Best
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
- Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - David Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
- Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Stefan T Engelter
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Nils Peters
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
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Lo JW, Crawford JD, Desmond DW, Bae HJ, Lim JS, Godefroy O, Roussel M, Köhler S, Staals J, Verhey F, Chen C, Xu X, Chong E, Kandiah N, Bordet R, Dondaine T, Mendyk AM, Brodaty H, Traykov L, Mehrabian S, Petrova N, Lipnicki DM, Pan Lam BC, Sachdev PS. Short-term Trajectories of Poststroke Cognitive Function: A STROKOG Collaboration Study. Neurology 2023:WNL.0000000000207281. [PMID: 37072222 DOI: 10.1212/wnl.0000000000207281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 02/27/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Past studies on post-stroke cognitive function have focused on the average performance or change over time, but few have investigated patterns of cognitive trajectories after stroke. This project used latent class growth analysis (LCGA) to identify clusters of patients with similar patterns of cognition scores over the first-year post-stroke and the extent to which long-term cognitive outcome is predicted by the clusters ("trajectory groups"). METHODS Data were sought from the Stroke and Cognition consortium (STROKOG). LCGA was used to identify clusters of trajectories based on standardized global cognition scores at baseline (T1) and at the 1-year follow-up (T2). One-step IPD meta-analysis was used to examine risk factors for trajectory groups and association of trajectory groups with cognition at the long-term follow-up (T3). RESULTS Nine hospital-based stroke cohorts with 1149 patients (63% male; mean age 66.4 years (SD=11.0)) were included. The median time assessed at T1 was 3.6 months post-stroke, 1.0 year at T2 and 3.2 years at T3. LCGA identified 3 trajectory groups, which were characterized by different mean levels of cognition scores at T1 (low-, -3.27SD (0.94), 17%; medium-, -1.23SD (0.68), 48%; and high-performance, 0.71SD (0.77), 35%). There was significant improvement in cognition for the high-performance group (0.22 SD/year, 95% CI 0.07, 0.36), but changes for the low and medium performance groups were not significant (-0.10 SD/year, 95% CI -0.33, 0.13; 0.11 SD/year, 95% CI -0.08, 0.24 respectively). Factors associated with the low- (versus high-) performance group include age (relative risk ratio [RRR] 1.18, 95% CI 1.14, 1.23), years of education (RRR 0.61, 95% CI 0.56, 0.67), diabetes (RRR 3.78, 95% CI 2.08, 6.88), large artery versus small vessel strokes (RRR 2.77, 95% CI 1.32, 5.83), and moderate/severe strokes (RRR 3.17, 95% 1.42, 7.08). Trajectory groups were predictive of global cognition at T3, but its predictive power was comparable to scores at T1. CONCLUSION The trajectory of cognitive function over the first-year post-stroke is heterogenous. Baseline cognitive function ∼3.6 months post-stroke is a good predictor of long-term cognitive outcome. Older age, lower levels of education, diabetes, large artery strokes, and greater stroke severity are risk factors for lower cognitive performance over the first year.
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Affiliation(s)
- Jessica W Lo
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia
| | | | - Hee-Joon Bae
- Department of Neurology, Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands
| | - Julie Staals
- Department of Neurology, School for Cardiovascular diseases (CARIM), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xin Xu
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Eddie Chong
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nagaendran Kandiah
- National Neuroscience Institute, Singapore
- Duke-NUS Medical School, Singapore
| | - Regis Bordet
- University of Lille, Inserm, CHU de Lille, Lille Neuroscience and Cognition. F-59000 Lille, France
| | - Thibaut Dondaine
- University of Lille, Inserm, CHU de Lille, Lille Neuroscience and Cognition. F-59000 Lille, France
| | - Anne-Marie Mendyk
- University of Lille, Inserm, CHU de Lille, Lille Neuroscience and Cognition. F-59000 Lille, France
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia
- Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia
| | - Latchezar Traykov
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria
| | - Shima Mehrabian
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria
| | | | | | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia
- Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia
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20
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Weaver NA, Mamdani MH, Lim JS, Biesbroek JM, Biessels GJ, Huenges Wajer IMC, Kang Y, Kim BJ, Lee BC, Lee KJ, Yu KH, Bae HJ, Bzdok D, Kuijf HJ. Disentangling poststroke cognitive deficits and their neuroanatomical correlates through combined multivariable and multioutcome lesion-symptom mapping. Hum Brain Mapp 2023; 44:2266-2278. [PMID: 36661231 PMCID: PMC10028652 DOI: 10.1002/hbm.26208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Studies in patients with brain lesions play a fundamental role in unraveling the brain's functional anatomy. Lesion-symptom mapping (LSM) techniques can relate lesion location to cognitive performance. However, a limitation of current LSM approaches is that they can only evaluate one cognitive outcome at a time, without considering interdependencies between different cognitive tests. To overcome this challenge, we implemented canonical correlation analysis (CCA) as combined multivariable and multioutcome LSM approach. We performed a proof-of-concept study on 1075 patients with acute ischemic stroke to explore whether addition of CCA to a multivariable single-outcome LSM approach (support vector regression) could identify infarct locations associated with deficits in three well-defined verbal memory functions (encoding, consolidation, retrieval) based on four verbal memory subscores derived from the Seoul Verbal Learning Test (immediate recall, delayed recall, recognition, learning ability). We evaluated whether CCA could extract cognitive score patterns that matched prior knowledge of these verbal memory functions, and if these patterns could be linked to more specific infarct locations than through single-outcome LSM alone. Two of the canonical modes identified with CCA showed distinct cognitive patterns that matched prior knowledge on encoding and consolidation. In addition, CCA revealed that each canonical mode was linked to a distinct infarct pattern, while with multivariable single-outcome LSM individual verbal memory subscores were associated with largely overlapping patterns. In conclusion, our findings demonstrate that CCA can complement single-outcome LSM techniques to help disentangle cognitive functions and their neuroanatomical correlates.
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Affiliation(s)
- Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Muhammad Hasnain Mamdani
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre, School of Computer Science, Montreal Neurological Institute (MNI), McGill University, Montreal, Canada
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Yeonwook Kang
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
- Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre, School of Computer Science, Montreal Neurological Institute (MNI), McGill University, Montreal, Canada
- Mila-Quebec Artificial Intelligence Institute, Montreal, Canada
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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Kernbach JM, Hartwigsen G, Lim JS, Bae HJ, Yu KH, Schlaug G, Bonkhoff A, Rost NS, Bzdok D. Bayesian stroke modeling details sex biases in the white matter substrates of aphasia. Commun Biol 2023; 6:354. [PMID: 37002267 PMCID: PMC10066402 DOI: 10.1038/s42003-023-04733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1401 patients, we isolate data-led representations of anatomical lesion patterns and hand-tailor a Bayesian analytical solution to carefully model the degree of sex divergence in predicting language outcomes ~3 months after stroke. We locate lesion-outcome effects in the left-dominant language network that highlight the ventral pathway as a core lesion focus across different tests of language performance. We provide detailed evidence for sex-specific brain-behavior associations in the domain-general networks associated with cortico-subcortical pathways, with unique contributions of the fornix in women and cingular fiber bundles in men. Our collective findings suggest diverging white matter substrates in how stroke causes language deficits in women and men. Clinically acknowledging such sex disparities has the potential to improve personalized treatment for stroke patients worldwide.
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Affiliation(s)
- Julius M Kernbach
- Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), RWTH Aachen University Hospital, Aachen, Germany
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Gesa Hartwigsen
- Max Planck Institute for Human Cognitive and Brain Sciences, Lise Meitner Research Group Cognition and Plasticity, Leipzig, Germany
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Gottfried Schlaug
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Anna Bonkhoff
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Natalia S Rost
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, QC, Canada.
- Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada.
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22
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Martí-Fàbregas J, Camps-Renom P, Best JG, Ramos-Pachon A, Guasch-Jiménez M, Martinez-Domeño A, Guisado-Alonso D, Gómez-Ansón BM, Ambler G, Wilson D, Lee KJ, Lim JS, Bae HJ, Shiozawa M, Koga M, Toyoda K, Hennerici MG, Chabriat H, Jouvent E, Wong DYK, Mak H, Lau KK, Kim YD, Song TJ, Heo JH, Eppinger S, Gattringer T, Uysal E, Demirelli DS, Bornstein N, Ben Assayag E, Hallevi H, Molad JA, Nishihara M, Tanaka J, Hara H, Yakushiji Y, Coutts SB, Smith E, Polymeris AA, Wagner B, Seiffge D, Lyrer PA, Peters N, Engelter ST, Al-Shahi Salman R, Jäger HR, Lip GYH, Goeldlin M, Panos L, Karayiannis CC, Phan TG, Srikanth VK, Christ N, Gunkel S, Fluri F, Leung TW, Soo YOY, Chu W, Abrigo J, Barbato C, Browning S, Simister R, Mendyk AM, Bordet R, Hilal S, Gyanwali B, Chen C, Jung S, Necioglu Orken D, Werring D, Prats-Sanchez L. Stroke Risk and Antithrombotic Treatment During Follow-up of Patients With Ischemic Stroke and Cortical Superficial Siderosis. Neurology 2023; 100:e1267-e1281. [PMID: 36535778 PMCID: PMC10033167 DOI: 10.1212/wnl.0000000000201723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In patients with ischemic stroke (IS) or transient ischemic attack (TIA) and cortical superficial siderosis (cSS), there are few data regarding the risk of future cerebrovascular events and also about the benefits and safety of antithrombotic drugs for secondary prevention. We investigated the associations of cSS and stroke risk in patients with recent IS or TIA. METHODS We retrospectively analyzed the Microbleeds International Collaborative Network (MICON) database. We selected patients with IS or TIA from cohorts who had MRI-assessed cSS, available data on antithrombotic treatments, recurrent cerebrovascular events (intracranial hemorrhage [ICrH], IS, or any stroke [ICrH or IS]), and mortality. We calculated incidence rates (IRs) and performed univariable and multivariable Cox regression analyses. RESULTS Of 12,669 patients (mean age 70.4 ± 12.3 years, 57.3% men), cSS was detected in 273 (2.2%) patients. During a mean follow-up of 24 ± 17 months, IS was more frequent than ICrH in both cSS (IR 57.1 vs 14.6 per 1,000 patient-years) and non-cSS (33.7 vs 6.3 per 1,000 patient-years) groups. Compared with the non-cSS group, cSS was associated with any stroke on multivariable analysis {IR 83 vs 42 per 1,000 patient-years, adjusted hazard ratio [HR] for cSS 1.62 (95% CI: 1.14-2.28; p = 0.006)}. This association was not significant in subgroups of patients treated with antiplatelet drugs (n = 6,554) or with anticoagulants (n = 4,044). Patients with cSS who were treated with both antiplatelet drugs and anticoagulants (n = 1,569) had a higher incidence of ICrH (IR 107.5 vs 4.9 per 1,000 patient-years, adjusted HR 13.26; 95% CI: 2.90-60.63; p = 0.001) and of any stroke (IR 198.8 vs 34.7 per 1,000 patient-years, adjusted HR 5.03; 95% CI: 2.03-12.44; p < 0.001) compared with the non-cSS group. DISCUSSION Patients with IS or TIA with cSS are at increased risk of stroke (ICrH or IS) during follow-up; the risk of IS exceeds that of ICrH for patients receiving antiplatelet or anticoagulant treatment alone, but the risk of ICrH exceeds that of IS in patients receiving both treatments. The findings suggest that either antiplatelet or anticoagulant treatment alone should not be avoided in patients with cSS, but combined antithrombotic therapy might be hazardous. Our findings need to be confirmed by randomized clinical trials.
