MRI characteristics of MOG-Ab associated disease in adults: An update

Area of Science:

• Neuroimmunology
• Neuroradiology
• Demyelinating Diseases

Background:

• Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disorder affecting the central nervous system.
• Distinguishing MOGAD from other inflammatory demyelinating diseases like aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) and multiple sclerosis (MS) is crucial for appropriate treatment and prognosis.
• Advances in understanding MOGAD necessitate an updated review of its characteristic radiological manifestations.

Purpose of the Study:

• To provide a comprehensive overview of the current knowledge on the radiological spectrum of MOGAD.
• To highlight the key magnetic resonance imaging (MRI) features that differentiate MOGAD from AQP4-NMOSD and MS.
• To discuss the diagnostic and prognostic implications of identifying specific MRI findings in MOGAD.

Main Methods:

• Systematic review of adult MOGAD cases with a focus on MRI findings.
• Comparative analysis of MRI features across optic nerve, spinal cord, and brain in MOGAD, AQP4-NMOSD, and MS.
• Integration of current literature on the radiological evolution of MOGAD.

Main Results:

• MOGAD exhibits distinct MRI patterns in the optic nerves, spinal cord, and brain compared to AQP4-NMOSD and MS.
• Specific lesion locations, morphology, and enhancement characteristics on MRI can suggest a diagnosis of MOGAD.
• Understanding these radiological differences is vital for accurate differential diagnosis.

Conclusions:

• MRI plays a pivotal role in the early and accurate diagnosis of MOGAD.
• Recognizing the unique radiological signature of MOGAD facilitates timely and appropriate management, potentially preventing long-term disability.
• Continued research into MOGAD's radiological features will further refine diagnostic criteria and therapeutic strategies.