Brain MRI features of Chinese Han patients with MOG-antibody disease

Background The spectrum of imaging features of patients with MOG antibody disease (MOGAD) remains unclear. We aimed to determine the brain MRI features of MOGAD in a Chinese Han cohort and to assess differences in brain MRI features between MOGAD and neuromyelitis optica spectrum disorders (NMOSDs). Methods We retrospectively reviewed the MRI images of 43 patients with MOGAD. As a routine diagnostic approach, all patients underwent serum aquaporin 4 IgG (AQP4-IgG) and MOG-IgG detection via cell-based assays. The topographies and features of brain lesions were independently assessed by two raters. As a comparison, topographies and features of brain lesions were also assessed using neuroimaging characteristics of NMOSDs recommended by the international panel for NMO diagnosis (IPND) in 2015. Results Thirty-five (81.4%) patients were found to have brain lesions. These brain lesions were classified into the following three patterns according to their distributions: (I) lesions involving midline structures and deep gray matte; (II) supratentorial white matter lesions; and (III) cortical gray matter lesions. There were 17 patients whose brain lesions did not fulfill the neuroimaging characteristics of NMOSDs recommended by the 2015 IPND, in which 11 patients had cortical gray matter lesions and/or juxtacortical white matter lesions, four patients had middle cerebral peduncles lesions, and two patients had gray matter lesions and juxtacortical white matter lesions, as well as middle cerebral peduncles lesions. Conclusion MOGAD in this Chinese Han cohort exhibited distinct brain MRI features, especially in terms of cortical gray matter lesions, juxtacortical white matter lesions, and middle cerebral peduncles lesions, which may help to further identify and diagnose patients with MOGAD while they are waiting for serological antibody results.