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Affiliation(s)
- Joan Martí-Fàbregas
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey.
| | - Pol Camps-Renom
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Jonathan G Best
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Anna Ramos-Pachon
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Marina Guasch-Jiménez
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Alejandro Martinez-Domeño
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Daniel Guisado-Alonso
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Beatriz M Gómez-Ansón
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Gareth Ambler
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Duncan Wilson
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Keon-Joo Lee
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Jae-Sung Lim
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Hee-Joon Bae
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Masayuki Shiozawa
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Masatoshi Koga
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Kazunori Toyoda
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Michael G Hennerici
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Hugues Chabriat
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Eric Jouvent
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Debbie Yuen Kwun Wong
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Henry Mak
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Kui Kai Lau
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Young Dae Kim
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Tae-Jin Song
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Ji-Hoe Heo
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Sebastian Eppinger
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Thomas Gattringer
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Ender Uysal
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Derya Selçuk Demirelli
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Natan Bornstein
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Einor Ben Assayag
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Hen Hallevi
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Jeremy A Molad
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Masashi Nishihara
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Jun Tanaka
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Hideo Hara
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Yusuke Yakushiji
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Shelagh B Coutts
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Eric Smith
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Alexandros A Polymeris
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Benjamin Wagner
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - David Seiffge
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Philippe A Lyrer
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Nils Peters
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Stefan T Engelter
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Rustam Al-Shahi Salman
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Hans Rudolf Jäger
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Gregory Y H Lip
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Martina Goeldlin
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Leonidas Panos
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Christopher Charles Karayiannis
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Thanh G Phan
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Velandai K Srikanth
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Nicolas Christ
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Sarah Gunkel
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Felix Fluri
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Thomas W Leung
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Yannie O Y Soo
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Winnie Chu
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Jill Abrigo
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Carmen Barbato
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Simone Browning
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Robert Simister
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Anne-Marie Mendyk
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Régis Bordet
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Saima Hilal
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Bibek Gyanwali
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Christopher Chen
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Simon Jung
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Dilek Necioglu Orken
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - David Werring
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
| | - Luis Prats-Sanchez
- From the Department of Neurology (J.M-F., P.C-R., A.R-P., M.G-J., A.M-D., D.G-A., L.P-S., L.P-S.), Neuroradiology Unit (B.M.G-A.), Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain; Department of Brain Repair and Rehabilitation (J.G.B., D.W., C.B., S.B., R.S., D.W.), UCL Stroke Research Centre, University College London Queen Square, Institute of Neurology, UK; Department of Statistical Science (G.A.), University College London, UK; Seoul National University College of Medicine Cerebrovascular Disease Center (K-J.L., H-J.B.); Department of Neurology (J-S.L.), Asan Medical Center University of Ulsan College of Medicine, South Korea; Department of Cerebrovascular Medicine (M.S., M.K., K.T.), National Cerebral and Cardiovascular Centre, Japan; Federation Universitätsmedizin Mannheim (M.G.H.), University of Heidelberg, Germany; Department of Neurology (H.C., E.J.), Translational Neurovascular Centre, Assistance Publique Hôpitaux de Paris, Lariboisière Hospital, France; Division of Neurology, Department of Medicine and Department of Diagnostic Radiology (D.Y.K.W., H.M., K.K.L.), The University of Hong Kong; Department of Neurology (Y.D.K., T-J.S., J-H.H.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.E., T.G.), Medical University of Graz, Austria; Department of Neurology (E.U., D.S.D.), Saglık Bilimleri University, Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Neurology (N.B., E.B.A., H.H., J.A.M.), Tel-Aviv Sourasky Medical Center, Israel; Department of Radiology and Division of Neurology, Department of Internal Medicine (M.N., J.T., H.H., Y.Y.), Saga University Faculty of Medicine, Japan; Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences (S.B.C., E.S.), Hotchkiss Brain Institute, University of Calgary, Canada; Department of Neurology and Stroke Centre (A.A.P., B.W., D.S., P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Centre for Clinical Brain Sciences (R.A-S.S.), School of Clinical Sciences, University of Edinburgh; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (H.R.J.), University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool, UK; Department of Neurology (M.G., L.P., S.J.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Peninsula Clinical School (C.C.K., T.G.P., V.K.S.), Peninsula Health and Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Neurology (N.C., S.G., F.F.), University Hospital of Würzburg, Germany; Department of Medicine and Therapeutics (T.W.L., Y.O.Y.S., W.C., J.A.), Prince of Wales Hospital, The Chinese University of Hong Kong; Univ Lille (A-M.M., R.B.), Inserm, CHU de Lille. Lille Neuroscience & Cognition, Paris, France; Memory Aging & Cognition Centre (S.H., B.G., C.C.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (D.N.O.), Istanbul Arel University, Turkey
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23
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Cheon DY, Han KD, Kim CH, Oh MS, Lee BC, Kim Y, Lee SH, Kim C, Lim JS, Lee M, Yu KH. Association between exercise habit changes and incident dementia after ischemic stroke. Sci Rep 2023; 13:3959. [PMID: 36894695 PMCID: PMC9998861 DOI: 10.1038/s41598-023-31229-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023] Open
Abstract
We aimed to investigate the effects of exercise habit changes on the risk of incident dementia after ischemic stroke using the Korean National Health Insurance Services Database. This study included 223,426 patients with a new diagnosis of ischemic stroke between 2010 and 2016 who underwent two serial ambulatory health checkups. The participants were divided into four categories according to their habit change or regular exercise: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers. The primary outcome was new diagnosis of dementia. Multivariate Cox proportional models were used to assess the effects of changes in exercise habits on the risk of incident dementia. After a median of 4.02 years of follow-up, 22,554 (10.09%) dementia cases were observed. After adjusting for covariates, exercise dropouts, new exercisers, and exercise maintainers were significantly associated with a lower risk of incident dementia than persistent non-exercisers (adjusted hazard ratio [aHR] 0.937; 95% confidence interval [CI] 0.905-0.970, aHR 0.876; 95% CI 0.843-0.909, aHR 0.705; 95% CI 0.677-0.734, respectively). The impact of changes in exercise habit was more prominent in the 40-65 years age group. An energy expenditure ≥ 1000 metabolic equivalents of task-min/wk post-stroke, regardless of pre-stroke physical activity status, was mostly associated with a lower risk of each outcome. In this retrospective cohort study, initiating or continuing moderate-to-vigorous exercise after ischemic stroke was associated with a lower risk of dementia development. Further, pre-stroke regular physical activity also reduced the risk of incident dementia. The promotion of exercise in ambulatory stroke patients may reduce their future risk of incident dementia.
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Affiliation(s)
- Dae Young Cheon
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Kyung do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Chi-Hun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
| | - Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
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24
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Kim YE, Lim JS, Lee Y, Lee JH. Teaching NeuroImage: Glucose Hhypermetabolism in the basal Basal gangliaGanglia: The decisive Decisive clue Clue to the diagnosis Diagnosis of an unusual Unusual antiAnti-LGI1 encephalitisEncephalitis. Neurology 2023:WNL.0000000000207131. [PMID: 36878706 DOI: 10.1212/wnl.0000000000207131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Ye Eun Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoojin Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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25
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Lim JS, Lee J, Kang Y, Park HT, Kim DE, Cha JK, Park TH, Heo JH, Lee KB, Park JM, Oh MS, Kim EG, Chang DI, Heo SH, Park MS, Park H, Yi S, Lee YB, Park KY, Lee SJ, Kim JG, Lee J, Cho KH, Rha JH, Kim YI, Lee JH, Choi JC, Oh KM, Kwon JH, Kim C, Park JH, Jung KH, Sung SM, Chung JW, Lee YS, Kim HY, Cho HJ, Park JW, Moon WJ, Bae HJ. Efficacy and safety of oxiracetam in patients with vascular cognitive impairment: A multicenter, randomized, double-blinded, placebo-controlled, phase IV clinical trial. Contemp Clin Trials 2023; 126:107108. [PMID: 36724841 DOI: 10.1016/j.cct.2023.107108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Oxiracetam may have a modest effect on preventing cognitive decline. Exercise can also enhance cognitive function. This trial aims to investigate the effect of oxiracetam on post-stroke cognitive impairment and explore whether this effect is modified by exercise. Furthermore, the mechanisms that mediate this effect will be investigated through a neural network analysis. METHODS This is a multicenter, randomized, double-blind, placebo-controlled phase IV trial. Patients who complained of cognitive decline 3 months after stroke and had a high risk of cognitive decline were eligible. Patients were randomly assigned to receive either 800 mg of oxiracetam or placebo twice daily for 36 weeks. After randomization, a predetermined exercise protocol was provided to each participant, and the degree of physical activity was assessed using wrist actigraphy at 4, 12, 24, and 36 weeks. Resting-state functional MRI was obtained in baseline and 36-week follow-up. Co-primary endpoints are changes in the Mini-Mental State Examination and Clinical Dementia Rating-Sum of Boxes. Secondary endpoints include changes in the NINDS-CSN VCIHS-Neuropsychology Protocol, Euro QoL, patient's global assessment, and functional network connectivity. If there is a significant difference in physical activity between the two groups, the interaction effect between physical activity and the treatment group will be examined. A total of 500 patients were enrolled from February 2018, and the last patient's final follow-up was completed in September 2022. CONCLUSION This trial is meaningful not only to prove the efficacy of oxiracetam, but also evaluate whether exercise can modify the effects of medication and how cognitive function can be restored. Trial registrationhttp://cris.nih.go.kr (KCT0005137).
