EMD Serono Research Articles

AI-based characterization of multiple sclerosis clinical symptomatology using lesion parenchymal fraction: empirical support for the topographical model of MS (P3-3.018)

<h3>Objective:</h3> To evaluate the relationship between lesion location, functional systems, and disability using an artificial intelligence (AI) model. <h3>Background:</h3> The topographical model of MS depicts localized lesion burden in a pool of variable neurological reserve, with the cervical cord at the shallow end. <h3>Design/Methods:</h3> 63 people with MS (30 RRMS, 33 SPMS, 51 female, baseline age 45.8±10.0 yrs) were longitudinally evaluated with MRI and clinical metrics (EDSS and functional system scores [FSS]) with median 2 time points, max. 8, (total: 154), follow-up 2.1±2.5 years. Imaging: icobrain was used to measure T2-FLAIR lesions on brain MRI, and adapted to measure T2 lesion volumes in cervical cord. To create a lesion/reserve ratio, localized lesion volume percentiles were divided by regional parenchymal volume percentile (cerebral, infratentorial, cervical cord), yielding regionally-specific lesion parenchymal fraction (LPF). Modeling: in 500 iterations, Random Forest (RF) regression models were trained to estimate cross-sectional EDSS and FSS. Estimations were Spearman correlated with actual scores; median correlation was assessed. To evaluate role of LPF, two estimator sets were used: 1) simple model: age and sex, 2) full model: age, sex, and topographical LPF. <h3>Results:</h3> Spearman correlations between fitted and true clinical scores were highest for overall EDSS (R=0.29), pyramidal (R=0.37), bowel/bladder (R=0.38), and cerebellar (R=0.27). Models including LPF outperformed the simple model in 100%, 100%, 98%, and 91% of iterations, respectively. The EDSS and pyramidal FSS were most strongly associated with infratentorial LPF, which also most strongly predicted conversion to SPMS. <h3>Conclusions:</h3> Lesion localization can be mapped to specific functional systems to explicate MS heterogeneity. Lesion parenchymal fraction, an assessment of lesion load/parenchymal volume ratio, is a quantified expression of the topographical model of MS and may be a useful MRI correlate of MS clinical symptoms. Using this metric, AI techniques can be refined to identify specific thresholds for conversion to SPMS. <b>Disclosure:</b> Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Expert Witness. The institution of Dr. Krieger has received research support from Novartis. The institution of Dr. Krieger has received research support from Bristol Myers Squibb. Thibo Billiet has received personal compensation for serving as an employee of icometrix. Miss Maes has received personal compensation for serving as an employee of icometrix. Dr. De Barros has received personal compensation for serving as an employee of Icometrix. Dr. Van Hecke has received personal compensation for serving as an employee of icometrix. Annemie Ribbens, 9599 has received personal compensation for serving as an employee of icometrix. Annemie Ribbens, 9599 has stock in icometrix. Chenyu Wang, 7886 has received personal compensation for serving as an employee of Sydney Neuroimaging Analysis Centre. The institution of Chenyu Wang, 7886 has received research support from Multiple Sclerosis Research Australia. Kain Kyle has received personal compensation for serving as an employee of Sydney Neuroimaging Analysis Centre. Kain Kyle has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sydney Neuroimaging Analysis Centre. Linda Ly has nothing to disclose. Dr. Garber has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Garber has received research support from Trish MS Foundation. Michael Barnett has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sydney Neuroimaging Analysis Centre. An immediate family member of Michael Barnett has received stock or an ownership interest from RxMx. The institution of Michael Barnett has received research support from Genzyme Sanofi. The institution of Michael Barnett has received research support from Biogen. The institution of Michael Barnett has received research support from Novartis.

