An international panel of specialists in neurology and paediatric neurology as well as basic researchers including Dr. Albert Saiz, senior consultant at the Hospital Clínic Neuroimmunology-Multiple Sclerosis Unit and researcher in the IDIBAPS Pathogenesis of autoimmune neuronal disorders group, participated in the article.
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a demyelinating disorder. Defined in recent years, it includes characteristic and recognizable clinical and radiological syndromes, which occur in people who have these antibodies. The associated symptoms can occur in the form of isolated episodes or as relapses, and can be confused with the symptoms of multiple sclerosis or neuromyelitis optica.
“Until now, many of these patients were diagnosed with multiple sclerosis (MS) and they were labelled as having “atypical features”, or as having a neuromyelitis optica spectrum disorder, or were lumped together with patients having idiopathic demyelinating diseases”, explains Albert Saiz.
The panel of researchers was created due to the need to establish criteria that would allow specialists to make a correct diagnosis, taking into account that the treatment and prognosis are different from those for MS or neuromyelitis optica.
In these criteria, six main clinical syndromes are defined, which are those that identify which patient should be tested for the presence of MOG antibodies. They define the technique that should be used to determine their presence and, if the result is “clear positive” for anti-MOG, this allows the diagnosis of MOGAD to be established. If the result is “low positive”, then additional clinical and radiological features are required to establish the diagnosis.
The validation of these criteria will help unify the diagnosis of MOGAD, facilitate the recognition of cohorts of patients diagnosed in a uniform way, a very necessary aspect when designing specific clinical trials, and will help identify new biological and radiological markers that allow for the personalized targeting of treatment for these patients.
The publication of the criteria in Lancet Neurology was the result of over a year of weekly meetings by 23 international researchers, all experts in the field of neuroimmunology, and with works that have contributed to the knowledge of this disease.
Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria
Banwell B, Bennett JL, Marignier R, Kim HJ, Brilot F, Flanagan EP, Ramanathan S, Waters P, Tenembaum S, Graves JS, Chitnis T, Brandt AU, Hemingway C, Neuteboom R, Pandit L, Reindl M, Saiz A, Sato DK, Rostasy K, Paul F, Pittock SJ, Fujihara K, Palace J.
Lancet Neurol. 2023 Jan 24:S1474-4422(22)00431-8. doi: 10.1016/S1474-4422(22)00431-8.