title: Antibodies to MOG in adults with inflammatory demyelinating disease of the CNS.
abstract: OBJECTIVE
  To evaluate the clinical relevance of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in a cohort of adults with inflammatory demyelinating disease (IDD) of the CNS.
  
  
  METHODS
  Live cell-based assays for MOG-Ab (IgG1 subset) and antibody to aquaporin-4 (AQP4-Ab) were performed in a cohort of 270 adult patients with IDD and 72 controls. Patients were first grouped by positive antibody result as MOG-Ab or AQP4-Ab, and the remainder were grouped by published diagnostic criteria.
  
  
  RESULTS
  Seventeen patients with IDD (6.3%) had MOG-Abs and 49 patients (18.1%) had AQP4-Abs; none had both antibodies. The MOG-Ab patients predominantly manifested with isolated symptoms of optic neuritis (83%). One-third of these patients experienced relapses, which involved only the optic nerve, and all relapsed within 1 year of disease onset. At onset, MRI in the MOG-Ab group uniquely demonstrated perineural enhancement, extending to the soft tissues around the optic nerves (33%). Although about 30% of MOG-Ab patients had brain MRI lesions, they had fewer periventricular lesions than the 26 patients with relapsing-remitting multiple sclerosis (MS); none of these lesions were ovoid or perpendicular to the ventricle. Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group. Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.
  
  
  CONCLUSIONS
  MOG-Abs may be a disease-specific biomarker in adult patients with IDD who have a disease distinct from NMO or MS. The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Sung-Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Woodhall
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Ji-Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Seong-Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Kyung Seok
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Kwang-Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.
authors.forename: Patrick
authors.initials: P
authors.lastname: Waters