2026 American Academy of Neurology Autoimmune Abstract Website

Objective:

To estimate the prevalence of depression in individuals with MOGAD and to identify demographic and clinical factors associated with depression in this population.

Background:

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare inflammatory disease of the central nervous system. Depression can undermine quality of life, treatment adherence, and disease outcomes. Its consequences are well documented in other demyelinating diseases, but its prevalence and impact in MOGAD remain unknown.

Design/Methods:

We identified adults with MOGAD enrolled in the patient-reported-outcomes sub-study of CANOPTICS, a Canadian prospective cohort of MOGAD and neuromyelitis optica spectrum disorder. At participant’s first study visit we collected: clinical variables (attack type, disease course [relapsing/monophasic], number of prior relapses, immunosuppressive therapy use, and expanded disability status score (EDSS), demographic data, brain and spinal MRI findings, and self-reported questionnaires for depression (Beck Depression Inventory-II [BDI-II]), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale), and pain intensity (McGill Pain Questionnaire–Short Form Visual Analogue Scale). Clinically significant depressive symptoms were defined as BDI-II≥14. Descriptive statistics and Spearman rank correlations were used for analysis.

Results:

Seventy-nine participants with MOGAD (58.2% female; mean age=44.0 [SD=13.7] years; 58.2% relapsing disease) were included in the analysis. Twenty-eight of the individuals with MOGAD (35.7%) presented with depression, which was moderate/severe in 19/28 (67.9%). Greater depressive symptoms correlated strongly with anxiety symptoms (ρ=0.76; 95%CI:0.62-0.86) and moderately with fatigue (ρ=0.48; 95%CI:0.28-0.66) and pain intensity (ρ=0.49; 95%CI:0.27-0.67); all associations were statistically significant (p<0.001). Relapsing disease, number of previous relapses and EDSS were not associated with depression.

Conclusions:

This study highlights a significant mental health burden in individuals with MOGAD characterized by depression, anxiety, fatigue, and pain, which tend to co-occur. These results highlight the impact of MOGAD beyond physical neurologic disability.