Longitudinal brain and skeletal muscle FDG-PET changes in people with stiff person syndrome spectrum disorders (P4-5.021)

<h3>Objective:</h3> To describe changes in fluorodeoxyglucose positron emission tomography (FDG-PET) findings in the brain and muscles of individuals with stiff person syndrome spectrum disorders (SPSD) longitudinally. <h3>Background:</h3> SPSD includes multiple clinical phenotypes that rarely can be paraneoplastic in origin. An FDG-PET scan is frequently obtained as part of the malignancy work-up, and abnormal metabolic activity unrelated to malignancy has been shown to occur in both the brain and skeletal muscles of patients with SPSD. However, it is unclear if such findings persist or change over time. <h3>Design/Methods:</h3> A retrospective study was performed of patients with SPSD who were seen at Johns Hopkins SPS Center from 2009 to March 2022, with at least two FDG-PET studies in the medical record with source images of sufficient quality for comparison. Quantitative data was extracted from dedicated brain FDG-PET scans using NeuroQ™, which calculates Z-scores of 47 brain regions compared to healthy controls. Body FDG-PET scans will be reviewed qualitatively by a blinded nuclear medicine radiologist to detect the presence and pattern of hypermetabolism in skeletal muscle. Patients’ clinical characteristics, including type of treatment, will be correlated with PET data. <h3>Results:</h3> Out of 98 SPSD patients who underwent an FDG-PET scan, 10 were identified that met inclusion criteria. Median age at time of SPSD onset was 51±15.8 years, 60% were males, and 60% were black. Mean duration from symptom onset to first FDG-PET scan was 0.78±0.62 years. The majority of patients had SPS-plus phenotype. All patients were seropositive for an SPSD-associated antibody and received an immune therapy. Preliminary data demonstrate that all patients had at least 1 region of dysmetabolism on initial brain scan, and at least 3 regions on follow-up. <h3>Conclusions:</h3> We will present longitudinal metabolic changes in brain and body FDG-PET scans of patients with SPSD, and determine if any changes observed are associated with clinical characteristics. <b>Disclosure:</b> Dr. Roman has nothing to disclose. The institution of Dr. Wang has received research support from Genentech. Dr. Sadaghiani has nothing to disclose. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autobahn. Dr. Newsome 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. Newsome has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Greenwich Biosciences. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. The institution of Dr. Newsome has received research support from Biogen. The institution of Dr. Newsome has received research support from Genentech/Roche. The institution of Dr. Newsome has received research support from Department of Defense. The institution of Dr. Newsome has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Newsome has received research support from National MS Society. The institution of Dr. Newsome has received research support from The Stiff Person Syndrome Research Foundation. Dr. Newsome has received personal compensation in the range of $5,000-$9,999 for serving as a Clinical adjudication committee member for clinical trial with medDay Pharmaceuticals. Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving as a Lead PI for Clinical Trial with Roche.

Symptom stability throughout Ocrelizumab infusion cycle in patients with Multiple Sclerosis: final results of SYMptom Burden on Ocrelizumab, a Longitudinal Study (SYMBOLS) (P7-3.017)

