Editorial Advisory Board Members Research Articles

Feasibility of Measuring Functional Performance of FSHD Patients Using Wearable Sensors to Quantify Physical Activity (S7.006)

<h3>Objective:</h3> Evaluate feasibility to monitor daily activity and assess functional outcomes using wearable sensor devices in an open label study (OLS) of losmapimod in facioscapulohumeral muscular dystrophy (FSHD). <h3>Background:</h3> Evaluation of clinical outcome assessments in FSHD is challenging due to the variable onset, severity, and progression. Fulcrum is evaluating the safety and efficacy of losmapimod for the treatment of FSHD with selected clinical outcome assessments in the ongoing OLS. Assessment with wearables may be a sensitive measure of upper extremity function, activities of daily living, and mobility in FSHD. <h3>Design/Methods:</h3> ActiMyo wearable activity monitoring devices were provided to participants in the OLS to be placed on 1 wrist and on 1 ankle. Activity was monitored during the day in the outpatient setting intermittently; alternating two weeks on and two weeks off until the end of the study. An 8-week baselining period was collected, with similar wear frequency, prior to initiating treatment. Participants performed prescribed movements of upper and lower extremities twice daily. <h3>Results:</h3> Fourteen subjects, ages 18 to 65 years with genetically confirmed FSHD1 and clinical severity score of 2 to 4 (range 0–5), received 15 mg losmapimod twice daily and completed the study over 60 weeks. Compliance for wearing the devices was 99%. All 14 participants were monitored for a total of 2941 days or 36758 hours, for an average of 2626 hours per participant. Multiple parameters calculated from the upper and lower extremities were found to be reliable (ICC &gt; 0.90). Analysis of correlations with clinical outcome assessments will be reported. <h3>Conclusions:</h3> Measurement of functional performance in FSHD patients using wearable sensors is feasible, reliable, and correlates with multiple clinical outcome assessments, activities of daily living, and mobility. This assessment could provide critical data about disease progression and treatment efficacy in future clinical trials. <b>Disclosure:</b> The institution of Mr. Kools has received research support from Fulcrum Therapeutics. The institution of Mrs. Voermans has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynacure. The institution of Mrs. Voermans has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Mrs. Voermans has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neuromuscular disorder. The institution of Karlien Mul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avidity Biosciences. Dr. Jiang has received personal compensation for serving as an employee of Fulcrum Therapeutics. Dr. Shoskes has received personal compensation for serving as an employee of Fulcrum Therapeutics. An immediate family member of Dr. Shoskes has received personal compensation for serving as an employee of Exact Science. Ms. Marshall has nothing to disclose. Dr. Tarachandani has received personal compensation for serving as an employee of UsinLife LLC. Dr. Figueredo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UsinLife LLC. Mr. Eggenspieler has received personal compensation in the range of $50,000-$99,999 for serving as a Healthcare director with Sysnav.

A Case of Monkeypox-associated Encephalomyelitis—Colorado, July–August, 2022 (P11-10.002)