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Affiliation(s)
- Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University, Seoul, Republic of Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Hyun-Tae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan, Republic of Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Ilsan, Republic of Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea
| | - Tai Hwan Park
- Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea
| | - Jae-Hyuk Heo
- Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea
| | - Kyung Bok Lee
- Department of Neurology, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Republic of Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Eung-Gyu Kim
- Department of Neurology, Inje University Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Dae-Il Chang
- Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Sung Hyuk Heo
- Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - HyunYoung Park
- Department of Neurology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - SangHak Yi
- Department of Neurology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Yeong Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Republic of Korea
| | - Soo Joo Lee
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University, School of Medicine, Daejeon, Republic of Korea
| | - Jae Guk Kim
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University, School of Medicine, Daejeon, Republic of Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Hospital, Yeungnam University School of Medicine, Daegu, Republic of Korea
| | - Kyung-Hee Cho
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joung-Ho Rha
- Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
| | - Yeong-In Kim
- Department of Neurology, Catholic Kwandong University International St. Mary's Hospital, Incheon, Republic of Korea
| | - Jun Hong Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
| | - Jay Chol Choi
- Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Kyung-Mi Oh
- Department of Neurology, Korea Univeristy Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea
| | - Chulho Kim
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jong-Ho Park
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Min Sung
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Republic of Korea
| | - Jong-Won Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong-Seok Lee
- Department of Neurology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hahn Young Kim
- Department of Neurology, Konkuk University Hospital, Konkuk University, Seoul, Republic of Korea
| | - Hyun-Ji Cho
- Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jeong Wook Park
- Department of Neurology, Uijeongbu St. Mary's Hospital, Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
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Joo L, Shim WH, Suh CH, Lim SJ, Heo H, Kim WS, Hong E, Lee D, Sung J, Lim JS, Lee JH, Kim SJ. Diagnostic performance of deep learning-based automatic white matter hyperintensity segmentation for classification of the Fazekas scale and differentiation of subcortical vascular dementia. PLoS One 2022; 17:e0274562. [PMID: 36107961 PMCID: PMC9477348 DOI: 10.1371/journal.pone.0274562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/31/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To validate the diagnostic performance of commercially available, deep learning-based automatic white matter hyperintensity (WMH) segmentation algorithm for classifying the grades of the Fazekas scale and differentiating subcortical vascular dementia. Methods This retrospective, observational, single-institution study investigated the diagnostic performance of a deep learning-based automatic WMH volume segmentation to classify the grades of the Fazekas scale and differentiate subcortical vascular dementia. The VUNO Med-DeepBrain was used for the WMH segmentation system. The system for segmentation of WMH was designed with convolutional neural networks, in which the input image was comprised of a pre-processed axial FLAIR image, and the output was a segmented WMH mask and its volume. Patients presented with memory complaint between March 2017 and June 2018 were included and were split into training (March 2017–March 2018, n = 596) and internal validation test set (April 2018–June 2018, n = 204). Results Optimal cut-off values to categorize WMH volume as normal vs. mild/moderate/severe, normal/mild vs. moderate/severe, and normal/mild/moderate vs. severe were 3.4 mL, 9.6 mL, and 17.1 mL, respectively, and the AUC were 0.921, 0.956 and 0.960, respectively. When differentiating normal/mild vs. moderate/severe using WMH volume in the test set, sensitivity, specificity, and accuracy were 96.4%, 89.9%, and 91.7%, respectively. For distinguishing subcortical vascular dementia from others using WMH volume, sensitivity, specificity, and accuracy were 83.3%, 84.3%, and 84.3%, respectively. Conclusion Deep learning-based automatic WMH segmentation may be an accurate and promising method for classifying the grades of the Fazekas scale and differentiating subcortical vascular dementia.
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Affiliation(s)
- Leehi Joo
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Su Jin Lim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hwon Heo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Woo Seok Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | | | | | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Jeong SY, Suh CH, Shim WH, Lim JS, Lee JH, Kim SJ. Incidence of Amyloid-Related Imaging Abnormalities in Patients With Alzheimer Disease Treated With Anti-β-amyloid Immunotherapy: A Meta-analysis. Neurology 2022; 99:e2092-e2101. [PMID: 36038268 DOI: 10.1212/wnl.0000000000201019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/01/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To assess the incidence of ARIA in clinical trials of anti-Aβ immunotherapy and compare the incidence among different agents and clinical characteristics to identify possible predisposing factors for ARIA. METHODS The PubMed and Embase databases were searched for clinical trials of anti-Aβ immunotherapy published on or before January 12, 2022. Phase 2 or 3 randomized controlled trials reporting detailed data sufficient to assess the incidence of ARIA were selected. The pooled incidences of ARIA and subgroup analyses according to agent and ApoE-4 carrier status were calculated using the DerSimonian-Liard random-effects model. The proportion of symptomatic ARIA cases was also calculated. RESULTS In total, 19 eligible studies, including 24 cohorts, were identified and 9,429 patients were analyzed. The overall pooled incidence of ARIA-effusion (E) and ARIA-hemorrhage (H) was 6.5% and 7.8%, respectively. In the subgroup analysis, the incidence of ARIA was different according to anti-Aβ immunotherapy agent. The cohorts treated with aducanumab had a significantly higher incidence of ARIA-E and ARIA-H (30.7% and 30.0%, respectively; both P < 0.001) compared to cohorts from other drugs. In subgroup analysis according to ApoE-4 carrier status, the incidences of ARIA-E and ARIA-H were higher in the ApoE-4 carrier group than those in ApoE-4 non-carrier group, but there was no statistical significance ( ApoE-4 carrier vs. non-carrier, ARIA-E; 8.6% vs. 6.9%, P = 0.663, and ARIA-H; 10.5% vs. 6.6%, P = 0.398). The pooled proportion of asymptomatic ARIA, detected by routine scheduled MRI surveillances, was 80.4%. CONCLUSIONS The overall incidences of ARIA-E and ARIA-H were 6.5% and 7.8%, respectively, and the pooled proportion of asymptomatic ARIA was 80.4%. The cohorts treated with aducanumab showed a significantly higher incidence of ARIA-E and ARIA-H (30.7% and 30.0%) compared with other drugs.
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Affiliation(s)
- So Yeong Jeong
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Park HY, Suh CH, Shim WH, Heo H, Kim WS, Lim JS, Lee JH, Kim HS, Kim SJ. Diagnostic yield of TOF-MRA for detecting incidental vascular lesions in patients with cognitive impairment: An observational cohort study. Front Neurol 2022; 13:958037. [PMID: 36090850 PMCID: PMC9453548 DOI: 10.3389/fneur.2022.958037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The role of three-dimensional (3D) TOF-MRA in patients with cognitive impairment is not well established. We evaluated the diagnostic yield of 3D TOF-MRA for detecting incidental extra- or intracranial artery stenosis and intracranial aneurysm in this patient group. Methods This retrospective study included patients with cognitive impairment undergoing our brain MRI protocol from January 2013 to February 2020. The diagnostic yield of TOF-MRA for detecting incidental vascular lesions was calculated. Patients with positive TOF-MRA results were reviewed to find whether additional treatment was performed. Logistic regression analysis was conducted to identify the clinical risk factors for positive TOF-MRA findings. Results In total, 1,753 patients (mean age, 70.2 ± 10.6 years; 1,044 women) were included; 199 intracranial aneurysms were detected among 162 patients (9.2%, 162/1,753). A 3D TOF-MRA revealed significant artery stenoses (>50% stenosis) in 162 patients (9.2%, 162/1,753). The overall diagnostic yield of TOF-MRA was 16.8% (294/1,753). Among them, 92 patients (31.3%, 92/294) underwent either medical therapy, endovascular intervention, or surgery. In total, eighty-one patients with stenosis were prescribed with either antiplatelet medications or lipid-lowering agent. In total, fifteen patients (aneurysm: 11 patients, stenosis: 4 patients) were further treated with endovascular intervention or surgery. Thus, the “number needed to scan” was 19 for identifying one patient requiring treatment. Multivariate logistic regression analysis showed that being female (odds ratio [OR] 2.05) and old age (OR 1.04) were the independent risk factors for intracranial aneurysm; being male (OR 1.52), old age (OR 1.06), hypertension (OR 1.78), and ischemic heart disease history (OR 2.65) were the independent risk factors for significant artery stenosis. Conclusions Our study demonstrated the potential benefit of 3D TOF-MRA, given that it showed high diagnostic yield for detecting vascular lesions in patients with cognitive impairment and the considerable number of these lesions required further treatment. A 3D TOF-MRA may be included in the routine MR protocol for the work-up of this patient population, especially in older patients and patients with vascular risk factors.
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Affiliation(s)
- Ho Young Park
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Chong Hyun Suh
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
- *Correspondence: Chong Hyun Suh
| | - Woo Hyun Shim
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hwon Heo
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Woo Seok Kim
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang Joon Kim
- Department of Radiology and Research, Asan Medical Center, Institute of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
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Park C, Jang JW, Joo G, Kim Y, Kim S, Byeon G, Park SW, Kasani PH, Yum S, Pyun JM, Park YH, Lim JS, Youn YC, Choi HS, Park C, Im H, Kim S. Predicting progression to dementia with “comprehensive visual rating scale” and machine learning algorithms. Front Neurol 2022; 13:906257. [PMID: 36071894 PMCID: PMC9443667 DOI: 10.3389/fneur.2022.906257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objective Identifying biomarkers for predicting progression to dementia in patients with mild cognitive impairment (MCI) is crucial. To this end, the comprehensive visual rating scale (CVRS), which is based on magnetic resonance imaging (MRI), was developed for the assessment of structural changes in the brains of patients with MCI. This study aimed to investigate the use of the CVRS score for predicting dementia in patients with MCI over a 2-year follow-up period using various machine learning (ML) algorithms. Methods We included 197 patients with MCI who were followed up more than once. The data used for this study were obtained from the Japanese-Alzheimer's Disease Neuroimaging Initiative study. We assessed all the patients using their CVRS scores, cortical thickness data, and clinical data to determine their progression to dementia during a follow-up period of over 2 years. ML algorithms, such as logistic regression, random forest (RF), XGBoost, and LightGBM, were applied to the combination of the dataset. Further, feature importance that contributed to the progression from MCI to dementia was analyzed to confirm the risk predictors among the various variables evaluated. Results Of the 197 patients, 108 (54.8%) showed progression from MCI to dementia. Tree-based classifiers, such as XGBoost, LightGBM, and RF, achieved relatively high performance. In addition, the prediction models showed better performance when clinical data and CVRS score (accuracy 0.701–0.711) were used than when clinical data and cortical thickness (accuracy 0.650–0.685) were used. The features related to CVRS helped predict progression to dementia using the tree-based models compared to logistic regression. Conclusions Tree-based ML algorithms can predict progression from MCI to dementia using baseline CVRS scores combined with clinical data.
