Brain MRI Differences Between MOG Antibody Disease and AQP4 NMOSD

Myelin Oligodendrocyte Glycoprotein (MOG) antibody and aquaporin-4 (AQP4) antibody seropositive diseases are immunological distinct subtypes of neuromyelitis optica spectrum disorders (NMOSD) with similar clinical presentations. Magnetic resonance imaging (MRI) findings can be instrumental in distinguishing MOG antibody disease from AQP4 antibody NMOSD. This is a retrospective study of 26 MOG and 25 AQP4 seropositive patients in which MRI features of the brain were compared. Brain abnormalities showed some overlap, but cortical grey/ juxtacortical white matter involvement was distinct to MOG patients, while area postrema involvement was a rare feature. Cortical grey/ juxtacortical white matter lesions on brain MRI might help distinguish MOG antibody disease from AQP4 positive NMOSD. These findings could be of value in distinguishing the two entities as early as the first presentation.