Radiologic Lag and Brain MRI Lesion Dynamics During Attacks in MOG Antibody–Associated Disease
Laura Cacciaguerra, Omar Abdel‐Mannan, Dimitrios Champsas, Kshitij Mankad, Karl N. Krecke, John J. Chen, Stephanie B. Syc‐Mazurek, Vyanka Redenbaugh, A. Sebastian López‐Chiriboga, Cristina Valencia-Sánchez, Cheryl Hemingway, Jan‐Mendelt Tillema, Olga Ciccarelli, Sean J. Pittock, Yael Hacohen, Eoin P. Flanagan
Abstract
BACKGROUND AND OBJECTIVES: Knowledge of the evolution of CNS demyelinating lesions within attacks could assist diagnosis. We evaluated intra-attack lesion dynamics in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) vs multiple sclerosis (MS) and aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorder (AQP4+NMOSD). METHODS: /Fisher exact test for statistical analysis. RESULTS: = 0.007). Resolution of ≥1 T2 lesions was exclusive to MOGAD (7/58 [12%]). DISCUSSION: Radiologic lag is common within MOGAD attacks. Dynamic imaging with frequent appearance and occasional disappearance of lesions within a single attack suggest MOGAD diagnosis over MS and AQP4+NMOSD. These findings have implications for clinical practice, clinical trial attack adjudication, and understanding of MOGAD pathogenesis.