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Updated: Jul 9, 2025
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Published on: July 19, 2019
A longitudinal analysis of brain volume changes in myelin oligodendrocyte glycoprotein antibody-associated disease
Mohammad Amin1,2, Oun Al-Iedani3,4, Rodney A Lea4,5
1Nepean Hospital, Kingswood, New South Wales, Australia.
Background And Purpose:
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a relapsing demyelinating condition. There are several cross-sectional studies showing evidence of brain atrophy in people with MOGAD (pwMOGAD), but longitudinal brain volumetric assessment is still an unmet need. Current recommendations do not include monitoring with MRI and assume distinct attacks. Evidence of ongoing axon loss will have diagnostic and therapeutic implications. In this study, we assessed brain volume changes in pwMOGAD over a mean follow-up period of 2 years and compared this to changes in people with multiple sclerosis (pwMS).
Methods:
This is a retrospective single-center study over a 7-year period from 2014 to 2021. MRI brain scans at the time of diagnosis and follow-up in remission were collected from 14 Caucasian pwMOGAD, confirmed by serum myelin oligodendrocyte glycoprotein immunoglobulin G antibody presence, detected by live cell-based assays. Total brain volume (TBV), white matter (WM), gray matter (GM), and demyelinating lesion volumes were assessed automatically using the Statistical Parametric Mapping and FMRIB automated segmentation tools. MRI brain scans at diagnosis and follow-up on remission were collected from 32-matched pwMS for comparison. Statistical analysis was done using analysis of variance.
Results:
There is evidence of TBV loss, affecting particularly GM, over an approximately 2-year follow-up period in pwMOGAD (p < .05), comparable to pwMS. WM and lesion volume change over the same period were not statistically significant (p > .1).
Conclusion:
We found evidence of loss of GM and TBV over time in pwMOGAD, similar to pwMS, although the WM and lesion volumes were unchanged.
Insights
Brain atrophy occurs in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) over two years, similar to multiple sclerosis. This longitudinal study reveals gray matter loss in MOGAD patients, highlighting the need for monitoring.
Area of Science:
- Neuroimmunology
- Neurodegeneration
- Radiology
Background:
- Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a relapsing demyelinating condition.
- Cross-sectional studies suggest brain atrophy in MOGAD, but longitudinal data is lacking.
- Current MOGAD management does not include MRI monitoring and assumes distinct attacks.
Purpose of the Study:
- To assess longitudinal brain volume changes in people with MOGAD (pwMOGAD).
- To compare brain volume changes in pwMOGAD to those in people with multiple sclerosis (pwMS).
- To investigate potential ongoing axon loss for diagnostic and therapeutic implications.
Main Methods:
- Retrospective single-center study (2014-2021) of 14 pwMOGAD and 32 matched pwMS.
- Collected MRI brain scans at diagnosis and follow-up (mean 2-year interval).
- Automated assessment of Total Brain Volume (TBV), White Matter (WM), Gray Matter (GM), and lesion volumes using SPM and FSL tools.
Main Results:
- Evidence of TBV loss, particularly affecting GM, in pwMOGAD over ~2 years (p < .05).
- Brain volume loss in pwMOGAD was comparable to that observed in pwMS.
- No statistically significant changes in WM or demyelinating lesion volumes were detected over the follow-up period (p > .1).
Conclusions:
- Longitudinal studies show gray matter and total brain volume loss in MOGAD over time.
- The rate of brain volume loss in MOGAD is similar to that in multiple sclerosis.
- Further research is needed to understand the implications of these volumetric changes for MOGAD patient management.
