# Opposing Influences of Optic Neuritis and Transverse Myelitis on the Future Location of Relapses in MOG Antibody–Associated Disease

## TL;DR

This study found that people with MOG antibody disease who first experience optic neuritis are more likely to have future relapses in the same area, while those with transverse myelitis are less likely to relapse in the same spot.

## Contribution

The study identifies opposing relapse patterns in MOGAD based on the initial clinical manifestation, optic neuritis or transverse myelitis.

## Key findings

- Optic neuritis as the first attack increases the risk of relapse in the same location.
- Transverse myelitis as the first attack decreases the risk of relapse in the same location.
- The study used logistic regression to determine the association between initial attack type and relapse location.

## Abstract

Studies in MS and NMOSD have shown that relapses can frequently occur in the same location as the first attack. Factors associated with this outcome in MOGAD are unclear.

The objective of this study was to investigate the likelihood of a relapse occurring at the same site in MOGAD.

This was a UK national cohort study. MOGAD patients with a minimum of one relapse and one year of follow‐up were included. To identify factors associated with relapse location, logistic regression was performed.

An increased risk of a relapse in the same location was observed when the first attack was optic neuritis—for the second attack (OR 12.9, 95% CI 3.31–50.55, p = .001) and all subsequent attacks (OR 5.39 95% CI 1.61–18.03, p = .006). Conversely, a reduced risk of relapse in the same location was associated with transverse myelitis—for the second attack (OR 0.25, 95% CI 0.07–0.82, p = .022) and all subsequent attacks (OR 0.25 95% CI 0.06–0.96, p = .045).

In relapsing MOGAD, patients with optic neuritis are at high risk of a new attack in the same location, while those with transverse myelitis are at low risk.

Retrospective cohort from the United Kingdom regarding MOGAD relapsing patients to investigate the new attack pattern. Sixty‐three patients were included and patients with optic neuritis as a first clinical manifestation have a high risk of a new attack in the same location. Conversely, patients with transverse myelitis are less likely to have a relapse in the same topography.