We also failed to identify a common direction of association between VSA and Moyamoya disease in the 10 susceptibility variants (excluding the variants at the RNF213 locus) and Moyamoya disease (5 of 10 variants showing the same risk allele) (eTable 7 and eAppendix in Supplement 1).31 Therefore, it is unlikely that Moyamoya disease confounded the findings. Here, RNF213 is linked to Moyamoya disease.