Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

Abstract

Aims: To explore differences in advanced brain magnetic resonance imaging (MRI) characteristics between myelin oligodendrocyte (MOG) immunoglobulin (IgG) and aquaporin-4 (AQP4) IgG seropositive (+) neuromyelitis optica spectrum disorders (NMOSD). Methods: 33 AQP4-IgG and 18 MOG-IgG seropositive NMOSD patients and 61 healthy control (HC) subjects were included. All 112 participants were scanned with the same standardized MRI-protocol on a 3-Tesla MRI-scanner. Brain volume and diffusion tensor imaging (DTI) parameters were assessed. Results: MOG-IgG+ patients showed reduced parallel diffusivity within white matter tracts compared to HC whereas AQP4-IgG+ showed no significant brain parenchymal damage in DTI analysis. AQP4-IgG+ patients showed reduced whole brain volumes and reduced volumes of several deep gray matter structures compared to HC whereas MOG-IgG+ patients did not show reduced brain or deep gray matter volumes compared to HC. Conclusions: Microstructural brain parenchymal damage in MOG-IgG+ patients was more pronounced than in AQP4-IgG+ patients, compared with HC, whereas normalized brain volume reduction was more severe in AQP4-IgG+ patients. Longitudinal imaging studies are warranted to further investigate this trend in NMOSD. Our results suggest Schmidt et al. MRI Differences in NMOSD that MOG-IgG+ and AQP4-IgG+ NMOSD patients differ in cerebral MRI characteristics. Advanced MRI analysis did not help to differentiate between MOG-IgG+ and AQP4-IgG+ patients in our study.

Anti-aquaporin 4 IgG Is Not Associated With Any Clinical Disease Characteristics in Neuromyelitis Optica Spectrum Disorder

“…Demographic characteristics, diagnoses, medical history, age at disease onset, time to diagnosis, duration of clinical observation, clinical attacks, attack-related factors such as clinical presentation, attack treatment, attack outcome and remission rate, resulting disability, other therapies, short-term remission status, laboratory values from routine tests, AQP4-and MOG-aAb status as determined by cell-based assays [due to its high relevance in this disease group (28)(29)(30)], annualized relapse rate (ARR), optical coherence tomography (OCT) (24) as well as magnetic resonance imaging (MRI) results (31) and an array of other variables ( Supplementary Table 1 Questionnaire (NEI-VFQ), National Eye Institute Visual Function Questionnaire (NEI-VFQ), Neuro-Ophthalmic Supplement (NOS) and visual analog scales (VAS) for general well-being, cognition, pain and fatigue, were also included. A complete list of all 1,232 variables can be found in Supplementary Table 1.…”

Practical recognition tools of immunoglobulin G serum antibodies against the myelin oligodendrocyte glycoprotein‐positive optic neuritis and its clinical implications

“…Aside from localized damage, Chien et al found that in AQP4‐IgG‐positive patients, deep grey matter volumes are decreased with an increased history of combined NMOSD‐related attack counts and disease duration 84 . There are still discrepancies in findings regarding deep grey matter volume differences in AQP4‐IgG‐seropositive NMOSD patients and healthy controls, where some studies find no significant differences, 85 whereas other studies have found some decreases in volumes 82,84 . There is evidence that deep grey matter involvement does occur, especially in children with MOG‐IgG‐seropositive autoimmune encephalitis 86 .…”

“…85 whereas other studies have found some decreases in volumes. 82,84 There is evidence that deep grey matter involvement does occur, especially in children with MOG-IgGseropositive autoimmune encephalitis. 86 These findings increase the likelihood that deep grey matter regions of the brain are affected in adult MOGAD as well and should be further studied.…”

“…Evaluation of advanced MRI metrics in NMOSD and MOGAD could offer more discriminatory power, and elucidate microstructural differences in the CNS between patients with NMOSD and MOGAD. Recently, Schmidt et al showed that despite no differences in the whole brain and deep grey matter volumes of the brain between MOG‐IgG‐seropositive patients from healthy controls, a decreased parallel diffusivity in the whole brain diffusion tensor analysis was found 82 . Meanwhile, no differences in diffusion‐weighted MRI metrics were found between AQP4‐IgG‐seropositive NMOSD patients and healthy controls, indicating that white matter tracts are more affected in MOGAD than in AQP4‐IgG‐positive patients.…”

“…Recently, Schmidt et al showed that despite no differences in the whole brain and deep grey matter volumes of the brain between MOG-IgG-seropositive patients from healthy controls, a decreased parallel diffusivity in the whole brain diffusion tensor analysis was found 82. Meanwhile, no differences in diffusion-weighted MRI met-…”