Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Cerebral Cortical Encephalitis: A Comparative Study With Antibody‐Negative and Non‐ <scp>MOG</scp> Antibody‐Positive Cortical Encephalitis in Chinese Adults

AIMS: To investigate the clinical, radiological, and prognostic characteristics of autoimmune cortical encephalitis associated with different autoantibodies in Chinese adults, and to compare the features of myelin oligodendrocyte glycoprotein antibody-associated cerebral cortical encephalitis (MOG-CCE) with antibody-negative and non-MOG antibody-positive autoimmune cortical encephalitis. METHODS: A retrospective study was conducted on 120 adult patients diagnosed with autoimmune cortical encephalitis at the Second Xiangya Hospital, Central South University, from 2014 to 2024. Patients were divided into three subgroups: the antibody-negative group, the non-MOG antibody-positive group, and the MOG-CCE group. Clinical, radiological, and therapeutic characteristics were analyzed, and logistic regression was performed to identify predictors of poor prognosis. RESULTS: MOG-CCE accounted for 18.3% of all autoimmune cortical encephalitis cases. Compared with other subtypes, MOG-CCE was characterized by seizure-dominant clinical presentation and unilateral cortical MRI lesions. Patients with MOG-CCE responded favorably to immunotherapy and exhibited lower recurrence and disability rates. In contrast, antibody-negative and non-MOG antibody-positive autoimmune cortical encephalitis showed more severe neuropsychiatric symptoms and poorer outcomes. A higher peak mRS score was the strongest independent predictor of long-term disability. CONCLUSIONS: MOG-CCE represents a distinct clinical phenotype within autoimmune cortical encephalitis, with favorable immunotherapy responsiveness and prognosis. Antibody profiling aids in disease classification and prognostic evaluation. Prospective multicenter studies are warranted to elucidate underlying mechanisms and refine individualized therapeutic strategies.