MOGAD: How It Differs From and Resembles Other Neuroinflammatory Disorders

Central vein sign and other radiographic features distinguishing myelin oligodendrocyte glycoprotein antibody disease from multiple sclerosis and aquaporin-4 antibody-positive neuromyelitis optica

“…Several recognized features of MOGAD optic neuritis were also identified in this study, including longitudinally extensive optic nerve lesions (median = 3.0 cm; range = 0.6-4.6 cm), significant rates of bilateral involvement (over 40%), anterior optic nerve involvement, and perineural sheath enhancement in active cases (Figure 5(c) and (d)). 5,10,24,25 Although dedicated orbital MRIs were not obtained in most of our MS and NMOSD patients, these findings contrast with known features of optic neuritis in MS and AQP4+ NMOSD. 5,10,24 Defining the radiographic features of MOGAD is of importance to address the prevalent problem of MS misdiagnosis.…”

“…5,10,24,25 Although dedicated orbital MRIs were not obtained in most of our MS and NMOSD patients, these findings contrast with known features of optic neuritis in MS and AQP4+ NMOSD. 5,10,24 Defining the radiographic features of MOGAD is of importance to address the prevalent problem of MS misdiagnosis. Misinterpretation of MRI findings plays a large role in MS misdiagnosis.…”

“…Historically, MOGAD patients have been classified as having AQP4-seronegative NMOSD, in many cases with LETM helping to meet the diagnostic criteria for seronegative NMOSD. 23 LETM, conus involvement, and central cord involvement have all been recognized to suggest MOGAD, 8,24 but none of these features were able to discriminate MOGAD from AQP4+ NMOSD in this study. Several recognized features of MOGAD optic neuritis were also identified in this study, including longitudinally extensive optic nerve lesions (median = 3.0 cm; range = 0.6-4.6 cm), significant rates of bilateral involvement (over 40%), anterior optic nerve involvement, and perineural sheath enhancement in active cases (Figure 5(c) and (d)).…”

Magnetic resonance imaging in neuromyelitis optica spectrum disorder

“…Longitudinally extensive spinal cord lesions are also seen in MOGAD [83] and monophasic (or relapsing) transverse myelitis without associated antibodies [84]. Lesions extending the whole length of the spinal cord to the conus can be seen in MOGAD, and this is uncommon in NMOSD [85,86]. In antibody-negative longitudinally extensive transverse myelitis the occurrence of another form of NMOSD-associated clinical attack would suggest seronegative NMOSD.…”

Two Pools of ATP Detected in the Brains of Pediatric Patients with Myelin Oligodendrocyte Glycoprotein Antibody Disorders (MOGAD) by 3D31P MR Spectroscopic Imaging (MRSI) at 7T

“…[24][25][26][27][28][29] This study is carried out on a cohort of pediatric patients with myelin oligodendrocyte glycoprotein antibody disorders (MOGAD)  an idiopathic, inflammatory, demyelinating condition of the central nervous system (CNS), with heterogeneity in individual symptoms, radiological manifestations and clinical course. [30][31][32] MOGAD lesions are often nonspecific on conventional MRI imaging; the diagnosis at the initial presentation requires an accurate serum antibody test. [31][32][33] Currently, there is still a lack of understanding of the molecular, biochemical and cellular mechanisms that cause specific lesions to form, though several energy abnormalities are considered to be present at the sites of demyelination.…”