MOG antibody and AQP4 antibody seropositive diseases are immunologically distinct subtypes of neuromyelitis optica spectrum disorders (NMOSD) with similar clinical presentations. MRI findings can be instrumental in distinguishing MOG antibody disease from AQP4 antibody NMOSD.
Objectives:
The aim of this study is to characterize the neuroradiological differences between MOG antibody disease and AQP4 antibody NMOSD with the aim to distinguish between the two entities.
Methods:
This is a retrospective study of 26 MOG and 25 AQP4 seropositive patients in which MRI features of the brain, spinal cord, and orbit were compared.
Results:
The majority of the abnormal findings in the MOG cohort were located on orbital MRIs, while spinal cord magnetic resonance (MR) abnormalities were more common in the AQP4 cohort. Brain abnormalities showed some overlap, but cortical gray/juxtacortical white matter involvement was distinct to MOG patients, while area postrema involvement was a rare feature.
Conclusion:
Cortical gray/juxtacortical white matter lesions on brain MRI might help distinguish MOG antibody disease from AQP4-positive NMOSD. These findings could be of value in distinguishing the two entities as early as the first presentation.
OhJLevyM. Neuromyelitis optica: An antibody-mediated disorder of the central nervous system. Neurol Res Int2012; 2012: 460825.
2.
WingerchukDMBanwellBBennettJL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology2015; 85(2): 177–189.
3.
JiaoYFryerJPLennonVA, et al. Updated estimate of AQP4-IgG serostatus and disability outcome in neuromyelitis optica. Neurology2013; 81(14): 1197–1204.
4.
JariusSRuprechtKKleiterI, et al. MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 1: Frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin. J Neuroinflammation2016; 13(1): 279.
5.
ProbstelAKRudolfGDornmairK, et al. Anti-MOG antibodies are present in a subgroup of patients with a neuromyelitis optica phenotype. J Neuroinflammation2015; 12: 46.
6.
KitleyJWoodhallMWatersP, et al. Myelin-oligodendrocyte glycoprotein antibodies in adults with a neuromyelitis optica phenotype. Neurology2012; 79(12): 1273–1277.
7.
KitleyJWatersPWoodhallM, et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: A comparative study. JAMA Neurol2014; 71(3): 276–283.
8.
SpadaroMGerdesLAKrumbholzM, et al. Autoantibodies to MOG in a distinct subgroup of adult multiple sclerosis. Neurol Neuroimmunol Neuroinflamm2016; 3(5): e257.
9.
AkaishiTSatoDKNakashimaI, et al. MRI and retinal abnormalities in isolated optic neuritis with myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies: A comparative study. J Neurol Neurosurg Psychiatry2016; 87(4): 446–448.
10.
RamanathanSPrelogKBarnesEH, et al. Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. Mult Scler2016; 22(4): 470–482.
11.
JariusSRuprechtKKleiterI, et al. MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation2016; 13(1): 280.
12.
MariottoSFerrariSMonacoS, et al. Clinical spectrum and IgG subclass analysis of anti-myelin oligodendrocyte glycoprotein antibody-associated syndromes: A multicenter study. J Neurol2017; 264(12): 2420–2430.
13.
KitleyJLeiteMIKukerW, et al. Longitudinally extensive transverse myelitis with and without aquaporin 4 antibodies. JAMA Neurol2013; 70(11): 1375–1381.
14.
KimHJPaulFLana-PeixotoMA, et al. MRI characteristics of neuromyelitis optica spectrum disorder: An international update. Neurology2015; 84(11): 1165–1173.
15.
KimSMWoodhallMRKimJS, et al. Antibodies to MOG in adults with inflammatory demyelinating disease of the CNS. Neurol Neuroimmunol Neuroinflamm2015; 2(6): e163.
16.
MealyMAWhetstoneAOrmanG, et al. Longitudinally extensive optic neuritis as an MRI biomarker distinguishes neuromyelitis optica from multiple sclerosis. J Neurol Sci2015; 355(1-2): 59–63.
17.
ApplegateKETelloRYingJ. Hypothesis testing III: Counts and medians. Radiology2003; 228(3): 603–608.
18.
Cobo-CalvoARuizAMaillartE, et al. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study. Neurology2018; 90(21): e1858–e1869.
19.
van PeltEDWongYYKetelslegersIA, et al. Neuromyelitis optica spectrum disorders: Comparison of clinical and magnetic resonance imaging characteristics of AQP4-IgG versus MOG-IgG seropositive cases in the Netherlands. Eur J Neurol2016; 23(3): 580–587.
20.
ChenJJFlanaganEPJitprapaikulsanJ, et al. Myelin oligodendrocyte glycoprotein antibody-positive optic neuritis: Clinical characteristics, radiologic clues, and outcome. Am J Ophthalmol2018; 195: 8–15.
21.
KhannaSSharmaAHueckerJ, et al. Magnetic resonance imaging of optic neuritis in patients with neuromyelitis optica versus multiple sclerosis. J Neuroophthalmol2012; 32(3): 216–220.
JurynczykMGeraldesRProbertF, et al. Distinct brain imaging characteristics of autoantibody-mediated CNS conditions and multiple sclerosis. Brain2017; 140(3): 617–627.
24.
DubeyDPittockSJKreckeKN, et al. Clinical, radiologic, and prognostic features of myelitis associated with myelin oligodendrocyte glycoprotein autoantibody. JAMA Neurol2019; 76(3): 301–309.
25.
SatoDKCallegaroDLana-PeixotoMA, et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology2014; 82(6): 474–481.
26.
Dos PassosGROliveiraLMda CostaBK, et al. MOG-IgG-associated optic neuritis, encephalitis, and myelitis: Lessons learned from neuromyelitis optica spectrum disorder. Front Neurol2018; 9: 217.
27.
SepulvedaMArmangueTMartinez-HernandezE, et al. Clinical spectrum associated with MOG autoimmunity in adults: Significance of sharing rodent MOG epitopes. J Neurol2016; 263(7): 1349–1360.