<h3>Objective:</h3> To determine whether symptom burden in Ocrelizumab (OCR)-treated MS patients varies over the 6-month infusion cycle. <h3>Background:</h3> OCR is a humanized anti-CD20 antibody therapy for multiple sclerosis (MS) given at 6-month intervals. Some patients report an increase in symptoms toward the end of the infusion cycle (“wearing off”). <h3>Design/Methods:</h3> One-year, prospective, observational, two-center study (NCT04855617) enrolled MS patients aged 18–80 with EDSS scores between 0–7 who were treated with OCR for ≥ 1 year or were initiated on OCR. All patients were followed at NYU MS Care Center (NYU), New York, NY, and the Elliot Lewis MS Center (ELC), Wellesley, MA. Patients completed NeuroQol short forms, SymptoMScreen, work productivity (WPAI:MS), and medical screening questionnaires at 4-, 12-, and 24-weeks post-infusion for two consecutive infusion cycles as well as a post-study completion questionnaire. <h3>Results:</h3> 115 participants were included in the study (n=53 NYU/n=62 ELC); 64% were female; 36% - non-White; baseline age - 46.2±12.5 years; disease duration −15.3±10.7 years; OCR treatment duration - 2.54 ±1.04 years; median (IQR) EDSS - 3.0 (1.5, 5.3); EDSS was &gt;= 4 in 48 patients (42%). Paired Wilcoxon nonparametric tests used to evaluate the changes in outcome scores from pre- to post-infusion showed no significant changes on any NeuroQol and SymptoMScreen scales. Scores on two WPAI-MS subscales (“impairment while working due to health” and “overall work impairment”) increased by 10% during the 2^nd cycle (p-values=0.02 and 0.001) but not the 1^st cycle. On the post-completion questionnaire, the percentage of patients who reported ‘wearing off’ always was 4%, usually - 33%, sometimes - 45%, and never - 17%. <h3>Conclusions:</h3> Although symptom burden remained stable throughout two OCR infusion cycles on multiple scales, most patients reported “wearing off” at least sometimes. We will discuss possible explanations for this discrepancy. <b>Disclosure:</b> Dr. Kister has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech-Roche. The institution of Dr. Kister has received research support from Genentech. Dr. Kister has received publishing royalties from a publication relating to health care. Prof. Oh has nothing to disclose. Ms. Douglas has nothing to disclose. Ms. O’Shea has nothing to disclose. An immediate family member of Tamar Bacon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. The institution of an immediate family member of Tamar Bacon has received research support from Gentech. An immediate family member of Tamar Bacon has received publishing royalties from a publication relating to health care. Dr. Bouley has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Banner Life Sciences. Dr. Bouley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Bouley 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. Bouley has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Bouley has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Bouley has received research support from Novartis. Dr. Lathi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. The institution of Dr. Katz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Theraputics. The institution of Dr. Katz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen Pharmaceuticals. The institution of Dr. Katz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viela Bio. The institution of Dr. Katz has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Katz has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Katz has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Sanofi-Genzyme. The institution of Dr. Katz has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Genentech. The institution of Dr. Katz has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD-Serono.

Recognizing Health Disparities in Multiple Sclerosis: Experiences and Perspectives of Patients of Diverse Racial and/or Ethnic Background (P9-3.008)

Recognizing Health Disparities in Multiple Sclerosis: Experiences and Perspectives of Patients of Diverse Racial and/or Ethnic Background (P9-3.008)

Race and Social Determinants of Health in Performance Outcomes among Relapsing Remitting Multiple Sclerosis Patients (P13-3.017)

Race and Social Determinants of Health in Performance Outcomes among Relapsing Remitting Multiple Sclerosis Patients (P13-3.017)

Lack of B-cell Depletion with Ocrelizumab (P7-3.006)

Lack of B-cell Depletion with Ocrelizumab (P7-3.006)

Safety and Efficacy of Inebilizumab in AQP4+ NMOSD Participants with History of Immunosuppression Treatment Prior to N-MOmentum Study (P13-5.003)

Safety and Efficacy of Inebilizumab in AQP4+ NMOSD Participants with History of Immunosuppression Treatment Prior to N-MOmentum Study (P13-5.003)

Association of B cell Subsets and Aquaporin-4 antibody titers with Disease Activity in Participants in the N-MOmentum trial Receiving Inebilizumab Treatment (S5.005)

Association of B cell Subsets and Aquaporin-4 antibody titers with Disease Activity in Participants in the N-MOmentum trial Receiving Inebilizumab Treatment (S5.005)

Acute NMOSD Attack in the Setting of Pembrolizumab Therapy: A Case Report (P13-5.009)

Acute NMOSD Attack in the Setting of Pembrolizumab Therapy: A Case Report (P13-5.009)

ILLUMINATE: Design of a Real-World, Non-Interventional Study Evaluating the Usability and Value of Integrated Digital Solutions for Routine Care of Patients with Multiple Sclerosis (P3-3.003)

