Brain structural and functional alterations in MOG antibody disease

Area of Science:

• Neuroscience
• Immunology
• Radiology

Background:

• The impact of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) on brain structure and function remains largely unknown.
• Understanding these changes is crucial for diagnosis and management.

Purpose of the Study:

• To investigate multimodal brain MRI alterations in MOGAD.
• To explore the clinical significance of these MRI findings.
• To differentiate MOGAD from aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders (AQP4+NMOSD).

Main Methods:

• Recruited 17 MOGAD, 20 AQP4+NMOSD, and 28 healthy controls (HC).
• Utilized voxel-wise gray matter (GM) volume, fractional anisotropy (FA), mean diffusivity (MD), and degree centrality (DC) analyses.
• Employed partial correlation and stepwise logistic regression for clinical associations and differential diagnosis.

Main Results:

• MOGAD patients showed GM atrophy and white matter (WM) fiber disruption compared to HC.
• Distinct patterns of GM volume and DC alterations were observed in MOGAD compared to AQP4+NMOSD.
• Hippocampus/parahippocampus atrophy correlated with disability and cognitive impairment.

Conclusions:

• MOGAD is associated with unique structural and functional brain alterations.
• Hippocampal atrophy is a key finding linked to clinical disability and cognitive deficits in MOGAD.
• Multimodal MRI, particularly FA and DC, can accurately differentiate MOGAD from AQP4+NMOSD.