ABSTRACT Background Stimulation of a specific site in the dorsolateral subthalamic nucleus (STN) was recently associated with slower motor progression in Parkinson’s Disease (PD), based on the deep brain stimulation (DBS) in early-stage PD pilot trial. Objective To test whether stimulation of this site is associated with improvements of long-term motor outcomes in advanced-stage PD. Methods Active contacts of the early DBS cohort (N=14) were analyzed. Sweet spot and connectivity models derived from this cohort were then used to estimate long-term motor outcomes in an independent DBS cohort of advanced-stage PD patients (N=29). Results In early-stage PD, proximity of stimulation to the dorsolateral STN associated with slower motor progression. In advanced-stage PD, stimulation proximity to the same site associated with better long-term motor outcomes (R=0.60, P<0.001). Conclusions Results suggest stimulation of a specific site in the dorsolateral STN associates with both slower motor progression and long-term motor improvements in PD.

Introduction and Problem Statement:The aging US population has led to the increased prevalence of neurodegenerative diseases and the critical need for specialists with advanced training in the management of these conditions. Focus on Common Movement Disorders (FOCMD), a 2-day educational course hosted by Vanderbilt University, was started 16 years ago to provide neurology residents with exposure to the diagnosis and treatment of movement disorders. Objectives:The aim of the course was to provide early-career neurology residents with relevant exposure to the field of movement disorders, through which we hope to increase medical knowledge of movement disorders and common Food and Drug Administration (FDA)-approved therapies and inspire residents to pursue fellowship training in the field. Methods and Curriculum Description:FOCMD consists of lectures and small-group workshops that provide an overview of common movement disorders and approved therapies. All North American neurology residency program directors are invited to nominate a first-year or second-year resident. Attendees are administered standardized multiple-choice precourse and postcourse examinations to assess foundational knowledge of common movement disorders and FDA-approved therapies and to measure acquisition of the course material. Past participants are regularly surveyed to gauge their impression of the course's effect on fellowship selection and their utilization of therapies common in the treatment of movement disorders. Results and Assessment Data:Since 2008, FOCMD has trained 854 neurology residents from 113 programs. Between 2010 and 2020, 507 residents completed the precourse and postcourse examinations. There was an increase of 22.4 (95% CI 20.67-24.49; p < 0.001) percentage points between the precourse and postcourse examinations or an additional 3.8 questions were answered correctly. Follow-up surveys were sent to 414 past participants, and 116 were completed. Survey responses revealed that 84% of past attendees completed a fellowship, 44% of which were in the field of movement disorders. In addition, 82% of past participants reported that the course affected subspecialty selection and 63% reported treating patients with movement disorders in their current practice. Discussion and Lessons Learned:Experience with FOCMD has shown it to be successful in introducing neurology residents to the subspecialty early in their career and increasing medical knowledge on movement disorders. An educational program of this format may also positively influence fellowship selection.

Objective: To determine whether patient satisfaction with teleneurology is as good or better than satisfaction with in-person visits and if teleneurology patient satisfaction has been consistent from 2020 to 2021 at Vanderbilt University Medical Center. Background: While telehealth has existed since the 1950s, there has been slow adoption and coverage in the U.S. Just before the COVID-19 pandemic, Vanderbilt University Medical Center (VUMC) averaged 5–10 direct-to-patient telehealth visits per day. The pandemic led the federal government to implement public health emergency policies that removed barriers to the adoption of telehealth. Within one month, direct-to-patient telehealth visits increased to over 2,000 per day. We report here a review of patient satisfaction data, collected through quality improvement projects. Design/Methods: Patients received satisfaction surveys via email. They rated their interactions with their neurologist, the care provided, and whether they felt the care provided met their medical needs. Using the Mann-Whitney U Test to control for sampling size disproportions, we compared teleneurology satisfaction to in-person satisfaction and teleneurology satisfaction at two different time points. Results: From March 1st, 2020 to May 31st, 2021, 1,053 patients completed surveys rating their teleneurology visit and 2,850 patients completed surveys rating their in-person visit. The average rating for teleneurology was above 96% compared to 94% for in-person visits. Comparing 2020 teleneurology visits to 2021 teleneurology visits, patients gave an average rating of 97% in 2020 and a 96% average rating in 2021. Conclusions: Patient satisfaction with teleneurology is as good or better than satisfaction with in-person visits and has been consistent from 2020 to 2021. Moving forward, access to telehealth must remain a vital part of our healthcare delivery system. Disclosure: Mr. Sharp has stock in AbbVie. Mr. Sharp has stock in Abbott. Mr. Makani has nothing to disclose. Dr. Charles has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. Dr. Charles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Charles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz. Dr. Charles has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Newronika. Dr. Charles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Charles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Iota. Dr. Charles has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Charles has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Charles has stock in Arena Therapeutics. The institution of Dr. Charles has received research support from Pharma 2 B. The institution of Dr. Charles has received research support from Intec. The institution of Dr. Charles has received research support from Merz. The institution of Dr. Charles has received research support from Novartis. The institution of Dr. Charles has received research support from Aeon. The institution of Dr. Charles has received research support from Impax. Ms. Harper has nothing to disclose.