Neuropsychologic impact of MOGAD: A patient reported outcomes study

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune demyelinating disorder of the central nervous system with monophasic or relapsing courses. While acute outcomes are well described, long-term patient-reported effects on cognition, fatigue, mood, and vision remain understudied.

To evaluate the feasibility of implementing patient-reported outcome measures (PROMs) in MOGAD and to characterize 12-month changes in quality of life, cognition, fatigue, anxiety, depression, and visual function.

Twenty-two adults meeting 2023 MOGAD criteria were enrolled from Massachusetts General Hospital, Brigham and Women's Hospital, and Mass Eye and Ear Infirmary. PROMs were administered at baseline, and at 3-, 6-, 9-, and 12-month intervals via REDCap, including PROMIS10 Global Physical and Mental Health, PROMIS Cognitive Abilities v2.0, PHQ-9, ASQ, MFIS, and NEI-VFQ-25. Mixed-effects models tested longitudinal effects, and cross-sectional analyses examined associations with phenotype, MOG-IgG titer, relapse, maintenance therapy, and psychiatric comorbidities.

ASQ (H(1)=3.77, p = 0.05) and VFQ-25 (H(1)=4.96, p = 0.03) scores were lower in patients with optic neuritis, while other phenotypes showed no PROM differences. No significant longitudinal changes were observed in any PROM. MOG-IgG titer and relapse status did not predict baseline scores. Patients receiving maintenance therapy had lower PROMIS10 Mental scores at baseline (44.9 vs. 48.3; p = 0.02). Mean ASQ rose from 96.6 to 130.8 over 12 months, exceeding reference values for anxiety; the same three patients with elevated ASQ also had PHQ-9 scores >10, indicating depression.

PROM implementation in MOGAD is feasible and highlights persistent fatigue, mood, and visual impairment, supporting routine use for patient-centered care.