<h3>Objective:</h3> Monkeypox virus (MPXV) disease was declared a public health emergency by the World Health Organization on July 23, 2022, making it imperative for neurologists to be aware of the potential neurologic implications of this outbreak. To aid in educating neurologists, we present a case of encephalomyelitis in the setting of confirmed MPXV infection. <h3>Background:</h3> MPXV is an orthopox virus in the Poxviridae family, which also includes variola virus (smallpox) and vaccina virus. Prior to May 2022, MPXV was largely confined to Central and Western Africa apart from occasional travel-related cases. However, rapid spread within primarily LGBTQ social networks has created an unexpected pandemic. Occasional reports of encephalitis have been reported in endemic regions with little detail. However, there have been a few reports worldwide of fatal encephalitis in presumed immunocompetent adults in the current pandemic as well as suspected secondary autoimmune encephalomyelitis as reported here. <h3>Design/Methods:</h3> N/A <h3>Results:</h3> A presumed immunocompetent, healthy, gay man in his 30s developed a febrile illness with a diffuse, itchy, vesiculopapular rash followed by progressive left upper and lower extremity weakness/numbness, urinary retention, headache, and intermittent priapism. CSF demonstrated a lymphocytic pleocytosis with elevated protein. Serum HIV antibody and nucleic acid tests were negative. Serum anti-MOG and AQP-4 antibody tests were negative. MRI brain showed multifocal T2/FLAIR subcortical, caudate, thalamic, splenium, and pontine lesions (some of which were partially enhancing). MRI spine showed a longitudinally-extensive, partially enhancing central cord T2 lesion from the cervical cord to conus. MPXV nucleic acid was confirmed from skin lesions but was not present in CSF. His symptoms gradually improved with oral tecovirimat and immunotherapy for suspected para-infectious autoimmune encephalomyelitis. <h3>Conclusions:</h3> MPXV can cause central nervous system disease, whether by direct viral invasion or a para-infectious autoimmune process. With prompt recognition and appropriate treatment, recovery can be achieved. <b>Disclosure:</b> Dr. Money has nothing to disclose. Dr. Hannan has nothing to disclose. Dr. Kleiner has nothing to disclose. Dr. Yuen has nothing to disclose. Mrs. Ferriman has nothing to disclose. Dr. Matthews has nothing to disclose. The institution of Dr. Beckham has received research support from Roche Diagnostics. The institution of Dr. Chauhan has received research support from NIH. The institution of an immediate family member of Dr. Chauhan has received research support from University of Colorado. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. The institution of Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Sands Anderson PC. The institution of Dr. Piquet has received research support from Rocky Mountain MS Center. The institution of Dr. Piquet has received research support from Novartis. The institution of Dr. Piquet has received research support from Abbvie. The institution of Dr. Piquet has received research support from Roche/Genentech. The institution of Dr. Piquet has received research support from NYU. Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as a Litigative Consultant with US-Dept HHS/DICP. Dr. Tyler has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Protagonist Therapeutics, Newark CA. Dr. Tyler has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Neurological Association/Wiley. Dr. Tyler has received intellectual property interests from a discovery or technology relating to health care. Dr. Tyler has received publishing royalties from a publication relating to health care. Dr. Tyler has a non-compensated relationship as a Director (ex officio) with American Neurological association that is relevant to AAN interests or activities. Dr. Tyler has a non-compensated relationship as a Director with International Society for Neurovirology that is relevant to AAN interests or activities. Dr. Pastula has nothing to disclose.

Treatments and Outcomes for Patients with Spinal Muscular Atrophy Type 2: Findings from RESTORE Registry (P7-9.010)

Treatments and Outcomes for Patients with Spinal Muscular Atrophy Type 2: Findings from RESTORE Registry (P7-9.010)

Characterization of Childhood Neurodegeneration and Associated Ataxia in UBTF-Related Disorder (P12-9.011)

<h3>Objective:</h3> To clarify the natural history of neurodegeneration related to a heterozygous missense de novo mutation in the upstream binding transcription factor (<i>UBTF</i>) gene and to understand the movement patterns extracted from continuous wrist and ankle accelerometer data. <h3>Background:</h3> <i>UBTF</i>-related childhood-onset neurodegeneration is characterized by a period of typical or mildly delayed development followed by regression. Affected individuals frequently experience movement disorders, including ataxia. <h3>Design/Methods:</h3> An online REDCap survey of families of patients with a pathogenic variant in <i>UBTF</i> was conducted. Between March 2021 and February 2022, 52 surveys were started. Duplicate and incomplete responses were excluded. Ten unique responses were fully submitted, and these were included for analysis. Patients with <i>UBTF</i>-related disorder evaluated in a neurogenetics clinic were enrolled for data collection using wearable wrist and ankle accelerometers. Longitudinal data during typical daily activities was collected remotely for continuous one-week periods. These findings were compared to similar data collected from patients with Ataxia-Telangiectasia (A-T) and control subjects. Motor activity was compared with clinical severity using the Brief Ataxia Rating Scale (BARS). <h3>Results:</h3> Median age of the survey subjects was 12.5 years (range 5–20 years), with symptom onset at a median of 2.5 years. All participants reported motor regression (median 3.75 years at onset), with 90% reporting ataxia. Motor activity data was collected from 5 participants (median age 12 years, range 8–12 years), with 3 time points included for one participant (2 with wrist data only) and 1 time point for the other 4 participants. Data from both sensors had high test-retest reliability. Motor activity showed similarities to A-T over controls across multiple measures and correlated with BARS scores. <h3>Conclusions:</h3> Ataxia is frequent in <i>UBTF-</i>related disorder. Motor activity data collected via wrist and ankle accelerometers is a highly reliable measure correlated to disease severity with results resembling other hereditary ataxias, indicating potential use as a motor biomarker. <b>Disclosure:</b> Dr. Nagy has nothing to disclose. Ms. Gupta has nothing to disclose. Ms. Molay has nothing to disclose. Miss De la Rosa Abreu has nothing to disclose. Catherine Becker has nothing to disclose. Dr. Gupta has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Biogen. The institution of Dr. Gupta has received research support from Biogen. An immediate family member of Dr. Eichler has received personal compensation for serving as an employee of UpToDate. Dr. Eichler has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for SwanBio Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alnylam. Dr. Eichler has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Origin Biosciences. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orchard Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Autobahn Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bluebird Bio. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for UpToDate. Dr. Eichler has received stock or an ownership interest from SwanBio Therapeutics. The institution of Dr. Eichler has received research support from Bluebird Bio. The institution of Dr. Eichler has received research support from Minoryx Therpeutics. The institution of Dr. Eichler has received research support from Sio Therapeutics. Dr. Eichler has received intellectual property interests from a discovery or technology relating to health care.

