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What's new in NMOSD and MOGAD?

R Marignier1

  • 1Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM), hôpital neurologique Pierre-Wertheimer, Bron, France.

Revue Neurologique
|September 14, 2024
PubMed

Insights

This review covers recent advances in neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). It examines diagnostic criteria, seronegative cases, and current/future treatments for these inflammatory demyelinating diseases.

Area of Science:

  • Neuroimmunology
  • Neurology
  • Ophthalmology

Background:

  • Neuromyelitis Optica Spectrum Disorders (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) are rare autoimmune conditions affecting the central nervous system.
  • Advances in understanding antibody targets have refined diagnostic approaches.
  • Significant knowledge gaps remain, particularly concerning seronegative presentations and optimal treatment strategies.

Purpose of the Study:

  • To review novelties in NMOSD and MOGAD.
  • To evaluate proposed MOGAD diagnostic criteria and their implications.
  • To discuss the current understanding and unmet needs in seronegative NMOSD and explore acute treatment options for both conditions.

Main Methods:

  • Mini-review of recent literature on NMOSD and MOGAD.
  • Analysis of proposed MOGAD diagnostic criteria, including cerebrospinal fluid-only antibody positivity.
  • Synthesis of current knowledge on seronegative NMOSD (nosology, clinical, biological, imaging features).

Main Results:

  • Proposed MOGAD criteria require evaluation for limitations and impact on patient subgroups.
  • The "double seronegative" NMOSD group presents diagnostic and therapeutic challenges.
  • Current and future acute treatment strategies for NMOSD and MOGAD are discussed.

Conclusions:

  • Refined diagnostic criteria for MOGAD are emerging, necessitating careful evaluation.
  • Understanding and managing seronegative NMOSD remains a critical unmet need.
  • Optimizing acute treatment is essential for improving outcomes in NMOSD and MOGAD.
Keywords:
Antibodies myelitisMultiple sclerosisMyelin oligodendrocyte glycoproteinNeuromyelitis opticaOptic neuritis

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