# Cognitive function in patients with myelin oligodendrocyte glycoprotein antibody-associated disease

## TL;DR

This study compares cognitive function in patients with MOGAD to healthy controls and other neurological disorders, finding similar risks for cognitive impairment.

## Contribution

The study provides the first detailed analysis of cognitive impairment in adult patients with MOGAD compared to multiple neurological disease groups.

## Key findings

- Patients with MOGAD showed worse performance in information processing speed and verbal memory compared to healthy controls.
- The risk of cognitive impairment in MOGAD was similar to that in AQP4+NMOSD and dsNMOSD patients.
- Cognitive impairment was defined as performance two standard deviations below healthy control means in specific tests.

## Abstract

Data on cognition in adult patients with myelin oligodendrocyte glycoprotein antibody-associated disease (pwMOGAD) are scarce.

To examine cognitive function in pwMOGAD and assess relative risks (RR) for cognitive impairment (CImp) in pwMOGAD relative to healthy controls (HC), aquaporin 4-immunoglobulin G positive neuromyelitis optica spectrum disorders (pwAQP4+NMOSD), and double-seronegative NMOSD (pwdsNMOSD) compared to HC.

Data derived from a cohort with neuroimmunological disorders. Cognitive performance was assessed using Rao’s brief repeatable battery of neuropsychological tests, compared to HC using confounder-adjusted linear regressions. CImp was defined as performing two standard deviations below the HC mean in any subtest. RR for CImp was calculated using generalized linear models.

We evaluated cognitive performance of 21 pwMOGAD and 25 HC. CImp was additionally determined in 43 pwAQP4+NMOSD and 15 pwdsNMOSD. PwMOGAD performed worse on Selective Reminding Test, and the symbol digit modalities test compared to HC. Adjusted RR for CImp were 1.9 (95% CI 0.9–4.1) in pwMOGAD, 1.9 (95% CI 1.0–3.9) in pwAQP4+NMOSD and 2.1 (95% CI 0.9–4.6) in pwdsNMOSD.

pwMOGAD performed worse in information processing speed, verbal learning, storage and retrieval compared to HC. RR for CImp in pwMOGAD compared to HC was similar to that estimated for pwAQP4+NMOSD and pwdsNMOSD.

The online version contains supplementary material available at 10.1007/s00415-025-13582-3.