Comparative analysis of clinical and imaging data between patients with myelin oligodendrocyte glycoprotein antibody disease and patients with aquaporin 4 antibody-positive neuromyelitis optica spectrum disorder

J Neurol. 2022 Mar;269(3):1641-1650. doi: 10.1007/s00415-021-10749-6. Epub 2021 Aug 12.

Abstract

Background: We aimed to compare the clinical data, laboratory findings, and imaging characteristics of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) and aquaporin 4 antibody (AQP4)-positive neuromyelitis optica spectrum disorder (NMOSD), as detailed comparative analyses of laboratory data for both diseases are rare.

Methods: Our retrospective study compared the clinical data, laboratory findings, and imaging characteristics of 118 AQP4-positive patients with first-episode NMOSD and 25 patients with first-episode MOGAD. Logistic regression was used to determine the factors that differentiated MOGAD and AQP4-positive NMOSD.

Results: There were significant differences in age, symptoms, recurrence rate, laboratory indicators, and imaging examinations between patients with MOGAD and patients with AQP4-positive NMOSD. Patients with MOGAD were younger and had higher levels of uric acid than those with AQP4-positive NMOSD. The proportion of cortical gray matter/juxtacortical white matter lesions was significantly higher in the MOGAD group than in the NMOSD group. Logistic regression revealed that young age [odds ratio (OR) = 0.947, 95% confidence interval (CI) = 0.905-0.99], high uric acid level (OR = 1.016, 95% CI = 1.006-1.027), and cortical gray matter/juxtacortical white matter involvement (OR = 3.889, 95% CI = 1.048-14.442) were significantly related to MOGAD.

Conclusion: The multivariate analysis of the present study demonstrated that age, uric acid level, and the presence of lesions in the cortical gray matter/juxtacortical white matter can aid in distinguishing patients with AQP4-positive NMOSD from those with MOGAD. These factors may also aid in determining which patients should be tested for antibodies.

Keywords: Aquaporin 4; Gray matter; Myelin oligodendrocyte glycoprotein; Neuromyelitis optica spectrum disorder; Uric acid; White matter.

Publication types

  • Comparative Study

MeSH terms

  • Aquaporin 4* / immunology
  • Autoantibodies
  • Demyelinating Autoimmune Diseases, CNS* / diagnostic imaging
  • Humans
  • Myelin-Oligodendrocyte Glycoprotein
  • Neuromyelitis Optica* / diagnostic imaging
  • Retrospective Studies

Substances

  • Aquaporin 4
  • Autoantibodies
  • Myelin-Oligodendrocyte Glycoprotein