Purpose or Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is a recently defined neuroimmune disorder that presents with a wide range of clinical and radiological features. This study aims to describe the diverse brain MRI findings observed in patients with MOGAD and discuss their clinical implications.
Methods & Materials: We analyzed brain MRI findings in patients diagnosed with MOGAD, focusing on lesion location, morphology, signal characteristics, and contrast enhancement patterns.
Results: Brain MRI findings in MOGAD patients are diverse and include:
White Matter Lesions: Hyperintense demyelinating lesions are commonly observed in the subcortical and deep white matter. These lesions are often asymmetrical and can be extensive.
Grey Matter Lesions: Lesions may involve the cerebral cortex and basal ganglia, distinguishing MOGAD from multiple sclerosis (MS), where grey matter involvement is less common.
Cortical Encephalitis: Cortical inflammation and edema are frequently seen, which may be associated with seizures.
Brainstem Lesions: Asymmetrical lesions in the brainstem can be present, correlating with clinical symptoms such as oculomotor dysfunction and cranial nerve involvement.
Infratentorial Lesions: Lesions in the cerebellum and brainstem may lead to symptoms like ataxia.
Contrast Enhancement: Active inflammation is reflected by contrast enhancement in acute lesions, which may guide treatment decisions.
Conclusions: MOGAD is characterized by diverse brain MRI findings, including both white and grey matter involvement, which are crucial for differentiating it from other demyelinating diseases such as MS. Cortical lesions, asymmetrical brainstem involvement, and contrast enhancement are significant markers. These findings provide valuable information for clinical decision-making and treatment planning.