ILLUMINATE: Design of a Real-World, Non-Interventional Study Evaluating the Usability and Value of Integrated Digital Solutions for Routine Care of Patients with Multiple Sclerosis (P3-3.003)

Final Analysis of Pregnancy Outcomes Following Exposure to Dimethyl Fumarate in a Prospective International Registry (S31.004)

Final Analysis of Pregnancy Outcomes Following Exposure to Dimethyl Fumarate in a Prospective International Registry (S31.004)

Barriers to Increasing Paid Parental Leave in U.S. Neurology Residencies: a Survey of Program Directors (S13.004)

<h3>Objective:</h3> To report on parental leave policies in U.S. adult neurology residencies and explore barriers to augmenting the duration of paid leave. <h3>Background:</h3> Though the American Board of Psychiatry and Neurology (ABPN) requires that programs allow at least 6 weeks of parental leave, there is little information about the status of parental leave policies across U.S. neurology residencies. <h3>Design/Methods:</h3> We distributed an anonymous online survey to U.S. adult neurology program directors (PDs). The survey addressed program demographics, components and length of parental leave, perceived impact on residents’ clinical training and academic development, and barriers to augmenting the policy. <h3>Results:</h3> We contacted 163 PDs and received 54 responses (response rate of 33%). 87% of programs had policies for both childbearing and non-childbearing residents. The average maximal length of leave without extension of training was 8.5 weeks (range 0–13) for childbearing residents and 6.2 weeks (0–13) for non-childbearing residents. 65% offered full pay and benefits during the leave, and a majority did not require full use of vacation (51%) or elective time (59%). 42% had policies for reducing clinical rotations to create a leave. The majority of PDs felt that parental leave had a positive impact on resident wellness and neutral impact on clinical competency, academic opportunities, and career development. PDs stated that the most common barriers to providing a 12-week paid policy were concerns about equity in the program and impact on other trainees (82%), staffing of clinical services (80%), and impact on clinical training (78%). <h3>Conclusions:</h3> Although most adult U.S. neurology programs in our cross-sectional study have established parental leave policies, there is significant variability regarding the duration of leave and the composition of leave that is offered. Policies to improve parental leave should focus on addressing commonly perceived barriers, such as additional solutions to staffing clinical services. <b>Disclosure:</b> Dr. Conway has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Conway has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Conway has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Prasad has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medicolegal firms. Dr. Prasad has stock in health care companies. Dr. Prasad has received publishing royalties from a publication relating to health care.

Diurnal Step Count Patterns in Progressive Multiple Sclerosis (P3-3.011)

<h3>Objective:</h3> Determine the relationship of diurnal step count patterns with disability in progressive multiple sclerosis (MS). <h3>Background:</h3> Worsening Expanded Disability Status Scale (EDSS) scores and longer Timed 25-Foot Walk (T25FW) times generally correspond to increased MS disability and correlate with lower daily physical activity. Patterns of diurnal physical activity and MS disability progression are understudied. <h3>Design/Methods:</h3> Participants (n=577) in the SPI2 study of MD1003 (high dose biotin) in progressive MS underwent EDSS and T25FW every three months with up to 27 months of follow up. A Fitbit flex (or flex2) continuously monitored step counts per minute. Recorded data was analyzed using the function-on-scalar regression technique where EDSS, T25FW and other patient demographics were used to predict per-patient diurnal step counts. <h3>Results:</h3> From 12pm to 8pm, EDSS (mean R2 = 0.36±0.02) outperformed T25FW (mean R2 = 0.26±0.02) in predicting mean diurnal step count curves per patient after adjusting for sex, age, and BMI. Including EDSS and T25FW increased mean R2 to 0.39±0.02. Men took 5.2% more steps than women from 12am to 7am on average, while women took 5.1% more steps than men from 10:30am to 1:30pm and 4.3% more from 7:30pm to 10pm on average (all p&lt;0.001). The impact of age was strongest from 3pm to 10pm, where each year of age corresponded to 0.44% fewer steps (p&lt;0.0001). From 10am to 11pm, every one-point increase in BMI translated to 1.3% fewer steps (p&lt;0.0001). Mean diurnal step count had midday troughs in summer, evening troughs in winter, and morning peaks in spring (all p&lt;0.001). <h3>Conclusions:</h3> The association between lower physical activity and disability metrics is not uniform throughout the day, and changes with the seasons. These results highlight the need for consistency in timing of clinical evaluation in research, and provide important insight into specific times of day that may be preferable for effective rehabilitation interventions. <b>Disclosure:</b> Mr. Navani has received personal compensation for serving as an employee of Datavant. Dr. Block has nothing to disclose. The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Atara. The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autobahn. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avotres. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gossamer Bio. Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuron23. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Pharma. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal/Sandoz. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siemens. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Therini. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. The institution of Dr. Cree has received research support from Genentech. Dr. Cree has received publishing royalties from a publication relating to health care. Prof. Abbasi-Asl has received research support from NIH. Prof. Abbasi-Asl has received research support from Weill Neurohub.