Analysis of Amyotrophic Lateral Sclerosis (ALS) Clinical Trials Posted on www.clinicaltrials.gov from 1999–2022. (P10-8.011)

<h3>Objective:</h3> To create a database of Amyotrophic Lateral Sclerosis (ALS) clinical trials on www.clinicaltrials.gov and analyze trends over the past three decades. <h3>Background:</h3> ALS is a progressive neurodegenerative disease of the brain and spinal cord neurons with a typical lifespan of 3–5 years from symptom onset. Clinical trials have evolved over the past three decades as more awareness and research funding have been dedicated to understanding and treating ALS, partially due to the ALS Ice Bucket Challenge in 2014. A review of the evolution of study design and parameters over time provides insights into the future of clinical trials and is reflective of improvements in the science. <h3>Design/Methods:</h3> “ALS” and “Amyotrophic Lateral Sclerosis” were searched on www.clinicaltrial.gov in August 2022. A database was created to capture information on trials: year posted, study type, primary endpoints, and inclusion criteria. <h3>Results:</h3> The term ALS had 777 results and Amyotrophic Lateral Sclerosis had 891 results, for a total of 954 unique clinical trials from 1999 to 2022. Two hundred and seventy-three trials were removed due to non-ALS trials (other neurological disorders, drug name with ALS, or advanced life support) and 681 were analyzed. Thirty-four countries were represented with the United States (n=288, 43%), France (n=71, 11%), and Italy (n=28, 4.1%) having the highest number. The largest number of new trials posted in one year was in 2021 with 81. Forty-eight percent of studies are completed, and 146 (21%) are actively recruiting. Length of time to primary endpoint ranged between one day to ten years. 40% of studies did not specify ALS diagnostic criteria for eligibility and 4% required genetic testing. <h3>Conclusions:</h3> Analyzing current and past trends of ALS clinical trials will help guide future trial designs in the hopes to optimize ALS outcomes and trials. <b>Disclosure:</b> Dr. Zelikovich has nothing to disclose. Eric Anderson has nothing to disclose. Dr. Rubin has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NeuroAlert. Dr. Rubin has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Merck Manual. Dr. Andrews has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Andrews has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Wave Life Sciences. Dr. Andrews has received personal compensation in the range of $0-$499 for serving as a Consultant for Cytokinetics. Dr. Andrews has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AL-S Pharma.

