Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396) *Drs Rolfs, Fazekas and Grittner contributed equally to this work. Authors contributions: Dr Rolfs has conceptualized, initiated, and designed and organized the study, has been involved in the recruitment of the patients, and wrote significant parts of the manuscript. Dr Fazekas was involved in the study planning and has done together with Drs Enzinger and Schmidt the analysis of all MRI scans; this group was mainly involved in the statistical analysis of the MRI data. Drs Martus, Grittner, Holzhausen have taken responsibility for all statistical analysis and for the data structure of the total data bank. Drs Dichgans, Böttcher, Tatlisumak, Tanislav, Jungehulsing, Putaala, Huber, Bodechtel, Lichy, Hennerici, Kaps, Meyer, Kessler have been most active in the recruitment of the patients, drafting the manuscript and significantly influencing the scientific discussion. Dr Heuschmann was involved in drafting the manuscript and influencing the scientific discussion. Dr Norrving chaired the steering and publication committees of sifap, has written parts of the manuscript, and has significantly influenced the scientific discussions. Drs Lackner and Paschke, H. Mascher, Dr Riess have been involved in the laboratory analyses. Dr Kolodny has mostly contributed to the discussion of the Fabry cases. Dr Giese assisted in writing and editing the manuscript. All authors have reviewed, critically revised and approved the final version of the manuscript.The sponsors of the study had no role in the study design, data collection, data analysis, interpretation, writing of the manuscript, or the decision to submit the manuscript for publication. The academic authors had unrestricted access to the derived dataset, and assume full responsibility for the completeness, integrity, and interpretation of the data, as well as writing the study report and the decision to submit for publication.†Listed in Appendix I in the online-only Data Supplement. Jeffrey L. Saver, MD, was guest editor for this article.

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Sensory events cause changes in brain activity, which underlie the perception of and behavioural responses to sensory stimuli. Evoked cortical responses are an important measure of these stimulus-evoked changes in brain activity. However, evidence on the relationship between behavioural responses and evoked responses is inconsistent. Therefore, we used magnetoencephalography to reinvestigate the relationship between evoked responses from somatosensory cortices and behavioural responses to somatosensory stimuli. We characterized modulations of somatosensory-evoked responses exerted by preceding painful and tactile conditioning stimuli (CS), and related these modulations of evoked responses to modulations of reaction times. Our results show that painful CS yield a long-lasting (> 4 s) facilitation of evoked responses, whereas tactile CS result in a shorter lasting (1-2 s) suppression of evoked responses to tactile stimuli. These contrary physiological effects were both associated with a significant shortening of reaction times. These findings indicate that the conditioning effects of painful and tactile stimuli represent essentially different modulatory mechanisms. Moreover, our results show that amplitudes of evoked responses from somatosensory cortices do not determine reaction times to tactile stimuli.

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