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Affiliation(s)
- Chaeyoon Park
- Department of Convergence Security, Kangwon National University, Chuncheon, South Korea
| | - Jae-Won Jang
- Department of Convergence Security, Kangwon National University, Chuncheon, South Korea
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
| | - Gihun Joo
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Seongheon Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Sang Won Park
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
| | | | - Sujin Yum
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
| | - Jung-Min Pyun
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hyun-Soo Choi
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon, South Korea
| | - Chihyun Park
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon, South Korea
| | - Hyeonseung Im
- Department of Convergence Security, Kangwon National University, Chuncheon, South Korea
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Chuncheon, South Korea
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon, South Korea
- *Correspondence: Hyeonseung Im
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
- SangYun Kim
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Biesbroek JM, Weaver NA, Aben HP, Kuijf HJ, Abrigo J, Bae HJ, Barbay M, Best JG, Bordet R, Chappell FM, Chen CPLH, Dondaine T, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kang Y, Kappelle LJ, Kim BJ, Köhler S, de Kort PLM, Koudstaal PJ, Kuchcinski G, Lam BYK, Lee BC, Lee KJ, Lim JS, Lopes R, Makin SDJ, Mendyk AM, Mok VCT, Oh MS, van Oostenbrugge RJ, Roussel M, Shi L, Staals J, Valdés-Hernández MDC, Venketasubramanian N, Verhey FRJ, Wardlaw JM, Werring DJ, Xin X, Yu KH, van Zandvoort MJE, Zhao L, Biessels GJ. Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke. Neuroimage Clin 2022; 34:103018. [PMID: 35504223 PMCID: PMC9079101 DOI: 10.1016/j.nicl.2022.103018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/14/2022] [Accepted: 04/22/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction. AIMS To determine if the network impact score is an independent predictor of PSCI, and of cognitive recovery or decline. METHODS We pooled data from patients with acute ischemic stroke from 12 cohorts through the Meta VCI Map consortium. PSCI was defined as impairment in ≥ 1 cognitive domain on neuropsychological examination, or abnormal Montreal Cognitive Assessment. Cognitive recovery was defined as conversion from PSCI < 3 months post-stroke to no PSCI at follow-up, and cognitive decline as conversion from no PSCI to PSCI. The network impact score was related to serial measures of PSCI using Generalized Estimating Equations (GEE) models, and to PSCI stratified according to post-stroke interval (<3, 3-12, 12-24, >24 months) and cognitive recovery or decline using logistic regression. Models were adjusted for age, sex, education, prior stroke, infarct volume, and study site. RESULTS We included 2341 patients with 4657 cognitive assessments. PSCI was present in 398/844 patients (47%) <3 months, 709/1640 (43%) at 3-12 months, 243/853 (28%) at 12-24 months, and 208/522 (40%) >24 months. Cognitive recovery occurred in 64/181 (35%) patients and cognitive decline in 26/287 (9%). The network impact score predicted PSCI in the univariable (OR 1.50, 95%CI 1.34-1.68) and multivariable (OR 1.27, 95%CI 1.10-1.46) GEE model, with similar ORs in the logistic regression models for specified post-stroke intervals. The network impact score was not associated with cognitive recovery or decline. CONCLUSIONS The network impact score is an independent predictor of PSCI. As such, the network impact score may contribute to a more precise and individualized cognitive prognostication in patients with ischemic stroke. Future studies should address if multimodal prediction models, combining the network impact score with demographics, clinical characteristics and other advanced brain imaging biomarkers, will provide accurate individualized prediction of PSCI. A tool for calculating the network impact score is freely available at https://metavcimap.org/features/software-tools/lsm-viewer/.
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Affiliation(s)
- J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Hugo P Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Mélanie Barbay
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne Picardy University, 80054 Amiens Cedex, France
| | - Jonathan G Best
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Russell Square House, 10 - 12 Russell Square, London WC1B 5EH, UK
| | - Régis Bordet
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Francesca M Chappell
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Thibaut Dondaine
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | | | - Olivier Godefroy
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne Picardy University, 80054 Amiens Cedex, France
| | - Bibek Gyanwali
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Olivia K L Hamilton
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, South Korea
| | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Paul L M de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Peter J Koudstaal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Gregory Kuchcinski
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bonnie Y K Lam
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Byung-Chul Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Renaud Lopes
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | | | - Anne-Marie Mendyk
- Université Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | | | - Martine Roussel
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne Picardy University, 80054 Amiens Cedex, France
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China; BrainNow Research Institute, Shenzhen, Guangdong Province, China
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Maria Del C Valdés-Hernández
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | | | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Joanna M Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Russell Square House, 10 - 12 Russell Square, London WC1B 5EH, UK
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Martine J E van Zandvoort
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen, Guangdong Province, China
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
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Boon IS, Teo RPJ, Yap MH, Lim JS, Goh HL, Boon CS, Au Yong TPT. Re: Clinical evaluation of a deep-learning-based computer-aided detection system for the detection of pulmonary nodules in a large teaching hospital. Clin Radiol 2021; 77:156-157. [PMID: 34906365 DOI: 10.1016/j.crad.2021.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 01/19/2023]
Affiliation(s)
- I S Boon
- Leeds Cancer Centre, St James's Institute of Oncology, Leeds, UK.
| | - R P J Teo
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - M H Yap
- The Manchester Metropolitan University, Manchester, UK
| | - J S Lim
- University of Southampton School of Medicine, Southampton, UK
| | - H L Goh
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C S Boon
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - T P T Au Yong
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
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Lo JW, Crawford JD, Desmond DW, Bae HJ, Lim JS, Godefroy O, Roussel M, Kang Y, Jahng S, Köhler S, Staals J, Verhey F, Chen C, Xu X, Chong EJ, Kandiah N, Yatawara C, Bordet R, Dondaine T, Mendyk AM, Brodaty H, Traykov L, Mehrabian S, Petrova N, Kim KW, Bae JB, Han JW, Lipnicki DM, Lam B, Sachdev PS. Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis. Stroke 2021; 53:1318-1327. [PMID: 34775838 DOI: 10.1161/strokeaha.121.035796] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Poststroke cognitive impairment is common, but the trajectory and magnitude of cognitive decline after stroke is unclear. We examined the course and determinants of cognitive change after stroke using individual participant data from the Stroke and Cognition Consortium. METHODS Nine longitudinal hospital-based cohorts from 7 countries were included. Neuropsychological test scores and normative data were used to calculate standardized scores for global cognition and 5 cognitive domains. One-step individual participant data meta-analysis was used to examine the rate of change in cognitive function and risk factors for cognitive decline after stroke. Stroke-free controls were included to examine rate differences. Based on the literature and our own data that showed short-term improvement in cognitive function after stroke, key analyses were restricted to the period beginning 1-year poststroke to focus on its long-term effects. RESULTS A total of 1488 patients (mean age, 66.3 years; SD, 11.1; 98% ischemic stroke) were followed for a median of 2.68 years (25th-75th percentile: 1.21-4.14 years). After an initial period of improvement through up to 1-year poststroke, decline was seen in global cognition and all domains except executive function after adjusting for age, sex, education, vascular risk factors, and stroke characteristics (-0.053 SD/year [95% CI, -0.073 to -0.033]; P<0.001 for global cognition). Recurrent stroke and older age were associated with faster decline. Decline was significantly faster in patients with stroke compared with controls (difference=-0.078 SD/year [95% CI, -0.11 to -0.045]; P<0.001 for global cognition in a subgroup analysis). CONCLUSIONS Patients with stroke experience cognitive decline that is faster than that of stroke-free controls from 1 to 3 years after onset. An increased rate of decline is associated with older age and recurrent stroke.
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Affiliation(s)
- Jessica W Lo
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | | | - Hee-Joon Bae
- Department of Neurology, Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (H.-J.B.)
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea (J.-S.L., Y.K.)
| | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France (O.G., M.R.)
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences, University Hospital of Amiens, France (O.G., M.R.)
| | - Yeonwook Kang
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea (J.-S.L., Y.K.).,Department of Psychology, Hallym University, Republic of Korea (Y.K.)
| | - Seungmin Jahng
- Department of Psychology, Sungkyunkwan University, Republic of Korea (S.J.)
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands (S.K., F.V.)
| | - Julie Staals
- Department of Neurology, School for Cardiovascular diseases (CARIM), Maastricht University Medical Center (MUMC+), The Netherlands (J.S.)
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht University, The Netherlands (S.K., F.V.)
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (C.C., E.J.C.)
| | - Xin Xu
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (X.X.)
| | - Eddie J Chong
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (C.C., E.J.C.)
| | - Nagaendran Kandiah
- National Neuroscience Institute, Singapore (N.K., C.Y.).,Duke-NUS Medical School, Singapore (N.K.)
| | | | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Thibaut Dondaine
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Anne-Marie Mendyk
- University of Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, France (R.B., T.D., A.-M.M.)
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.).,Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia (H.B., P.S.S.)
| | - Latchezar Traykov
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria (L.T., S.M.)
| | - Shima Mehrabian
- Clinic of Neurology, UH "Alexandrovska", Medical University - Sofia, Bulgaria (L.T., S.M.)
| | - Neli Petrova
- Kaneff University Hospital, Ruse, Bulgaria (N.P.)
| | - Ki Woong Kim
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Republic of Korea (K.W.K.).,Department of Psychiatry, Seoul National University, College of Medicine, Republic of Korea (K.W.K.).,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (K.W.K., J.B.B., J.W.H.)
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - Ben Lam
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.)
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), UNSW, Sydney, Australia (J.W.L., J.D.C., H.B., D.M.L., B.L., P.S.S.).,Dementia Collaborative Research Centre, UNSW Medicine, UNSW, Sydney, Australia (H.B., P.S.S.)
