Objective:

To determine MRI lesion frequency in distinct neuro-anatomic compartments in MOGAD patients at different ages of presentation.

Background:

MOGAD is a novel neuro-inflammatory disorder that appears to present differently clinically in children (usually acute disseminated encephalomyelitis) and adults (usually more restricted forms, e.g. optic neuritis or myelitis). Relatively little is known about differences in radiologic involvement in adults and children at the time of presentation.

Design/Methods:

We included all patients with neurologist-diagnosed MOGAD in NYU MS Center database who had both brain and spinal cord MRIs available for review from the time of presentation. MRI and reports were reviewed and the presence of lesions in the optic nerve, supra- and infra-tentorial brain, spinal cord, and spinal roots were ascertained (present v absent). Patients were divided into pediatric (0-17 years) and adult (18+ years) groups and lesion frequency in each compartment were compared with chi-square test, χ². p<0.05 was considered significant.

Results:

54 patients met inclusion criteria (all seropositive for MOG antibody by cell-based assay). Mean age in years, was 9.52 ± 4.1 in children and 40.31 ± 14 in adults; male-to-female ratio was 2:3 in children and 1:1.2 in adults; 60.0% of children were non-White, as were 39.7% of adults. Course was monophasic in 24.0% of children and 34.5% in adults. A significant difference in lesion frequency between groups was found in the supratentorial compartment (72.0% pediatric vs 31.0% adult, p=0.003) but not in the optic nerve (60.0% vs 55.2%, p=0.72), infratentorial brain (36.0% vs 31.0%, p=0.70), spinal cord (56.0% vs 41.4%, p=0.29), and spinal nerve roots  (12.0% vs 24.1%, p=0.25)

Conclusions:

In children with MOGAD, supratentorial brain was more frequently involved than in adults, while other neuroanatomic compartments were similarly affected.