Comparison of neuroimaging and clinical findings of myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) and seronegative neuromyelitis optica spectrum disease (NMOSD)

Purpose: The aim of this study is to compare the clinical and neuroimaging findings of pediatric patients with myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) and seronegative neuromyelitis optica spectrum disorder (NMOSD). Materials and Methods: This retrospective study included 8 MOGAD and 10 seronegative NMOSD patients admitted to Cukurova University between 2015 and 2025, with a minimum follow-up of one year. MOGAD was diagnosed according to the 2023 International MOGAD Panel criteria, while NMOSD was defined by the 2015 IPND criteria. Results: The mean age at diagnosis was 12,1±2,9 years in the MOGAD group and 9,4±4.4 years in the NMOSD group. Relapse-free survival was higher in MOGAD, with 50% of patients experiencing no further attacks. In contrast, all NMOSD patients relapsed. At the end of follow-up, 87.5% of MOGAD patients achieved complete recovery, while all NMOSD patients had persistent sequelae. MRI analysis showed cortical and conus lesions as predominant in MOGAD, whereas NMOSD more frequently demonstrated long-segment spinal cord involvement, posterior orbital lesions, and brainstem or deep gray matter involvement. Conclusion: MOGAD is associated with fewer relapses and better recovery, while NMOSD is characterized by recurrent attacks and a high rate of permanent disability. The frequency of these imaging findings may contribute to improved diagnostic accuracy and prognostic prediction.