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Lim JS, Goh HL, Au Yong TPT, Boon CS, Boon IS. Patient-Centred Digital Medicine. Clin Oncol (R Coll Radiol) 2021; 34:e80. [PMID: 34732294 DOI: 10.1016/j.clon.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/03/2022]
Affiliation(s)
- J S Lim
- University of Southampton School of Medicine, Southampton, UK
| | - H L Goh
- Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T P T Au Yong
- Department of Radiology, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - C S Boon
- Department of Clinical Oncology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - I S Boon
- Department of Clinical Oncology, Leeds Cancer Centre, St James's Institute of Oncology, Leeds, UK
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Lim JS, Lee JJ, Woo CW. Post-Stroke Cognitive Impairment: Pathophysiological Insights into Brain Disconnectome from Advanced Neuroimaging Analysis Techniques. J Stroke 2021; 23:297-311. [PMID: 34649376 PMCID: PMC8521255 DOI: 10.5853/jos.2021.02376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022] Open
Abstract
The neurological symptoms of stroke have traditionally provided the foundation for functional mapping of the brain. However, there are many unresolved aspects in our understanding of cerebral activity, especially regarding high-level cognitive functions. This review provides a comprehensive look at the pathophysiology of post-stroke cognitive impairment in light of recent findings from advanced imaging techniques. Combining network neuroscience and clinical neurology, our research focuses on how changes in brain networks correlate with post-stroke cognitive prognosis. More specifically, we first discuss the general consequences of stroke lesions due to damage of canonical resting-state large-scale networks or changes in the composition of the entire brain. We also review emerging methods, such as lesion-network mapping and gradient analysis, used to study the aforementioned events caused by stroke lesions. Lastly, we examine other patient vulnerabilities, such as superimposed amyloid pathology and blood-brain barrier leakage, which potentially lead to different outcomes for the brain network compositions even in the presence of similar stroke lesions. This knowledge will allow a better understanding of the pathophysiology of post-stroke cognitive impairment and provide a theoretical basis for the development of new treatments, such as neuromodulation.
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Affiliation(s)
- Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Joong Lee
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Choong-Wan Woo
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea
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35
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Weaver NA, Lim JS, Schilderinck J, Biessels GJ, Kang Y, Kim BJ, Kuijf HJ, Lee BC, Lee KJ, Yu KH, Bae HJ, Biesbroek JM. Strategic Infarct Locations for Poststroke Depressive Symptoms: A Lesion- and Disconnection-Symptom Mapping Study. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 8:387-396. [PMID: 34547548 DOI: 10.1016/j.bpsc.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/11/2021] [Accepted: 09/08/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Depression is the most common neuropsychiatric complication after stroke. Infarct location is associated with poststroke depressive symptoms (PSDS), but it remains debated which brain structures are critically involved. We performed a large-scale lesion-symptom mapping study to identify infarct locations and white matter disconnections associated with PSDS. METHODS We included 553 patients (mean [SD] age = 69 [11] years, 42% female) with acute ischemic stroke. PSDS were measured using the 30-item Geriatric Depression Scale. Multivariable support vector regression (SVR)-based analyses were performed both at the level of individual voxels (voxel-based lesion-symptom mapping) and at predefined regions of interest to relate infarct location to PSDS. We externally validated our findings in an independent stroke cohort (N = 459). Finally, disconnectome-based analyses were performed using SVR voxel-based lesion-symptom mapping, in which white matter fibers disconnected by the infarct were analyzed instead of the infarct itself. RESULTS Infarcts in the right amygdala, right hippocampus, and right pallidum were consistently associated with PSDS (permutation-based p < .05) in SVR voxel-based lesion-symptom mapping and SVR region-of-interest analyses. External validation confirmed the association between infarcts in the right amygdala and pallidum, but not the right hippocampus, and PSDS. Disconnectome-based analyses revealed that disconnections in the right parahippocampal white matter, right thalamus and pallidum, and right anterior thalamic radiation were significantly associated (permutation-based p < .05) with PSDS. CONCLUSIONS Infarcts in the right amygdala and pallidum and disconnections of right limbic and frontal cortico-basal ganglia-thalamic circuits are associated with PSDS. Our findings provide a comprehensive and integrative picture of strategic infarct locations for PSDS and shed new light on pathophysiological mechanisms of depression after stroke.
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Affiliation(s)
- Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea
| | - Janniek Schilderinck
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yeonwook Kang
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea; Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Biesbroek JM, Lim JS, Weaver NA, Arikan G, Kang Y, Kim BJ, Kuijf HJ, Postma A, Lee BC, Lee KJ, Yu KH, Bae HJ, Biessels GJ. Anatomy of phonemic and semantic fluency: A lesion and disconnectome study in 1231 stroke patients. Cortex 2021; 143:148-163. [PMID: 34450565 DOI: 10.1016/j.cortex.2021.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/16/2021] [Accepted: 06/28/2021] [Indexed: 01/02/2023]
Abstract
Disturbances of semantic and phonemic fluency are common after brain damage, as a manifestation of language, executive, or memory dysfunction. Lesion-symptom mapping (LSM) studies can provide fundamental insights in shared and distinct anatomical correlates of these cognitive functions and help to understand which patients suffer from these deficits. We performed a multivariate support vector regression-based lesion-symptom mapping and structural disconnection study on semantic and phonemic fluency in 1231 patients with acute ischemic stroke. With the largest-ever LSM study on verbal fluency we achieved almost complete brain lesion coverage. Lower performance on both fluency types was related to left hemispheric frontotemporal and parietal cortical regions, and subcortical regions centering on the left thalamus. Distinct correlates for phonemic fluency were the anterior divisions of middle and inferior frontal gyri. Distinct correlates for semantic fluency were the posterior regions of the middle and inferior temporal gyri, parahippocampal and fusiform gyri and triangular part of the inferior frontal gyrus. The disconnectome-based analyses additionally revealed phonemic fluency was associated with a more extensive frontoparietal white matter network, whereas semantic fluency was associated with disconnection of the fornix, mesiotemporal white matter, splenium of the corpus callosum. These results provide the most detailed outline of the anatomical correlates of phonemic and semantic fluency to date, stress the crucial role of subcortical regions and reveal a novel dissociation in the left temporal lobe.
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Affiliation(s)
- J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Gozdem Arikan
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
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Sun H, Lim JS, Silva CF, Maczuga SA, Hollins LC. Insurance coverage gap for treatment of melasma compared to rosacea: it pays to be light. Br J Dermatol 2021; 185:1252-1254. [PMID: 34254297 DOI: 10.1111/bjd.20641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Abstract
Treatments for many common dermatologic diagnoses are denied insurance coverage due to their arbitrary cosmetic classification. Melasma is one such diagnosis often considered cosmetic by payers, and since it is commonly identified in darker-skinned individuals, its cosmetic classification creates an economic barrier for patients of color. Although dermatologists have previously described insurance coverage gaps for conditions typically seen in patients of color, this coverage gap has never been quantified.1 Thus, we investigated the rate of insurance coverage for first-line topical treatments for rosacea versus melasma. Rosacea and melasma share a number of key features - both are common, chronic, dermatological conditions that are exacerbated by sun exposure, are primarily treated topically, and cause measurably decreased quality of life in affected patients.2,3 Rosacea, however, is often diagnosed in patients with Fitzpatrick skin types I-II, with 91.8% of rosacea diagnoses seen in white patients, while melasma is predominantly diagnosed in patients with Fitzpatrick skin types III-V.4-6.
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Affiliation(s)
- H Sun
- Penn State College of Medicine, Hershey, PA, U.S.A
| | - J S Lim
- Pennsylvania State, Department of Dermatology, Hershey, PA, U.S.A
| | - C F Silva
- Pennsylvania State, Department of Dermatology, Hershey, PA, U.S.A
| | - S A Maczuga
- Pennsylvania State, Department of Dermatology, Hershey, PA, U.S.A
| | - L C Hollins
- Pennsylvania State, Department of Dermatology, Hershey, PA, U.S.A
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Lee M, Oh MS, Jung S, Lee JH, Kim CH, Jang MU, Kim YE, Bae HJ, Park J, Kang Y, Lee BC, Lim JS, Yu KH. Differential effects of body mass index on domain-specific cognitive outcomes after stroke. Sci Rep 2021; 11:14168. [PMID: 34239011 PMCID: PMC8266804 DOI: 10.1038/s41598-021-93714-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022] Open
Abstract
Although the obesity paradox is an important modifiable factor in cardiovascular diseases, little research has been conducted to determine how it affects post-stroke cognitive function. We aimed to investigate the association between body mass index (BMI) and domain-specific cognitive outcomes, focusing on the subdivision of each frontal domain function in post-ischemic stroke survivors. A total of 335 ischemic stroke patients were included in the study after completion of the Korean-Mini Mental Status Examination (K-MMSE) and the vascular cognitive impairment harmonization standards neuropsychological protocol at 3 months after stroke. Frontal lobe functions were analyzed using semantic/phonemic fluency, processing speed, and mental set shifting. Our study participants were categorized into four groups according to BMI quartiles. The z-scores of K-MMSE at 3 months differed significantly between the groups after adjustment for initial stroke severity (p = 0.014). Global cognitive function in stroke survivors in the Q1 (the lowest quartile) BMI group was significantly lower than those in Q2 and Q4 (the highest quartile) BMI groups (K-MMSE z-scores, Q1: − 2.10 ± 3.40 vs. Q2: 0.71 ± 1.95 and Q4: − 1.21 ± 1.65). Controlled oral word association test findings indicated that phonemic and semantic word fluency was lower in Q4 BMI group participants than in Q2 BMI group participants (p = 0.016 and p = 0.023 respectively). BMI might differentially affect cognitive domains after ischemic stroke. Although being underweight may negatively affect global cognition post-stroke, obesity could induce frontal lobe dysfunctions, specifically phonemic and semantic word fluency.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - San Jung
- Department of Neurology, Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Ju-Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Chul-Ho Kim
- Department of Neurology, Chunchon Sacred Heart Hospital, Chunchon, South Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Young Eun Kim
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaeseol Park
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chunchon, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Kyung-Ho Yu
- Department of Neurology, Hallym Neurological Institute, Hallym University Sacred Heart Hospital, 896, Anyang-City, 430-070, South Korea.
