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Different magnetic resonance imaging features between MOG antibody- and AQP4 antibody-mediated disease: A Chinese
Chen Chen1, Chunxin Liu1, Ling Fang2
1Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China.
Abstract:
Few studies have compared radiological features obtained on magnetic resonance imaging (MRI) between myelin oligodendrocyte glycoprotein antibody (MOG-ab)- and aquaporin 4 antibody (AQP4-ab)-positive patients. In this study, 77 MOG-ab and 92 AQP4-ab patients were enrolled. The results demonstrated that the brain MRI-based incidence of subcortical white matter lesions was higher in MOG-ab patients (p < .000) than in AQP4-ab patients and that the former therefore had a higher incidence of periventricular lesions (p = .003). The posterior limb of the internal capsule was more prone to lesions in MOG-ab patients (p = .019). Large lesions and U- or S-shaped lesions were also more frequent in MOG-ab (p < .000 and p = .013, respectively). Half of the MOG-ab patients had spinal cord involvement, and 36.5% presented with longitudinally extensive transverse myelitis (LETM). However, among the MOG-ab and AQP4-ab patients with spinal attack, there was no significant difference in the proportion with LETM (p = .057). In conclusion, a higher proportion of MOG-ab patients than AQP4-ab patients had brain lesions in white matter. Among MOG-ab patients who had an attack in the spinal cord, 65.5% also had LETM during the disease course. Conus medullaris lesions were rare in Chinese MOG-ab patients.
Insights
Myelin oligodendrocyte glycoprotein antibody (MOG-ab) and aquaporin 4 antibody (AQP4-ab) patients show distinct brain MRI features. MOG-ab patients exhibit more white matter lesions, including subcortical and periventricular types.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Few studies compare MRI findings between MOG-ab and AQP4-ab positive patients.
- Understanding radiological differences aids in diagnosing and managing these autoimmune neurological conditions.
Purpose of the Study:
- To compare the radiological features on MRI between MOG-ab and AQP4-ab positive patients.
- To identify distinct lesion patterns associated with each antibody type.
Main Methods:
- Retrospective analysis of MRI scans from 77 MOG-ab and 92 AQP4-ab patients.
- Comparison of lesion location, size, and shape between the two groups.
Main Results:
- MOG-ab patients showed a higher incidence of subcortical white matter lesions (p < .000) and periventricular lesions (p = .003) compared to AQP4-ab patients.
- Posterior limb of the internal capsule lesions (p = .019), large lesions (p < .000), and U- or S-shaped lesions (p = .013) were more frequent in MOG-ab patients.
- Spinal cord involvement was observed in half of MOG-ab patients, with 36.5% presenting longitudinally extensive transverse myelitis (LETM); however, no significant difference in LETM proportion was found between MOG-ab and AQP4-ab patients with spinal attacks (p = .057).
Conclusions:
- MOG-ab positivity is associated with a greater proportion of white matter brain lesions compared to AQP4-ab positivity.
- Among MOG-ab patients with spinal cord attacks, a significant proportion (65.5%) experienced LETM.
- Conus medullaris lesions were infrequent in the studied Chinese MOG-ab patient cohort.
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