Burden of Migraine and Migraine-Associated Symptoms in People with Differing Ethnic and Racial Backgrounds: Results of the OVERCOME (US) Study (S41.003)

Burden of Migraine and Migraine-Associated Symptoms in People with Differing Ethnic and Racial Backgrounds: Results of the OVERCOME (US) Study (S41.003)

Continued Validation of the RBD Symptom Severity Scale (RBDSSS) in Participants of the North American Prodromal Synucleinopathy (NAPS) Consortium (P6-13.004)

Continued Validation of the RBD Symptom Severity Scale (RBDSSS) in Participants of the North American Prodromal Synucleinopathy (NAPS) Consortium (P6-13.004)

12-Month Effectiveness and Tolerability of Brivaracetam in the Real-World: The International EXPERIENCE Pooled Analysis (P11-1.003)

12-Month Effectiveness and Tolerability of Brivaracetam in the Real-World: The International EXPERIENCE Pooled Analysis (P11-1.003)

Improving Early Recognition of Potentially Treatable Causes of Rapidly Progressive Dementia (P5-12.001)

Improving Early Recognition of Potentially Treatable Causes of Rapidly Progressive Dementia (P5-12.001)

Characterizing Prodrome (Premonitory Phase) in Migraine: Results From the PRODROME Trial Screening Period (S41.009)

Characterizing Prodrome (Premonitory Phase) in Migraine: Results From the PRODROME Trial Screening Period (S41.009)

In Vivo And Ex Vivo Characterization Of Meningeal Translocator Protein Expression In Multiple Sclerosis (S9.010)

In Vivo And Ex Vivo Characterization Of Meningeal Translocator Protein Expression In Multiple Sclerosis (S9.010)

Stroke and Transient Ischemic Attack Care Transitions Clinic: Providing Timely, Evidence-Based Care (P11-5.019)

Stroke and Transient Ischemic Attack Care Transitions Clinic: Providing Timely, Evidence-Based Care (P11-5.019)

Five-Year Safety of Ofatumumab in People Living With Relapsing Multiple Sclerosis (P8-3.004)

Five-Year Safety of Ofatumumab in People Living With Relapsing Multiple Sclerosis (P8-3.004)

Eye Movement and Coma Recovery after Cardiac Arrest (P1-7.006)

<h3>Objective:</h3> To characterize eye movements in comatose patients after cardiac arrest (CA). <h3>Background:</h3> Most patients resuscitated from CA present with altered levels of consciousness due to brain injury. One potential marker of arousal recovery is evidence of eye movements. Brainstem pathways and thalamocortical projections responsible for eye movements share similar anatomic structures responsible for arousal. Our aim is to quantify eye movements using electro-oculography (EOG) data from patients presenting with CA. <h3>Design/Methods:</h3> We are conducting a retrospective study of patients presenting within 24 hours of CA. We identify eye movements on EOG over a period of up to 72 hours, excluding periods of clinical care, sedation, and epileptiform activity. We will study the association of eye movement frequency and the following outcomes by two weeks: 1. Present corneal or pupillary reflex; 2. Eye opening (to stimuli or spontaneously); 3. Command following. Patients are excluded if they have ophthalmoplegia, dementia, or traumatic brain injury. We will compare eye movement frequency in our comatose cohort to a separate cohort of non-comatose patients who underwent sleep studies. <h3>Results:</h3> Our preliminary data consists of 100 patients, mean (± SD) age of 60.2 (± 15.3) years and 38% were female. By 2 weeks, 85% had a pupillary reflex, 75% had a corneal reflex, 43% opened eyes to stimuli, and 21% followed commands. Of 151.5 hours of EOG time across four patients, we preliminarily found eye movements present in 0.56% of total time, with a median of 0.73% and range of 0% to 2.29%. This is comparable to our cohort of 47 patients who underwent sleep studies, with eye movements present in 3.2% of N2, 2.9% of N3, and 19.8% of REM. <h3>Conclusions:</h3> Eye movements in comatose patients may be indicative of recovery potential. Understanding these differences could have prognostic significance and help in triaging care and family discussions. <b>Disclosure:</b> The institution of Mr. Cronin has received research support from American Heart Association. Miss Hwang has nothing to disclose. The institution of an immediate family member of Miss Wack has received research support from Canon Medical Systems USA, Inc. Brian Pugsley has nothing to disclose. Mary Russo has nothing to disclose. Dr. Greer has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme, Inc. Dr. Greer has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for multiple. The institution of Dr. Greer has received research support from Becton Dickenson, Inc. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Ong has nothing to disclose.