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Lee M, Kim CH, Kim Y, Jang MU, Mo HJ, Lee SH, Lim JS, Yu KH, Lee BC, Oh MS. High Triglyceride Glucose Index Is Associated with Poor Outcomes in Ischemic Stroke Patients after Reperfusion Therapy. Cerebrovasc Dis 2021; 50:691-699. [PMID: 34229319 DOI: 10.1159/000516950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The triglyceride glucose index (TyG index) is a simple and reliable surrogate marker of insulin resistance (IR) that can predict functional outcomes and mortality after acute ischemic stroke (AIS). However, it is unclear whether the TyG index is associated with functional outcomes in patients with stroke who receive reperfusion therapy. Thus, we aimed to explore the prognostic value of the TyG index for the clinical outcomes of patients with AIS who underwent reperfusion therapy. METHODS We retrospectively assessed patients with AIS, with occlusion of either the middle cerebral artery or internal carotid artery, who were evaluated using multiphase computed tomography angiography (mCTA) and received reperfusion therapy. The TyG index was calculated as "ln [fasting glucose level (mg/dL) × triglyceride level (mg/dL)]/2." Collateral status was evaluated using mCTA based on the University of Calgary Scale. Clinical outcomes included 3-month functional outcomes, early neurological deterioration, recanalization status, and hemorrhagic transformation. RESULTS In all, 183 subjects (age 69.5 ± 12.4 years; men, 59.0%) were enrolled. The median initial National Institutes of Health Stroke Scale score was 15.0 (interquartile range [IQR] 11-18). The median TyG index was 4.8 (IQR, 4.6-5.1), and 158 patients had TyG levels >4.49, which represents the presence of IR. On univariate analysis, a higher TyG index was associated with both early neurological deterioration (18.4 vs. 0.0%, p = 0.041) and a 3-month poor functional outcome (mRS3-6) (61.4 vs. 32.0%, p = 0.011). After adjusting for multiple variables, including age, sex, type of reperfusion therapy, recanalization status, initial stroke severity, type of stroke, and history of hypertension and diabetes, high TyG index remained an independent predictor of a poor 3-month functional outcome (adjusted OR, 5.22; p = 0.014). However, TyG levels were not significantly associated with collateral status (p = 0.756). CONCLUSIONS IR, represented by a high TyG index, may predict poor 3-month functional outcomes in patients with AIS who undergo reperfusion therapy.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea,
| | - Chul-Ho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Hee Jung Mo
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
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Lee M, Lim JS, Kim CH, Lee SH, Kim Y, Hun Lee J, Jang MU, Sun Oh M, Lee BC, Yu KH. High Neutrophil-Lymphocyte Ratio Predicts Post-stroke Cognitive Impairment in Acute Ischemic Stroke Patients. Front Neurol 2021; 12:693318. [PMID: 34276542 PMCID: PMC8280279 DOI: 10.3389/fneur.2021.693318] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Systemic inflammation is associated with an increased risk of cognitive impairment and dementia, but the associations between them in stroke patients are less clear. We examined the impact of systemic inflammation represented as the neutrophil-lymphocyte ratio (NLR) on the development of post-stroke cognitive impairment (PSCI) and domain-specific cognitive outcomes 3-month after ischemic stroke. Methods: Using prospective stroke registry data, we consecutively enrolled 345 participants with ischemic stroke whose cognitive functions were evaluated 3-month after stroke. Their cognition was assessed with the Korean version of the Vascular Cognitive Impairment Harmonization Standards and the Korean-Mini Mental Status Examination. PSCI was defined as a z-score of < -2 standard deviations for age, sex, and education adjusted means in at least one cognitive domain. The participants were categorized into five groups according to the quintiles of NLR (lowest NLR, Q1). The cross-sectional association between NLR and PSCI was assessed using multiple logistic regression, adjusting for age, sex, education, vascular risk factors, and stroke type. Results: A total of 345 patients were enrolled. The mean age was 63.0 years and the median NIHSS score and NLR were 2 [1-4] and 2.26 [1.65-2.91], respectively. PSCI was identified in 71 (20.6%) patients. NLR was a significant predictor for PSCI both as a continuous variable (adjusted OR, 1.14; 95% CI, 1.00-1.31) and as a categorical variable (Q5, adjusted OR, 3.26; 95% CI, 1.17-9.08). Patients in the Q5 group (NLR ≥ 3.80) showed significantly worse performance in global cognition and in visuospatial and memory domains. Conclusions: NLR in the acute stage of ischemic stroke was independently associated with PSCI at 3 months after stroke, and high NLR was specifically associated with cognitive dysfunction in the memory and visuospatial domains. Thus, systemic inflammation may be a modifiable risk factor that may influence cognitive outcomes after stroke.
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Affiliation(s)
- Minwoo Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea.,Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Chul-Ho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Chuncheon, South Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Chuncheon, South Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Seoul, South Korea
| | - Ju Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Seoul, South Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Hwaseong, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
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Weaver NA, Kuijf HJ, Aben HP, Abrigo J, Bae HJ, Barbay M, Best JG, Bordet R, Chappell FM, Chen CPLH, Dondaine T, van der Giessen RS, Godefroy O, Gyanwali B, Hamilton OKL, Hilal S, Huenges Wajer IMC, Kang Y, Kappelle LJ, Kim BJ, Köhler S, de Kort PLM, Koudstaal PJ, Kuchcinski G, Lam BYK, Lee BC, Lee KJ, Lim JS, Lopes R, Makin SDJ, Mendyk AM, Mok VCT, Oh MS, van Oostenbrugge RJ, Roussel M, Shi L, Staals J, Del C Valdés-Hernández M, Venketasubramanian N, Verhey FRJ, Wardlaw JM, Werring DJ, Xin X, Yu KH, van Zandvoort MJE, Zhao L, Biesbroek JM, Biessels GJ. Strategic infarct locations for post-stroke cognitive impairment: a pooled analysis of individual patient data from 12 acute ischaemic stroke cohorts. Lancet Neurol 2021; 20:448-459. [PMID: 33901427 DOI: 10.1016/s1474-4422(21)00060-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/24/2021] [Accepted: 02/12/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Post-stroke cognitive impairment (PSCI) occurs in approximately half of people in the first year after stroke. Infarct location is a potential determinant of PSCI, but a comprehensive map of strategic infarct locations predictive of PSCI is unavailable. We aimed to identify infarct locations most strongly predictive of PSCI after acute ischaemic stroke and use this information to develop a prediction model. METHODS In this large-scale multicohort lesion-symptom mapping study, we pooled and harmonised individual patient data from 12 cohorts through the Meta-analyses on Strategic Lesion Locations for Vascular Cognitive Impairment using Lesion-Symptom Mapping (Meta VCI Map) consortium. The identified cohorts (as of Jan 1, 2019) comprised patients with acute symptomatic infarcts on CT or MRI (with available infarct segmentations) and a cognitive assessment up to 15 months after acute ischaemic stroke onset. PSCI was defined as performance lower than the fifth percentile of local normative data, on at least one cognitive domain on a multidomain neuropsychological assessment or on the Montreal Cognitive Assessment. Voxel-based lesion-symptom mapping (VLSM) was used to calculate voxel-wise odds ratios (ORs) for PSCI that were mapped onto a three-dimensional brain template to visualise PSCI risk per location. For the prediction model of PSCI risk, a location impact score on a 5-point scale was derived from the VLSM results on the basis of the mean voxel-wise coefficient (ln[OR]) within each patient's infarct. We did combined internal-external validation by leave-one-cohort-out cross-validation for all 12 cohorts using logistic regression. Predictive performance of a univariable model with only the location impact score was compared with a multivariable model with addition of other clinical PSCI predictors (age, sex, education, time interval between stroke onset and cognitive assessment, history of stroke, and total infarct volume). Testing of visual ratings was done by three clinicians, and accuracy, inter-rater reliability, and intra-rater reliability were assessed with Cohen's weighted kappa. FINDINGS In our sample of 2950 patients (mean age 66·8 years [SD 11·6]; 1157 [39·2%] women), 1286 (43·6%) had PSCI. We achieved high lesion coverage of the brain in our analyses (86·9%). Infarcts in the left frontotemporal lobes, left thalamus, and right parietal lobe were strongly associated with PSCI (after false discovery rate correction, q<0·01; voxel-wise ORs >20). On cross-validation, the location impact score showed good correspondence, based on visual assessment of goodness of fit, between predicted and observed risk of PSCI across cohorts after adjusting for cohort-specific PSCI occurrence. Cross-validations showed that the location impact score by itself had similar performance to the combined model with other PSCI predictors, while allowing for easy visual assessment. Therefore the univariable model with only the location impact score was selected as the final model. Correspondence between visual ratings and actual location impact score (Cohen's weighted kappa: range 0·88-0·92), inter-rater agreement (0·85-0·87), and intra-rater agreement (for a single rater, 0·95) were all high. INTERPRETATION To the best of our knowledge, this study provides the first comprehensive map of strategic infarct locations associated with risk of PSCI. A location impact score was derived from this map that robustly predicted PSCI across cohorts. Furthermore, we developed a quick and reliable visual rating scale that might in the future be applied by clinicians to identify individual patients at risk of PSCI. FUNDING The Netherlands Organisation for Health Research and Development.
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Affiliation(s)
- Nick A Weaver
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, UMC Utrecht, Utrecht, Netherlands
| | - Hugo P Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, Netherlands
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Mélanie Barbay
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences, Jules Verne Picardy University, Amiens, France
| | - Jonathan G Best
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK
| | - Régis Bordet
- Université Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Francesca M Chappell
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore
| | - Thibaut Dondaine
- Université Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | | | - Olivier Godefroy
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences, Jules Verne Picardy University, Amiens, France
| | - Bibek Gyanwali
- Department of Pharmacology, National University of Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore
| | - Olivia K L Hamilton
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, Netherlands
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, South Korea
| | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Paul L M de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Gregory Kuchcinski
- Université Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Bonnie Y K Lam
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, Seoul, South Korea
| | - Renaud Lopes
- Université Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Stephen D J Makin
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anne-Marie Mendyk
- Université Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Margaret Kam Ling Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | | | - Martine Roussel
- Department of Neurology, Amiens University Hospital, Laboratory of Functional Neurosciences, Jules Verne Picardy University, Amiens, France
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; BrainNow Research Institute, Shenzhen, China
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Maria Del C Valdés-Hernández
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | | | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Joanna M Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, South Korea
| | - Martine J E van Zandvoort
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, Netherlands
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen, China
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, University Medical Centre (UMC) Utrecht Brain Center, Utrecht, Netherlands.
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Bonkhoff AK, Lim JS, Bae HJ, Weaver NA, Kuijf HJ, Biesbroek JM, Rost NS, Bzdok D. Generative lesion pattern decomposition of cognitive impairment after stroke. Brain Commun 2021; 3:fcab110. [PMID: 34189457 PMCID: PMC8233115 DOI: 10.1093/braincomms/fcab110] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/21/2021] [Accepted: 05/20/2021] [Indexed: 01/28/2023] Open
Abstract
Cognitive impairment is a frequent and disabling sequela of stroke. There is however incomplete understanding of how lesion topographies in the left and right cerebral hemisphere brain interact to cause distinct cognitive deficits. We integrated machine learning and Bayesian hierarchical modelling to enable a hemisphere-aware analysis of 1080 acute ischaemic stroke patients with deep profiling ∼3 months after stroke. We show the relevance of the left hemisphere in the prediction of language and memory assessments and relevance of the right hemisphere in the prediction of visuospatial functioning. Global cognitive impairments were equally well predicted by lesion topographies from both sides. Damage to the hippocampal and occipital regions on the left was particularly informative about lost naming and memory functions, while damage to these regions on the right was linked to lost visuospatial functioning. Global cognitive impairment was predominantly linked to lesioned tissue in the supramarginal and angular gyrus, the post-central gyrus as well as the lateral occipital and opercular cortices of the left hemisphere. Hence, our analysis strategy uncovered that lesion patterns with unique hemispheric distributions are characteristic of how cognitive capacity is lost due to ischaemic brain tissue damage.
