Brain Volume Measures in Adults with MOG-Antibody-Associated Disease: A Longitudinal Multicenter Study

TL;DR

This study finds that brain volume changes in MOGAD patients differ from those in MS patients, suggesting distinct disease mechanisms.

Contribution

The study provides new longitudinal MRI data comparing brain volume changes in MOGAD, RRMS, and healthy controls.

Findings

MOGAD patients showed lower annual brain volume loss compared to RRMS patients.

MOGAD patients had higher global brain and white matter volumes than RRMS patients.

T2 lesion volume increased over time in RRMS but not in MOGAD patients.

Abstract

Background/Objectives: Little is known about the impact of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) on brain atrophy. This multicenter longitudinal study compares brain MRI volumes and T2 lesion volume between MOGAD patients, relapsing-remitting MS (RRMS) patients and a healthy control (HC) group with brain MRI scans available from an online repository. Methods: In total, 16 adult MOGAD patients (9 F) were age- and sex-matched with 44 RRMS patients (17 F) recruited in Verona MS Center and 14 HC subjects. The availability of two brain MRI scans performed 18 ± 6 months apart was mandatory for each patient. Annual percentage brain volume change (PBVC/y), baseline global brain, white matter (WM), gray matter (GM) regional brain volumes and T2 lesion volume were compared between groups. Results: PBVC/y was lower in MOGAD than in RRMS patients (p = 0.014) and lower in HC subjects than in MS patients (p = 0.005). Overall, MOGAD showed higher mean global brain (p = 0.012) and WM volume (p = 0.024) but lower median T2 lesion volume at timepoint 1 (p < 0.001); T2 lesion volume increased over time in the RRMS (p < 0.001) but not in the MOGAD cohort (p = 0.262). Conclusions: The structural brain MRI features of MOGAD show higher global brain and WM volumes and lower brain volume loss over time compared to RRMS, suggesting different underlining pathogenetic mechanisms.

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