Updates in NMOSD and MOGAD Diagnosis and Treatment: A Tale of Two Central Nervous System Autoimmune Inflammatory Disorders

Neurol Clin. 2024 Feb;42(1):77-114. doi: 10.1016/j.ncl.2023.06.009. Epub 2023 Aug 7.

Abstract

Aquaporin-4-IgG positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) and myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are antibody-associated diseases targeting astrocytes and oligodendrocytes, respectively. Their recognition as distinct entities has led to each having its own diagnostic criteria that require a combination of clinical, serologic, and MRI features. The therapeutic approach to acute attacks in AQP4+NMOSD and MOGAD is similar. There is now class 1 evidence to support attack-prevention medications for AQP4+NMOSD. MOGAD lacks proven treatments although clinical trials are now underway. In this review, we will outline similarities and differences between AQP4+NMOSD and MOGAD in terms of diagnosis and treatment.

Keywords: AQP4-IgG; Diagnosis; MOG; MOG-IgG; Treatment; aquaporin-4; myelin oligodendrocyte glycoprotein; neuromyelitis optica spectrum disorder.

Publication types

  • Review

MeSH terms

  • Aquaporin 4
  • Autoantibodies
  • Central Nervous System
  • Central Nervous System Diseases*
  • Humans
  • Immunoglobulin G
  • Myelin-Oligodendrocyte Glycoprotein
  • Neuromyelitis Optica* / diagnosis
  • Neuromyelitis Optica* / therapy

Substances

  • Myelin-Oligodendrocyte Glycoprotein
  • Immunoglobulin G
  • Autoantibodies
  • Aquaporin 4