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Affiliation(s)
- Anna K Bonkhoff
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, MA, Boston, USA
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Natalia S Rost
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, MA, Boston, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, Canada.,Mila-Quebec Artificial Intelligence Institute, Montreal, Canada
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Sim JH, Jo JY, Kim H, Lim JS, Choi SS, Nam S, Ku S, Choi IC. Implementation of a comprehensive preoperative screening process for elective and emergency surgery during the peak of the COVID-19 outbreak. Br J Surg 2021; 108:e175-e176. [PMID: 33793748 PMCID: PMC7929334 DOI: 10.1093/bjs/znab030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/08/2020] [Accepted: 01/11/2021] [Indexed: 11/20/2022]
Affiliation(s)
- J H Sim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - J-Y Jo
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - J S Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S-S Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S Nam
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S Ku
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - I-C Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Best JG, Ambler G, Wilson D, Lee KJ, Lim JS, Shiozawa M, Koga M, Li L, Lovelock C, Chabriat H, Hennerici M, Wong YK, Mak HKF, Prats-Sanchez L, Martínez-Domeño A, Inamura S, Yoshifuji K, Arsava EM, Horstmann S, Purrucker J, Lam BYK, Wong A, Kim YD, Song TJ, Lemmens R, Eppinger S, Gattringer T, Uysal E, Tanriverdi Z, Bornstein NM, Ben Assayag E, Hallevi H, Molad J, Nishihara M, Tanaka J, Coutts SB, Polymeris A, Wagner B, Seiffge DJ, Lyrer P, Algra A, Kappelle LJ, Al-Shahi Salman R, Jäger HR, Lip GYH, Fischer U, El-Koussy M, Mas JL, Legrand L, Karayiannis C, Phan T, Gunkel S, Christ N, Abrigo J, Leung T, Chu W, Chappell F, Makin S, Hayden D, Williams DJ, Mess WH, Nederkoorn PJ, Barbato C, Browning S, Wiegertjes K, Tuladhar AM, Maaijwee N, Guevarra AC, Yatawara C, Mendyk AM, Delmaire C, Köhler S, van Oostenbrugge R, Zhou Y, Xu C, Hilal S, Gyanwali B, Chen C, Lou M, Staals J, Bordet R, Kandiah N, de Leeuw FE, Simister R, Hendrikse J, Kelly PJ, Wardlaw J, Soo Y, Fluri F, Srikanth V, Calvet D, Jung S, Kwa VIH, Engelter ST, Peters N, Smith EE, Hara H, Yakushiji Y, Orken DN, Fazekas F, Thijs V, Heo JH, Mok V, Veltkamp R, Ay H, Imaizumi T, Gomez-Anson B, Lau KK, Jouvent E, Rothwell PM, Toyoda K, Bae HJ, Marti-Fabregas J, Werring DJ. Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies. Lancet Neurol 2021; 20:294-303. [PMID: 33743239 DOI: 10.1016/s1474-4422(21)00024-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/16/2020] [Accepted: 01/08/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Balancing the risks of recurrent ischaemic stroke and intracranial haemorrhage is important for patients treated with antithrombotic therapy after ischaemic stroke or transient ischaemic attack. However, existing predictive models offer insufficient performance, particularly for assessing the risk of intracranial haemorrhage. We aimed to develop new risk scores incorporating clinical variables and cerebral microbleeds, an MRI biomarker of intracranial haemorrhage and ischaemic stroke risk. METHODS We did a pooled analysis of individual-patient data from the Microbleeds International Collaborative Network (MICON), which includes 38 hospital-based prospective cohort studies from 18 countries. All studies recruited participants with previous ischaemic stroke or transient ischaemic attack, acquired baseline MRI allowing quantification of cerebral microbleeds, and followed-up participants for ischaemic stroke and intracranial haemorrhage. Participants not taking antithrombotic drugs were excluded. We developed Cox regression models to predict the 5-year risks of intracranial haemorrhage and ischaemic stroke, selecting candidate predictors on biological relevance and simplifying models using backward elimination. We derived integer risk scores for clinical use. We assessed model performance in internal validation, adjusted for optimism using bootstrapping. The study is registered on PROSPERO, CRD42016036602. FINDINGS The included studies recruited participants between Aug 28, 2001, and Feb 4, 2018. 15 766 participants had follow-up for intracranial haemorrhage, and 15 784 for ischaemic stroke. Over a median follow-up of 2 years, 184 intracranial haemorrhages and 1048 ischaemic strokes were reported. The risk models we developed included cerebral microbleed burden and simple clinical variables. Optimism-adjusted c indices were 0·73 (95% CI 0·69-0·77) with a calibration slope of 0·94 (0·81-1·06) for the intracranial haemorrhage model and 0·63 (0·62-0·65) with a calibration slope of 0·97 (0·87-1·07) for the ischaemic stroke model. There was good agreement between predicted and observed risk for both models. INTERPRETATION The MICON risk scores, incorporating clinical variables and cerebral microbleeds, offer predictive value for the long-term risks of intracranial haemorrhage and ischaemic stroke in patients prescribed antithrombotic therapy for secondary stroke prevention; external validation is warranted. FUNDING British Heart Foundation and Stroke Association.
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Affiliation(s)
- Jonathan G Best
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, Gower Street, London, UK
| | - Duncan Wilson
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Masayuki Shiozawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Linxin Li
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Caroline Lovelock
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Hugues Chabriat
- Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, Department of Neurology, Paris, France; Federation Hospitalo-Universitaire NeuroVasc, Université de Paris, Paris, France; INSERM U1141, Paris, France
| | - Michael Hennerici
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Yuen Kwun Wong
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Henry Ka Fung Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Luis Prats-Sanchez
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Alejandro Martínez-Domeño
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Shigeru Inamura
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Kazuhisa Yoshifuji
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Ethem Murat Arsava
- A A Martinos Center for Biomedial Imaging, Department of Neurology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Solveig Horstmann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Purrucker
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Bonnie Yin Ka Lam
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Adrian Wong
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Robin Lemmens
- Experimental Neurology, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium; Vlaams Instituut voor Biotechnologie, Center for Brain & Disease Research; Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Ender Uysal
- Department of Radiology, Saglık Bilimleri University, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Zeynep Tanriverdi
- Department of Neurology, İzmir Katip Çelebi University Atatürk Education and Research Hospital, İzmir Turkey
| | - Natan M Bornstein
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Einor Ben Assayag
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Hen Hallevi
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jeremy Molad
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Masashi Nishihara
- Department of Radiology, Saga University Faculty of Medicine, Saga, Japan
| | - Jun Tanaka
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Shelagh B Coutts
- Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Alexandros Polymeris
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland
| | - Benjamin Wagner
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland
| | - David J Seiffge
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK; Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland; Department of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland
| | - Philippe Lyrer
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland
| | - Ale Algra
- Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands; Department of Neurology and Neurosurgery, Utrecht University, Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, Utrecht University, Utrecht, The Netherlands
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, UK
| | - Hans R Jäger
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK; Liverpool Heart & Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Urs Fischer
- Department of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland
| | - Marwan El-Koussy
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland
| | - Jean-Louis Mas
- Department of Neurology, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris, INSERM, Université de Paris, Paris, France
| | - Laurence Legrand
- Department of Neuroradiology, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris, INSERM, Université de Paris, Paris, France
| | | | - Thanh Phan
- Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Sarah Gunkel
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Nicolas Christ
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Special Administrative Region, China
| | - Thomas Leung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Special Administrative Region, China
| | - Winnie Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Special Administrative Region, China
| | - Francesca Chappell
- Centre for Clinical Brain Sciences, Edinburgh Imaging, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Stephen Makin
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Derek Hayden
- The Neurovascular Research Unit and Health Research Board, Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland; Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - David J Williams
- Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences Dublin, Ireland; Department of Geriatric and Stroke Medicine, Beaumont Hospital Dublin, Ireland
| | - Werner H Mess
- Department of Clinical Neurophysiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Paul J Nederkoorn
- Department of Neurology, Amsterdam University Medical Centres, Netherlands
| | - Carmen Barbato
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK; Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Simone Browning
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK; Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Noortje Maaijwee
- Department for Neurology and Neurorehabilitation, Neurocenter, Lucerne State Hospital, Lucerne, Switzerland
| | | | | | - Anne-Marie Mendyk
- Degenerative and vascular cognitive disorders, University of Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Christine Delmaire
- Degenerative and vascular cognitive disorders, University of Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France; Department of Radiology, Fondation A de Rothschild, Paris, France
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands
| | - Robert van Oostenbrugge
- Department of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, The Netherlands
| | - Ying Zhou
- Department of Neurology, The 2nd affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Chao Xu
- Department of Neurology, The 2nd affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Saima Hilal
- Memory Aging & Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bibek Gyanwali
- Memory Aging & Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christopher Chen
- Memory Aging & Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Min Lou
- Department of Neurology, The 2nd affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Julie Staals
- Department of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, The Netherlands
| | - Régis Bordet
- Degenerative and vascular cognitive disorders, University of Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert Simister
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK; Comprehensive Stroke Service, University College London Hospitals NHS Trust, London, UK
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Peter J Kelly
- The Neurovascular Research Unit and Health Research Board, Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland
| | - Joanna Wardlaw
- Centre for Clinical Brain Sciences, Edinburgh Imaging, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Yannie Soo
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Special Administrative Region, China
| | - Felix Fluri
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Velandai Srikanth
- Peninsula Clinical School, Peninsula Health, Monash University, Melbourne, Australia
| | - David Calvet
- Department of Neurology, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris, INSERM, Université de Paris, Paris, France
| | - Simon Jung
- Department of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland
| | - Vincent I H Kwa
- Department of Neurology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Stefan T Engelter
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland; Neurology and Neurorehabilitation, Department of Geriatric Medicine FELIX PLATTER, University of Basel, Switzerland
| | - Nils Peters
- Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Switzerland; Neurology and Neurorehabilitation, Department of Geriatric Medicine FELIX PLATTER, University of Basel, Switzerland
| | - Eric E Smith
- Calgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Hideo Hara
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Yusuke Yakushiji
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan; Department of Neurology, Kansai Medical University, Osaka, Japan
| | | | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia; Department of Neurology, Austin Health, Heidelberg, VIC, Australia
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Vincent Mok
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Roland Veltkamp
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany; Department of Brain Sciences, Imperial College London, London, UK
| | - Hakan Ay
- A A Martinos Center for Biomedial Imaging, Department of Neurology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA; Takeda, Cambridge, MA, USA
| | - Toshio Imaizumi
- Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Beatriz Gomez-Anson
- Unit of Neuroradiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric Jouvent
- Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, Department of Neurology, Paris, France; Federation Hospitalo-Universitaire NeuroVasc, Université de Paris, Paris, France; INSERM U1141, Paris, France
| | - Peter M Rothwell
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Joan Marti-Fabregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain
| | - David J Werring
- UCL Stroke Research Centre, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK.