Fatigue and Other Patient-Reported Outcomes in Patients With RRMS who Switched to Ocrelizumab: 4-Year Data From CASTING-LIBERTO (P6-3.010)

Fatigue and Other Patient-Reported Outcomes in Patients With RRMS who Switched to Ocrelizumab: 4-Year Data From CASTING-LIBERTO (P6-3.010)

Dose Selection and Clinical Development of Efgartigimod PH20 Subcutaneous in Patients with Generalized Myasthenia Gravis (P1-5.017)

Dose Selection and Clinical Development of Efgartigimod PH20 Subcutaneous in Patients with Generalized Myasthenia Gravis (P1-5.017)

Efficacy and safety of ravulizumab in adults with anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder: outcomes from the phase 3 CHAMPION-NMOSD trial (S5.002)

Efficacy and safety of ravulizumab in adults with anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder: outcomes from the phase 3 CHAMPION-NMOSD trial (S5.002)

Community-Academic Initiative to Measure and Improve Underrepresented Group Participation in Parkinson’s Disease Research (P10-11.002)

<h3>Objective:</h3> To better understand the reason for lack of racial and ethnic diversity in Parkinson’s Disease (PD) clinical trials by measuring community members’ baseline knowledge of PD, trust of researchers, and willingness to participate in research. <h3>Background:</h3> PD clinical trial participants are disproportionately non-Hispanic Caucasian, creating limited generalizability of research findings. It is unclear why there is incommensurate rates of underrepresented group (URG) research participation; lower health literacy and lack of trust have been suggested as contributors. Community engagement through education on PD and associated studies has the potential to improve awareness and understanding of research, and in turn increase participation rates. <h3>Design/Methods:</h3> Four educational workshops with a total of 92 participants were held at community centers in URG-predominant Chicago neighborhoods. Pre- and post-workshop surveys qualitatively assessed participants’ knowledge of PD symptoms and signs, trust in medical researchers, and willingness to participate in clinical trials. <h3>Results:</h3> The majority of participants identified as either African American (35.9%) or Asian (37%). Survey results indicated that on the whole, community members were trustful of clinical researchers and had positive feelings towards research and researchers’ intentions. Participants were most open to participate in studies that could be done within their homes or offered financial compensation, and were least open to participate in studies that involved obtaining biological samples. Very few respondents had ever been asked to participate in a PD clinical trial before (8.1%). Respondents had a basic baseline understanding of PD, and tremor was the symptom most commonly identified as an early sign of PD (32.6%). <h3>Conclusions:</h3> Surveying predominantly AA and Asian community members of URG-rich Chicago communities revealed moderate to high levels of trust of researchers in these groups, and a willingness to participate in patient-centered clinical trials that mitigate barriers and include facilitators. <b>Disclosure:</b> An immediate family member of Ms. Marre has received personal compensation for serving as an employee of EMD Serono, Inc.. An immediate family member of Ms. Marre has received personal compensation for serving as an employee of MFS Investment Management. Ms. Marre has received research support from Office of Undergraduate Research which is administered by Northwestern University’s Office of the Provost. Emily Zivin has nothing to disclose. Karen Williams has nothing to disclose. Mr. Shramuk has received personal compensation for serving as an employee of Northwestern University. Ms. Lancki has nothing to disclose. Dr. Adrissi has nothing to disclose. Dr. Larson has received personal compensation in the range of $0-$499 for serving as a Consultant for Acadia Pharmaceuticals.

