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Live-Cell-Based Assay Outperforms Fixed Assay in MOGAD Diagnosis: A Retrospective Validation Against the 2023
Anna Zhou1, Weihua Zhang1, Ji Zhou1
1Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing 100045, China.
Diagnostics (Basel, Switzerland)
|January 10, 2026
Summary
The live cell-based assay (Live-CBA) shows higher sensitivity for diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in pediatric patients meeting 2023 criteria. This improves diagnostic accuracy compared to the fixed-cell-based assay (Fixed-CBA).
Area of Science:
- Neurology
- Immunology
- Demyelinating Diseases
Background:
- Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a key demyelinating condition in children.
- Recent establishment of diagnostic criteria for MOGAD necessitates evaluation of diagnostic tools.
- Comparing fixed-cell-based assays (Fixed-CBA) and live cell-based assays (Live-CBA) is crucial for accurate MOGAD diagnosis.
Purpose of the Study:
- To assess and compare the diagnostic performance of Fixed-CBA and Live-CBA.
- To evaluate these assays in patients fulfilling the 2023 MOGAD clinical diagnostic criteria.
- To determine the impact of assay choice on diagnostic classification and accuracy.
Main Methods:
- Retrospective study of 86 patients suspected of MOGAD (June 2023-June 2024).
- Patient selection based on 2023 International MOGAD Panel criteria for core clinical demyelinating events.
- Serum samples tested simultaneously using Fixed-CBA and Live-CBA for MOG antibodies (MOG-Abs); controls included MS, AQP4-Abs-positive NMOSD, and non-CNS inflammatory diseases.
Main Results:
- Live-CBA demonstrated higher sensitivity (55.8%) compared to Fixed-CBA (44.2%), with both assays showing high specificity (97%).
- Cortical encephalitis cases showed the highest MOG-Ab positivity rates: 85.7% (Live-CBA) and 71.4% (Fixed-CBA).
- Live-CBA confirmed more MOGAD cases (28 vs. 19), leading to diagnostic reclassification in nine patients (17.3% improvement).
Conclusions:
- Both Fixed-CBA and Live-CBA show increased sensitivity when applied to patients meeting the 2023 MOGAD criteria.
- The Live-CBA offers an 11.6% increase in sensitivity over Fixed-CBA.
- Utilizing Live-CBA enhances MOGAD diagnostic accuracy by 17.3% in this patient cohort.
