Geraldes, Ruth;
Arrambide, Georgina;
Banwell, Brenda;
Rovira, Àlex;
Cortese, Rosa;
Lassmann, Hans;
Messina, Silvia;
... MAGNIMS Study Group; + view all
(2024)
The influence of MOGAD on diagnosis of multiple sclerosis using MRI.
Nature Reviews Neurology
10.1038/s41582-024-01005-2.
(In press).
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Barkhof_Geraldes_How does Myelin Oligodendrocyte Glycoprotein antibody-mediated disease influence the way we diagnose Multiple Sclerosis using MRI_rev_clean.pdf Access restricted to UCL open access staff until 4 March 2025. Download (358kB) |
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an immune-mediated demyelinating disease that is challenging to differentiate from multiple sclerosis (MS), as the clinical phenotypes overlap, and people with MOGAD can fulfil the current MRI-based diagnostic criteria for MS. In addition, the MOG antibody assays that are an essential component of MOGAD diagnosis are not standardized. Accurate diagnosis of MOGAD is crucial because the treatments and long-term prognosis differ from those for MS. This Expert Recommendation summarizes the outcomes from a Magnetic Resonance Imaging in MS workshop held in Oxford, UK in May 2022, in which MS and MOGAD experts reflected on the pathology and clinical features of these disorders, the contributions of MRI to their diagnosis and the clinical use of the MOG antibody assay. We also critically reviewed the literature to assess the validity of distinctive imaging features in the current MS and MOGAD criteria. We conclude that dedicated orbital and spinal cord imaging (with axial slices) can inform MOGAD diagnosis and also illuminate differential diagnoses. We provide practical guidance to neurologists and neuroradiologists on how to navigate the current MOGAD and MS criteria. We suggest a strategy that includes useful imaging discriminators on standard clinical MRI and discuss imaging features detected by non-conventional MRI sequences that demonstrate promise in differentiating these two disorders.
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