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DISSECTION O - ESOC25-604 FIBROMUSCULAR DYSPLASIA AND SPONTANEOUS CERVICAL ARTERY DISSECTION: A SECONDARY ANALYSIS OF THE STOP-CAD STUDY Ahmad Nehme 1 , Liqi Shu 2 , Marion Boulanger 1 , Daniel Mandel 2 , Christopher Leon Guerrero 3 , Esther Kim 3 , Nils Henninger 4 , Bastien Rioux 5 , Aaron Rothstein 6 , Michele Romoli 7 , Setareh Salehi Omran 8 , Marialuisa Zedde 9 , Richa Sharma 10 , Shadi Yaghi 2 , Emmanuel Touz 1 1 Department of Neurology, CHU de Caen-Normandie, Caen, France, 2 Department of Neurology, The Warren Alpert Medical School of Brown University, Brown Medical School, Providence, United States, 3 Sanger Heart and Vascular Institute, Atrium Health, Charlotte, United States, 4 Department of Neurology, University of Massachusetts Chan Medical School, Worcester, United States, 5 Department of Neurosciences, Universit de Montral, Montreal, Canada, 6 Department of Neurology, University of Pennsylvania, Philadelphia, United States, 7 Department of Neurosciences, Bufalini Hospital, Cesena, Italy, 8 Department of Neurology, University of Colorado, Aurora, United States, 9 Neurology Unit, Stroke Unit, Azienda Unit Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy, 10 Department of Neurology, Yale New Haven Hospital, New Haven, United States Background and Aims: Fibromuscular dysplasia (FMD) is found in 6-14% of patients with spontaneous cervical artery dissection (sCeAD)

What they found: Significant improvement in muscle insulin signaling (AKT/mTOR pathway) Increased expression of genes for mitochondrial biogenesis Increased expression of tissue remodeling Drop in HOMA-IR of ~25 % No adverse events Why it matters: This was the first high-quality randomized clinical trial of NMN in humans

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