Clinical characterisation of patients in the post-acute stage of anti-NMDA receptor encephalitis: a prospective cohort study and comparison with patients with schizophrenia spectrum disorders (S22.006)

Clinical characterisation of patients in the post-acute stage of anti-NMDA receptor encephalitis: a prospective cohort study and comparison with patients with schizophrenia spectrum disorders (S22.006)

Effect of Eptinezumab on Utility Scores in Patients with Migraine: Results from the DELIVER Study (P13-12.011)

Effect of Eptinezumab on Utility Scores in Patients with Migraine: Results from the DELIVER Study (P13-12.011)

Teaching neurologists through microlearning: the first 4 years of the eLearning experience with NeuroBytes (P13-2.001)

<h3>Objective:</h3> Determine the impact of the AAN NeuroBytes eLearning program on learning and neurological practice. <h3>Background:</h3> NeuroBytes are brief multimedia videos that provide focused, clinically relevant topic updates in neurology. Neurobytes were launched in January 2019 to deliver microlearning in neurology. We assessed the impact of Neurobytes on satisfaction, learning, and practice. <h3>Design/Methods:</h3> We conducted a programmatic review to evaluate all NeuroBytes from January 2019 (launch) to date of analysis (October 2022). Each NeuroByte course included the video and a survey. Assessment data included: course enrollments, completion rate, satisfaction, and influence on practice. Course enrollment was defined as opening for viewing; course completion required completing the post-course survey which assessed user satisfaction and influence on practice. Data were stratified by user type. To assess the program’s impact, four primary outcomes were defined: (1) course enrollments, (2) course completion rate, (3) satisfaction rate, and (4) percent reporting a change in practice. Descriptive statistics were performed. <h3>Results:</h3> From Jan 2019 – Sept 2022 104 NeuroBytes were released. Total enrollments were 65,089; mean enrollments of 598±377 per course. Mean course completion was 39% (range 7% to 92%). On post-course survey, 87% were satisfied/extremely satisfied. Courses covered 20 subspecialties and COVID-19. The most frequent topics were neuromuscular (n=10) and vascular (n=9). The most popular NeuroByte courses were ‘Dual antiplatelet therapy in ischemic stroke’ (n=1,851 enrollments) and ‘The neurologic exam via telemedicine’ (n=1,848). Member neurologists accounted for 55% of course enrollments, followed by juniors (18%), non-AAN members (13%), APP (6%), or student (3%). <h3>Conclusions:</h3> NeuroBytes are a successful microlearning tool for delivering continuing professional development. The primary strengths of the program are accessibility, high-yield learning, breadth of topics, and appeal to a range of learners. Not all content is conducive to micro-delivery. Ongoing efforts will define how this program influences daily practice and lifelong learning. <b>Disclosure:</b> The institution of Dr. Quick has received research support from NINDS. The institution of Dr. Quick has received research support from NEALS. Dr. Miller has nothing to disclose. Dr. Siegler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AstraZeneca. Mr. Rook has nothing to disclose. Ms. Morris has nothing to disclose. Mr. Cramer has nothing to disclose. Xiaoyu Sun has received personal compensation for serving as an employee of American Academy of Neurology. An immediate family member of Xiaoyu Sun has received personal compensation for serving as an employee of Syneos Health. An immediate family member of Xiaoyu Sun has stock in Syneos Health. An immediate family member of Xiaoyu Sun has stock in BioNTech. Dr. Cook has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Cook has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Dr. Cook has a non-compensated relationship as a Board Member with Alliance for Patient Access that is relevant to AAN interests or activities. Dr. Sabayan has nothing to disclose. The institution of Dr. Kraakevik has received research support from Parkinson Foundation. Dr. Moeller has received publishing royalties from a publication relating to health care. The institution of Dr. Isaacson has received research support from National Institutes of Health. The institution of Dr. Isaacson has received research support from Women’s Alzheimer’s Movement. The institution of Dr. Isaacson has received research support from Aces for Alzheimer’s. Dr. Isaacson has received publishing royalties from a publication relating to health care. Dr. London has nothing to disclose. Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.

