Silent New Brain MRI Lesions in Children with MOG‐Antibody Associated Disease
Giulia Fadda, Brenda Banwell, Patrick Waters, Ruth Ann Marrie, E. Ann Yeh, Julia O’Mahony, Douglas L. Arnold, Amit Bar‐Or, the Canadian Pediatric Demyelinating Disease Network
Abstract
Anti-myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) antibodies are associated clinically with either a monophasic or relapsing disease course. We investigated the frequency and clinical importance of acquired asymptomatic brain magnetic resonance imaging (MRI) lesions in a prospective incident cohort of 74 MOG-IgG positive children with serial MRI scans over a median of 5 years from presentation. Silent new lesions were detected in 14% of MOG-IgG positive participants, most commonly within the first months post-onset, with a positive predictive value for clinically relapsing disease of only 20%. Detection of asymptomatic lesions alone need not prompt initiation of chronic immunotherapy. ANN NEUROL 2021;89:408-413.