The cerebellar peduncle lesion as an age-independent feature of MOG antibody associated disease
This study used MRI to compare specific features of myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease to aquaporin 4 (AQP4)-Ab-associated disease.
In this cross-sectional study, we used MRIs to compare demyelinating lesion sites in 134 MOG-Ab-positive and 70 AQP4-Ab-positive patients referred to Tohoku University in 2018. The brain was divided into 21 sectors, and an independent neurologist and a neuroradiologist identified the locations of the lesions using MRI.
MOG-Ab-positive patients had a significantly higher ratio of acute disseminated lesions to solitary lesions compared to AQP4-positive patients (108:26 vs 30:40) (P < 0.001). MOG-Ab-positive patients also had significantly higher amounts of subcortical white matter lesions of the temporal lobe (23.1%) and cerebellar peduncle (22.4%) than AQP4-Ab-positive patients (0.0% and 4.3%, respectively). AQP4-Ab-positive patients had more frequent dorsal medulla lesions (30.0 %) compared to MOG-Ab-positive patients (6.0 %) (P < 0.001). By comparing in age group, paediatric MOG-Ab-positive cases had a significantly higher number of temporal lobe lesions compared to adults, but the incidence of cerebellar peduncle lesions was not statistically different.
Lesions in the cerebellar peduncle are a distinctive and age-independent indication of MOG-Ab-associated diseases and could help provide differential diagnosis between these disorders and AQP4-Ab-associated diseases.