Characterizing EEG and Serum Biomarker Trends in Immune Effector Cell-Associated Neurotoxicity: A Case Series (P10-1.001)

<h3>Objective:</h3> To characterize electroencephalographic (EEG) trends over time in immune effector cell-associated neurotoxicity syndrome (ICANS) and identify correlations between neuron-derived serum biomarkers of inflammation, neurotoxicity grade, and EEG findings. <h3>Background:</h3> Chimeric antigen receptor T-cell therapy (CAR-T) can be effective for refractory hematologic malignancies, but may be complicated by ICANS. Previous studies link higher peak neurotoxicity grades with EEG background abnormalities and higher incidences of rhythmic and periodic patterns (RPPs). <h3>Design/Methods:</h3> We performed a retrospective analysis of CAR-T patients who were enrolled into an IRB-approved prospective, longitudinal observational study. Data including demographics, ICE scores, and neurologic symptoms were prospectively entered. Serum biomarkers including Ang-1, Ang-2, IL-6, UCH-L1, and S100b were drawn prior to CAR-T and at defined time points thereafter. EEG data was reviewed, with encephalopathy grade defined by American Clinical Neurophysiology Society (ACNS) criteria. <h3>Results:</h3> Forty-five patients were included in the study. Ten patients (22%) developed ICANS. EEG data was available for five (11%) patients, with a median of 35 hours recorded per patient. Zero patients had confirmed electrographic seizures. Median ICE score prior to EEG was 1. Backgrounds were mildly or moderately encephalopathic, with improving organization and faster frequencies over time. GPDs or LPDs of 0.5–2Hz were rare to abundant and gradually improved with time. Focal slowing and sharp waves were common. S100b consistently increased above (average 45%) and Ang-2 decreased below (average 53%) baseline at the time of becoming symptomatic for two patients (drawn within 48 hours before/after EEG was obtained), whereas Ang-1, IL-6, and UCH-L1 had more variable changes. <h3>Conclusions:</h3> Patients with ICANS who underwent EEGs had up to moderate electrographic (and severe clinical) encephalopathy and RPPs that spontaneously improved with time. Higher encephalopathy grade occurred in those with greater S100b increases. Our observations will need to be confirmed in an independent population with serial samples and EEG data on all patients. <b>Disclosure:</b> Dr. Nguyen has nothing to disclose. Lila Renteria has nothing to disclose. Dr. Motika has nothing to disclose. Dr. Hinson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Hinson has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for UCSF. Dr. Hinson has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association.

The Insula Modulates the Effects of Aerobic Training on Cardiovascular Function and Ambulation in Multiple Sclerosis (P10-3.010)

<h3>Objective:</h3> To understand the effects of aerobic training (AT), focusing on the role of insula (differentiating in right and left) in establishing cardiovascular fitness (CF) and AT responses in people with multiple sclerosis (pwMS). <h3>Background:</h3> Impairment in the autonomic control of cardiovascular function is very common in pwMS. Insula is a key region related to this function with differences between left and right hemisphere. Insula lesions and atrophy are frequent in pwMS and appear to be related to cardiovascular alterations. AT targets the cardiopulmonary system and is proposed as a neuroprotective strategy in several neurological conditions. <h3>Design/Methods:</h3> Sixty-one pwMS were randomized in two groups (MS-AT and MS-C) to perform 24 training sessions of 30–40 minutes for 2–3 times per week. MS-AT performed moderate AT, while MS-C underwent non-specific motor training. All patients had a baseline and follow-up evaluation after the training period, including assessment of maximal peak of oxygen consumption (VO2max), heart rate reserve (HRR), 6-minute walk test (6MWT) and a MRI scan to quantify lesion volumes (LV), global and regional brain atrophy. Two age- and sex-matched healthy control (HC) groups were enrolled for baseline comparison of CF and brain volumetry data. <h3>Results:</h3> At baseline, MS patients showed impaired values of VO2max, HRR and 6MWT (p&lt;0.001) and a widespread pattern of atrophy compared to HC, including bilateral insula. In MS, higher left insula LV correlated to higher HRR (R=0.27, p&lt;0.05). After training, MS-AT experienced an improvement in 6MWT compared to MS-C and this enhancement was greater in patients without insular lesions. At follow-up, MS-C showed a reduction of left anterior insula volume compared to baseline (p&lt;0.001). <h3>Conclusions:</h3> In pwMS, AT improves CF and walking capacity. It showed a neuroprotective effect, especially for the left insula that has a stronger relationship with CF, compared to the contralateral region. <b>Disclosure:</b> Dr. Albergoni has nothing to disclose. Loredana Storelli has nothing to disclose. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Bristol Myers Squibb, Celgene, Genzyme, Merck Serono, Novartis, Roche, and Teva. The institution of Maria Assunta Rocca has received research support from Italian Ministry of Health, MS Society of Canada and Fondazione Italiana Sclerosi Multipla. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer, Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi Genzyme, Takeda, and Teva Pharmaceutical Industries. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bayer, Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi Genzyme, Takeda, and Teva Pharmaceutical Industries. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, Teva Pharmaceutical Industries, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).