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Lim JS, Au Yong TPT, Boon CS, Boon IS. COVID-19 Vaccine Prioritisation for Medical Students: The Forgotten Cohort? Clin Oncol (R Coll Radiol) 2021; 33:e359. [PMID: 33752932 PMCID: PMC7923859 DOI: 10.1016/j.clon.2021.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 10/26/2022]
Affiliation(s)
- J S Lim
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - T P T Au Yong
- Department of Radiology, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - C S Boon
- Department of Clinical Oncology, The Clatterbridge Cancer Centre, Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - I S Boon
- Department of Clinical Oncology, Leeds Cancer Centre, St James's Institute of Oncology, Leeds, UK
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Kim Y, Lim JS, Oh MS, Yu KH, Lee JS, Park JH, Kim YJ, Rha JH, Hwang YH, Heo SH, Ahn SH, Lee JH, Kwon SU. Blood pressure variability is related to faster cognitive decline in ischemic stroke patients: PICASSO subanalysis. Sci Rep 2021; 11:5049. [PMID: 33658545 PMCID: PMC7930263 DOI: 10.1038/s41598-021-83945-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/18/2021] [Indexed: 12/27/2022] Open
Abstract
Blood pressure variability (BPV) is associated with higher cardiovascular morbidity risks; however, its association with cognitive decline remains unclear. We investigated whether higher BPV is associated with faster declines in cognitive function in ischemic stroke (IS) patients. Cognitive function was evaluated between April 2010 and August 2015 using the Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment in 1,240 Korean PICASSO participants. Patients for whom baseline and follow-up cognitive test results and at least five valid BP readings were available were included. A restricted maximum likelihood–based Mixed Model for Repeated Measures was used to compare changes in cognitive function over time. Among a total of 746 participants (64.6 ± 10.8 years; 35.9% female). Baseline mean-MMSE score was 24.9 ± 4.7. The median number of BP readings was 11. During a mean follow-up of 2.6 years, mean baseline and last follow-up MMSE scores were 25.4 ± 4.8 vs. 27.8 ± 4.4 (the lowest BPV group) and 23.9 ± 5.2 vs. 23.2 ± 5.9 (the highest BPV group). After adjusting for multiple variables, higher BPV was independently associated with faster cognitive decline over time. However, no significant intergroup difference in cognitive changes associated with mean systolic BP was observed. Further research is needed to elucidate how BPV might affect cognitive function.
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Affiliation(s)
- Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jae-Sung Lim
- Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Ho Park
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Yong-Jae Kim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joung-Ho Rha
- Department of Neurology, Inha University Hospital, Incheon, Republic of Korea
| | - Yang-Ha Hwang
- Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sung Hyuk Heo
- Department of Neurology, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seong Hwan Ahn
- Department of Neurology, Chosun University Hospital, Gwangju, Republic of Korea
| | - Ju-Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
| | - Sun U Kwon
- Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
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Lim JS, Kwon SU, Yu KH, Yu S, Park JH, Lee BC, Oh MS, Kim YJ, Rha JH, Hwang YH, Lee JS, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Kim HY, Kim EG, Cha JK, Park MS, Nam HS, Bae HJ, Kim DE, Park J, Kang Y, Choi J, Lee J. Cilostazol and Probucol for Cognitive Decline after Stroke: A Cognitive Outcome Substudy of the PICASSO Trial. J Stroke 2021; 23:128-131. [PMID: 33600710 PMCID: PMC7900397 DOI: 10.5853/jos.2020.03650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Korea
| | - Sungwook Yu
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong-Ho Park
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Korea
| | - Yong-Jae Kim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joung-Ho Rha
- Department of Neurology, Inha University Hospital, Incheon, Korea
| | - Yang-Ha Hwang
- Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Sung Hyuk Heo
- Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea
| | - Seong Hwan Ahn
- Department of Neurology, Chosun University Hospital, Gwangju, Korea
| | - Woo-Keun Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Moo Park
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Ju-Hun Lee
- Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sung-Il Sohn
- Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Jin-Man Jung
- Department of Neurology, Korea University Ansan Hospital, Ansan, Korea
| | - Hahn Young Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
| | - Eung-Gyu Kim
- Department of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, Korea
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hyo Suk Nam
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jaeseol Park
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, Korea
| | - Jimi Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.,BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
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Weaver NA, Kancheva AK, Lim JS, Biesbroek JM, Wajer IMCH, Kang Y, Kim BJ, Kuijf HJ, Lee BC, Lee KJ, Yu KH, Biessels GJ, Bae HJ. Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts. Int J Stroke 2021; 16:981-989. [PMID: 33472574 PMCID: PMC8554493 DOI: 10.1177/1747493020984552] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.
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Affiliation(s)
- Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Angelina K Kancheva
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Irene MC Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Yeonwook Kang
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
- Department of Psychology, Hallym University, Chuncheon, Republic of Korea
| | - Beom J Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Keon-Joo Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
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Kim Y, Lee JH, Lee SH, Kim YJ, Kim C, Jang MU, Jung S, Lim JS, Oh MS, Yu KH, Lee BC. Serum Homocysteine Is Associated With HDL Only in Stroke Patients With Small Vessel Occlusion. Front Neurol 2020; 11:565506. [PMID: 33343484 PMCID: PMC7738472 DOI: 10.3389/fneur.2020.565506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Although controversial, homocysteine (Hcy) and lipid parameters have been associated with particular stroke subtypes. However, there are limited studies concerning the relationship between Hcy and lipid levels in acute ischemic stroke (AIS). We evaluated the impact of Hcy levels on lipid profiles in terms of specific stroke subtypes. Methods: A total of 2,324 patients with first-ever AIS were recruited from two hospitals in South Korea. The exclusion criteria were as follows: (a) pre-stroke modified Rankin scale (mRS) ≥ 1, (b) undetermined or other stroke etiology, and (c) absence of Hcy data. Among the 1,580 eligible patients, the Hcy level was divided into tertile groups. Logistic regression was used to assess association of Hcy levels with lipid levels by stroke subtypes. Results: Significant downward trends in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were only observed in patients with small vessel occlusion (SVO) as Hcy increased. In logistic regression analysis, while in patients with SVO subtype, the highest level of Hcy tertiles (OR = 1.648, 95% CI = 1.047-2.594) was associated with the lower HDL level (≤40 mg/dL), the significance disappeared in patients with LAA and CE subtypes. Conclusion: Although our study does not demonstrate causal relationship, we suggest that Hcy might play a mediating role between HDL and SVO stroke development. To clarify the role of Hcy on AIS, this study will provide academic support for designing future research.
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Affiliation(s)
- Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Ju-Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - San Jung
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jae-Sung Lim
- Hallym Neurological Institute, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, South Korea
| | - Mi Sun Oh
- Hallym Neurological Institute, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, South Korea
| | - Kyung-Ho Yu
- Hallym Neurological Institute, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, South Korea
| | - Byung-Chul Lee
- Hallym Neurological Institute, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, South Korea
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Lee J, Lim JS, Chu Y, Lee CH, Ryu OH, Choi HH, Park YS, Kim C. Prediction of Coronary Artery Calcium Score Using Machine Learning in a Healthy Population. J Pers Med 2020; 10:jpm10030096. [PMID: 32825442 PMCID: PMC7565334 DOI: 10.3390/jpm10030096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 01/05/2023] Open
Abstract
Background: Coronary artery calcium score (CACS) is a reliable predictor for future cardiovascular disease risk. Although deep learning studies using computed tomography (CT) images to predict CACS have been reported, no study has assessed the feasibility of machine learning (ML) algorithms to predict the CACS using clinical variables in a healthy general population. Therefore, we aimed to assess whether ML algorithms other than binary logistic regression (BLR) could predict high CACS in a healthy population with general health examination data. Methods: This retrospective observational study included participants who had regular health screening including coronary CT angiography. High CACS was defined by the Agatston score ≥ 100. Univariable and multivariable BLR was performed to assess predictors for high CACS in the entire dataset. When performing ML prediction for high CACS, the dataset was randomly divided into a training and test dataset with a 7:3 ratio. BLR, catboost, and xgboost algorithms with 5-fold cross-validation and grid search technique were used to find the best performing classifier. Performance comparison of each ML algorithm was evaluated with the area under the receiver operating characteristic (AUROC) curve. Results: A total of 2133 participants were included in the final analysis. Mean age and proportion of male sex were 55.4 ± 11.3 years and 1483 (69.5%), respectively. In multivariable BLR analysis, age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.10–1.15, p < 0.001), male sex (OR, 2.91; 95% CI, 1.57–5.38, p < 0.001), systolic blood pressure (OR, 1.02; 95% CI, 1.00–1.03, p = 0.019), and low-density lipoprotein cholesterol (OR, 1.00; 95% CI, 0.99–1.00, p = 0.047) were significant predictors for high CACS. Performance in predicting high CACS of xgboost was AUROC of 0.823, followed by catboost (0.750) and BLR (0.585). The comparison of AUROC between xgboost and BLR was significant (p for AUROC comparison < 0.001). Conclusions: Xgboost ML algorithm was found to be a more reliable predictor of CACS in healthy participants compared to the BLR algorithm. ML algorithms may be useful for predicting CACS with only laboratory data in healthy participants.
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Affiliation(s)
- Jongseok Lee
- School of Business Administration, Hallym University, Chuncheon 24252, Korea; (J.L.); (C.H.L.)
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Younggi Chu
- Industry-University Cooperation Group, Hallym University, Chuncheon 24252, Korea;
| | - Chang Hee Lee
- School of Business Administration, Hallym University, Chuncheon 24252, Korea; (J.L.); (C.H.L.)
| | - Ohk-Hyun Ryu
- Department of Endocrinology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea;
| | - Hyun Hee Choi
- Department of Cardiology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea;
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea;
| | - Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
- Correspondence: ; Tel.: +82-33-240-5255; Fax: +82-33-255-6244
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