Impact of the COVID-19 Pandemic on Personal Networks and Neurological Outcomes of People with Multiple Sclerosis (P12-3.001)

Impact of the COVID-19 Pandemic on Personal Networks and Neurological Outcomes of People with Multiple Sclerosis (P12-3.001)

Long-Term Safety and Effectiveness of Delayed-release Dimethyl Fumarate in Multiple Sclerosis Patients Treated in Routine Medical Practice, an updated analysis of the ESTEEM Study (P7-3.009)

Long-Term Safety and Effectiveness of Delayed-release Dimethyl Fumarate in Multiple Sclerosis Patients Treated in Routine Medical Practice, an updated analysis of the ESTEEM Study (P7-3.009)

US Census Tracts with Higher Proportions of Hispanics, Individuals with Disabilities, and Rural Location have Worse Geospatial Access to Neurological Care (P5-9.002)

<h3>Objective:</h3> To examine neurological care spatial access disparities among various demographic segments of the U.S. population. <h3>Background:</h3> Incidence of neurological conditions in the U.S. is rising. A shortage of neurology clinicians and poorly understood disparities may hinder access to neurological care. There is a critical need to define community characteristics that may contribute to care access. <h3>Design/Methods:</h3> Neurologist practice locations from 2022 CMS Care Compare physician data were used to compute spatial access to neurological care measures for all U.S. census tracts. Census tract-level community characteristics (sex, age, race, ethnicity, education, income, insurance, % with computer, % without a vehicle, % with limited English % with hearing, vision, cognitive and ambulatory difficulty) were obtained from 2020 American Community Survey 5-year estimates. Rural-urban status was obtained from 2010 rural-urban commuting areas codes. Generalized additive models were built using 60-mile enhanced two-step floating catchment area spatial access ratios and three-step floating catchment area spatial access ratios as outcomes and community characteristics as predictors. <h3>Results:</h3> Using results from 73,057 U.S. census tracts, we found that access to neurological care (% change in ratio of neurologists to individuals) was significantly lower for rural (−80.8%) and micropolitan (−61.1%) areas. Additionally, tracts with a higher percentage of Hispanic populations (−0.5%), males (−0.9%), public insurance (−0.3%), uninsured (−0.9%), individuals with hearing difficulty (−5.2%), vision difficulty (−1.2%), and ambulatory difficulty (−1.9%) (p&lt;0.001) had lower access. Urban census tracts and tracts with greater Black (0.3%) and older (0.8%) populations were found to have higher spatial access to neurologists <h3>Conclusions:</h3> Access to neurological care appears worse in rural regions and in regions with higher proportions of Hispanics, and individuals with disabilities. For urban and Black communities proximity to neurologists is less likely a significant contributor to poor access. To improve neurological care disparities, future interventions will need to target unique access drivers for specific populations. <b>Disclosure:</b> Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave. Dr. McGinley 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. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. McGinley has received research support from Novartis. The institution of Dr. McGinley has received research support from Biogen. The institution of Dr. McGinley has received research support from Genentech. The institution of Dr. McGinley has received research support from NIH. Mr. Harvey has nothing to disclose. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech/Roche. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech. Dr. Buchalter has stock in Pfizer Inc. Dr. Buchalter has stock in Viatris Inc. Dr. Buchalter has received personal compensation in the range of $100,000-$499,999 for serving as a Predoctoral and Postdoctoral Trainee with NIH.