Distinct patterns of MRI lesions in MOG antibody disease and AQP4 NMOSD: a systematic review and meta-analysis

Clinical Features and Imaging Findings of Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disorder (MOGAD)

“…Lumbosacral spinal cord involvement is a characteristic manifestation of MOGAD, which is significantly higher than that in NMOSD and MS patients ( Kitley et al, 2014 ; Sato et al, 2014 ). Carandini’s meta-analysis yielded similar results (OR = 3.47; 95% CI = 1.66–7.24; p = 0.0009) ( Carandini et al, 2021 ). The incidence of lumbar medulla and conus involvement has been reported to be approximately 30.1-41% ( Dubey et al, 2019 ; Ciron et al, 2020 ; Rempe et al, 2021 ).…”

“…As we searched, it became clear that MOGAD patients usually have longitudinally bilateral optic nerve swelling, and abnormal signals around sheath or adipose tissue were occasionally found on imaging ( Deneve et al, 2019 ; Ducloyer et al, 2020 ; Shor et al, 2021 ). Meta-analysis results of Carandini et al (2021) showed that retrobulbar ON ( p = 0.0006) is usually caused by MOG-IgG, accompanied by optic papilloedema ( p < 0.00001). Gao et al (2021) recently used ophthalmological indicators (fractional anisotropy, primary visual cortex volume, visual acuity) to analyze the structural and functional changes after ON in MOGAD patients, and the results showed that the AQP-4 group exhibited lower indicator values than the healthy control group, but there was no difference in the values between the MOGAD group and the control group, which may be the reason why MOGAD patients usually had a better prognosis.…”

“…MOGAD is a demyelinating disease of the central nervous system (CNS). Typical symptoms of MOGAD include ON and myelitis, which overlap with multiple sclerosis (MS) and NMOSD ( Carandini et al, 2021 ). Although the specific pathophysiologic mechanism remains inconclusive, MOGAD usually manifests as direct demyelinating pathological changes that are similar to MS, unlike NMOSD, in which astrocytes are first damaged and then demyelinated ( Salama et al, 2019 ; Mader et al, 2020 ).…”

“…Optic neuritis (ON) is the most common symptom of MOGAD in adults, occurring in approximately 54-61% of patients ( Biotti et al, 2017 ; Hacohen et al, 2017 ; Cobo-Calvo et al, 2018 ; Carandini et al, 2021 ; Kunchok et al, 2021b ). Miller et al (2020) prospectively observed 65 patients diagnosed with acute ON within 1 year, 14% of whom were MOG-IgG positive.…”

“…In general, MRI of the optic nerve in MOGAD patients shows hyperintensity on T2-weighted images and significant enhancement after gadolinium administration. Abnormal optic nerve signals are located in the anterior part of the optic nerve and the retrobulbar region, rarely involving the optic chiasma ( Carandini et al, 2021 ). The extent of ON is usually more than half of the optic nerve length ( Shor et al, 2021 ).…”