Clinical characteristics associated with the development of preoperative and postoperative seizures in patients with glioblastoma (P3-1.002)

<h3>Objective:</h3> To determine the factors which predict the occurrence of preoperative seizures (PRS) and post-operative seizures (POS) among patients with glioblastoma (GBM). <h3>Background:</h3> Seizures have been well described in patients with GBM, albeit at a lower frequency than low grade gliomas. Although recent studies suggest epileptogenesis has more to do with genetic molecular markers in low grade glioma-related seizure, information on factors that influence the development of of GBM-related PRS and POS is lacking. <h3>Design/Methods:</h3> We performed a single-center retrospective cohort study of patients with GBM evaluated at Mayo Clinic Florida, between 2018 and 2022. Clinical factors including, tumor molecular markers, neurophysiological and imaging findings were analyzed according to the status of PRS and POS. <h3>Results:</h3> One hundred thirty-two adult patients (median age=61.5 years), 79 (59.85%) females) were included. The most common locations were the temporal (n=50, 42.02%) and frontal (n=47, 39.50%) lobes. All patients underwent GBM resection, with 17.1% undergoing total resection (n=22). Sixty-two patients (46.27%) underwent intra-operative electrocorticography during GBM resection. Isocitrate dehydrogenase 1 (IDH1) wildtype was present in 121 patients (90.3%), 61 patients had O⁶-methylguanine-DNA methyltransferase (<i>MGMT</i>)-methylated GBM (46.21%). Forty patients (33.9%) had PRS, and 39 patients (38.24%) had POS (median follow-up=17.27 months; IQR=10.6–30.1). IDH1 wildtype and MGMT methylation status were not associated with PRS or POS. Patients with PRS were younger (59 years vs. 64 years, <b><i>p=0.021</i></b>) and experienced a longer survival time (16.1 months vs. 8.3 months, <b><i>p=0.044</i></b>) compared to patients without PRS. Occipital lobe GBM was associated with a lower likelihood of PRS (<b><i>p=0.043</i></b>) and POS (<b><i>p=0.001</i></b>). <h3>Conclusions:</h3> PRS is associated with younger age and longer survival time. PRS and POS are less likely to occur with occipital lobe tumors. Further studies are needed to confirm our findings and elucidate the influence of other tumor molecular markers in the development of PRS and POS in patients with GBM. <b>Disclosure:</b> Dr. Sánchez Boluarte has nothing to disclose. Dr. Garcia has nothing to disclose. Dr. Gunasekera has nothing to disclose. Dr. Tatum has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bioserenity. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Defense Law Firm on behalf of a patient with epilepsy with funds donated to the Epilepsy Foundation of America. The institution of Dr. Tatum has received research support from Esai. The institution of Dr. Tatum has received research support from Mayo Clinic. The institution of Dr. Tatum has received research support from Liva Nova. The institution of Dr. Tatum has received research support from Engage Pharmaceuticals. The institution of Dr. Tatum has received research support from Xenon. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Sirven has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Sirven has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Sirven has stock in Doximity. Dr. Sirven has received publishing royalties from a publication relating to health care. Dr. Sirven has a non-compensated relationship as a Host with WJCT Public Media/ NPR that is relevant to AAN interests or activities. Dr. Freund has nothing to disclose. The institution of Dr. Ritaccio has received research support from NIH. Dr. Ritaccio has received intellectual property interests from a discovery or technology relating to health care. Kaisorn Chaichana has nothing to disclose. Alfredo Quiñones-Hinojosa has nothing to disclose. Dr. Feyissa has nothing to disclose.