PT  - JOURNAL ARTICLE
AU  - Frederik Bartels
AU  - Birgit Baumgartner
AU  - Annette Aigner
AU  - Graham Cooper
AU  - Astrid Blaschek
AU  - Eva Maria Wendel
AU  - Annikki Bertolini
AU  - Michael Karenfort
AU  - Matthias Baumann
AU  - Robert Cleaveland
AU  - Andreas Wegener-Panzer
AU  - Steffen Leiz
AU  - Michela Salandin
AU  - Peter Krieg
AU  - Tobias Reindl
AU  - Markus Reindl
AU  - Carsten Finke
AU  - Kevin Rostásy
TI  - Impaired Brain Growth in Myelin Oligodendrocyte Glycoprotein Antibody–Associated Acute Disseminated Encephalomyelitis
AID  - 10.1212/NXI.0000000000200066
DP  - 2023 Mar 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e200066
VI  - 10
IP  - 2
4099  - http://nn.neurology.org/content/10/2/e200066.short
4100  - http://nn.neurology.org/content/10/2/e200066.full
SO  - Neurol Neuroimmunol Neuroinflamm2023 Mar 01; 10
AB  - Background and Objectives Acute disseminated encephalomyelitis (ADEM) is the most common phenotype in pediatric myelin oligodendrocyte glycoprotein (MOG) antibody–associated disease. A previous study demonstrated impaired brain growth in ADEM. However, the effect of MOG antibodies on brain growth remains unknown. Here, we performed brain volume analyses in MOG-positive and MOG-negative ADEM at onset and over time.Methods In this observational cohort study, we included a total of 62 MRI scans from 24 patients with ADEM (54.2% female; median age 5 years), of which 16 (66.7%) were MOG positive. Patients were compared with healthy controls from the NIH pediatric MRI data repository and a matched local cohort. Mixed-effect models were applied to assess group differences and other relevant factors, including relapses.Results At baseline and before any steroid treatment, patients with ADEM, irrespective of MOG antibody status, showed reduced brain volume compared with matched controls (median [interquartile range] 1,741.9 cm3 [1,645.1–1,805.2] vs 1,810.4 cm3 [1,786.5–1,836.2]). Longitudinal analysis revealed reduced brain growth for both MOG-positive and MOG-negative patients with ADEM. However, MOG-negative patients showed a stronger reduction (−138.3 cm3 [95% CI −193.6 to −82.9]) than MOG-positive patients (−50.0 cm3 [−126.5 to −5.2]), independent of age, sex, and treatment. Relapsing patients (all MOG positive) showed additional brain volume loss (−15.8 cm3 [−68.9 to 37.3]).Discussion Patients with ADEM exhibit brain volume loss and failure of age-expected brain growth. Importantly, MOG-negative status was associated with a more pronounced brain volume loss compared with MOG-positive patients.3D=three dimensional; ADEM=acute disseminated encephalomyelitis; ADS=acquired demyelinating syndrome; EDSS=Expanded Disability Status Scale; GM=gray matter; IVIG=IV immunoglobulin; MDEM=multiphasic ADEM; MOG=myelin oligodendrocyte glycoprotein; MOGAD=MOG antibody–associated disease; MS=multiple sclerosis; NfL=neurofilament light chain; OND=other neurologic disorders; POMS=pediatric-onset MS; WBV=whole-brain volume; WM=white matter