Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI

ABSTRACT Background Myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) can radiographically mimic multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The disease hallmarks cortical lesion, central vein sign (CVS) and paramagnetic rim lesions identified in...

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Main Authors: Lei Su, Joseph Kuchling, Chenyang Gao, Thoralf Niendorf, Carsten Finke, Zhe Zhang, Ai Guo, Jing Jing, De‐Cai Tian, Yu‐Jing Li, Mengting Zhang, Xiaoyu Shi, Xinyao Liu, Huabing Wang, Yaou Liu, Claudia Chien, Michael Levy, Yunyun Duan, Friedemann Paul, Fu‐Dong Shi
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Annals of Clinical and Translational Neurology
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Online Access:https://doi.org/10.1002/acn3.70080
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author Lei Su
Joseph Kuchling
Chenyang Gao
Thoralf Niendorf
Carsten Finke
Zhe Zhang
Ai Guo
Jing Jing
De‐Cai Tian
Yu‐Jing Li
Mengting Zhang
Xiaoyu Shi
Xinyao Liu
Huabing Wang
Yaou Liu
Claudia Chien
Michael Levy
Yunyun Duan
Friedemann Paul
Fu‐Dong Shi
author_facet Lei Su
Joseph Kuchling
Chenyang Gao
Thoralf Niendorf
Carsten Finke
Zhe Zhang
Ai Guo
Jing Jing
De‐Cai Tian
Yu‐Jing Li
Mengting Zhang
Xiaoyu Shi
Xinyao Liu
Huabing Wang
Yaou Liu
Claudia Chien
Michael Levy
Yunyun Duan
Friedemann Paul
Fu‐Dong Shi
author_sort Lei Su
collection DOAJ
description ABSTRACT Background Myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) can radiographically mimic multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The disease hallmarks cortical lesion, central vein sign (CVS) and paramagnetic rim lesions identified in MS have not yet been comprehensively investigated in MOGAD. Methods We have characterized 45 patients with MOGAD using 7.0 Tesla (7 T) MRI at two academic research hospitals in China and Germany. 7 T MRI, laboratory, and clinical data were collected. The classification of cortical lesions, proportion of CVS, and the phase shifts of lesions on susceptibility weighted imaging were analyzed. Results Of the 45 patients enrolled with MOGAD, 282 lesions were identified. We further detected 31 (11%) cortical lesions including leukocortical, intracortical, and subpial types, of which intracortical lesions (16/31, 52%) were frequently involved. CVS was identified in 53 (19%) lesions of 21 (47%) patients, 154 (55%) lesions showed multiple veins sign (MVS) in 30 (67%) patients. The number (4.3 ± 6.0 vs. 1.5 ± 2.1, p = 0.0049) and percentage (52% vs. 18%, p < 0.0001) of MVS lesions for each MOGAD patient were higher than those of CVS. Eight patients (18%) had 39 (14%) lesions of hypointense signal with paramagnetic phase shifts on SWI, showing nodular phase changes and irregular borders in appearance. Conclusions In our observational MOGAD cohort, all three types of cortical lesions were recognized, with intracortical lesions being the most common. The number and proportion of lesions with MVS were higher than those with CVS. Lesions with paramagnetic phase changes were rare and non‐rim‐like in appearance. These findings provide a better understanding of the underlying pathology of MOGAD and will help in the differentiation of MOGAD from other demyelinating disorders.
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spelling doaj-art-c0d9a01de11f4906bf64c2f5869293802025-08-20T03:11:39ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-07-011271431144110.1002/acn3.70080Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRILei Su0Joseph Kuchling1Chenyang Gao2Thoralf Niendorf3Carsten Finke4Zhe Zhang5Ai Guo6Jing Jing7De‐Cai Tian8Yu‐Jing Li9Mengting Zhang10Xiaoyu Shi11Xinyao Liu12Huabing Wang13Yaou Liu14Claudia Chien15Michael Levy16Yunyun Duan17Friedemann Paul18Fu‐Dong Shi19Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaExperimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin Berlin GermanyTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaExperimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin Berlin GermanyExperimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin Berlin GermanyTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaDepartment of Neurology Tianjin Medical University General Hospital Tianjin ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaDepartment of Radiology, Beijing Tiantan Hospital Capital Medical University Beijing ChinaExperimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin Berlin GermanyDepartment of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USADepartment of Radiology, Beijing Tiantan Hospital Capital Medical University Beijing ChinaExperimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin Berlin GermanyTiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing ChinaABSTRACT Background Myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) can radiographically mimic multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The disease hallmarks cortical lesion, central vein sign (CVS) and paramagnetic rim lesions identified in MS have not yet been comprehensively investigated in MOGAD. Methods We have characterized 45 patients with MOGAD using 7.0 Tesla (7 T) MRI at two academic research hospitals in China and Germany. 7 T MRI, laboratory, and clinical data were collected. The classification of cortical lesions, proportion of CVS, and the phase shifts of lesions on susceptibility weighted imaging were analyzed. Results Of the 45 patients enrolled with MOGAD, 282 lesions were identified. We further detected 31 (11%) cortical lesions including leukocortical, intracortical, and subpial types, of which intracortical lesions (16/31, 52%) were frequently involved. CVS was identified in 53 (19%) lesions of 21 (47%) patients, 154 (55%) lesions showed multiple veins sign (MVS) in 30 (67%) patients. The number (4.3 ± 6.0 vs. 1.5 ± 2.1, p = 0.0049) and percentage (52% vs. 18%, p < 0.0001) of MVS lesions for each MOGAD patient were higher than those of CVS. Eight patients (18%) had 39 (14%) lesions of hypointense signal with paramagnetic phase shifts on SWI, showing nodular phase changes and irregular borders in appearance. Conclusions In our observational MOGAD cohort, all three types of cortical lesions were recognized, with intracortical lesions being the most common. The number and proportion of lesions with MVS were higher than those with CVS. Lesions with paramagnetic phase changes were rare and non‐rim‐like in appearance. These findings provide a better understanding of the underlying pathology of MOGAD and will help in the differentiation of MOGAD from other demyelinating disorders.https://doi.org/10.1002/acn3.700807 T MRIcentral vein signcortical lesionmyelin oligodendrocyte glycoproteinparamagnetic rim lesion
spellingShingle Lei Su
Joseph Kuchling
Chenyang Gao
Thoralf Niendorf
Carsten Finke
Zhe Zhang
Ai Guo
Jing Jing
De‐Cai Tian
Yu‐Jing Li
Mengting Zhang
Xiaoyu Shi
Xinyao Liu
Huabing Wang
Yaou Liu
Claudia Chien
Michael Levy
Yunyun Duan
Friedemann Paul
Fu‐Dong Shi
Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
Annals of Clinical and Translational Neurology
7 T MRI
central vein sign
cortical lesion
myelin oligodendrocyte glycoprotein
paramagnetic rim lesion
title Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
title_full Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
title_fullStr Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
title_full_unstemmed Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
title_short Brain Characteristics in Patients With Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disorder by 7.0 Tesla MRI
title_sort brain characteristics in patients with myelin oligodendrocyte glycoprotein antibody associated disorder by 7 0 tesla mri
topic 7 T MRI
central vein sign
cortical lesion
myelin oligodendrocyte glycoprotein
paramagnetic rim lesion
url https://doi.org/10.1002/acn3.70080
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