Influential Factors and Predictors of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Related to Severity in the First Episode

Object: To investigate the clinical characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) with varying degrees of severity in the first disease course and to explore the related factors and biological indicators that imply the severity of the disease. Methods: This retrospective study comprised 74 individuals with newly diagnosed MOGAD who were admitted to our hospital from January 2018 to June 2021. Based on severity in the first disease course, patients were separated into mild-to-moderate (EDSS≤3) and severe (EDSS>3) groups using the expanded disability status scale (EDSS). To investigate the clinical manifestations and biological markers associated with the severity of disease in the first episode, clinical data were compared. Results: Compared with mild-to-moderate group, the incidences of weakness, paresthesia, headache, bowel and bladder dysfunction were higher in severe group ( P =0.013, P <0.001, P =0.042, P =0.006, respectively), and these patients were also older ( P =0.014). On MRI images, cervical cord lesions ( P =0.030), thoracic cord lesions ( P <0.001), conus involvement ( P =0.003), longitudinally extensive lesions ( P =0.001) were more prevalent in severe group. The severe group had a greater CSF/serum albumin quotient (QALB) than the mild-to-moderate group ( P <0.001). A scoring model with a cut-off value of 4 can imply the degree of neurological impairment, and the area under the receiver operating characteristic curve was 0.871, with a sensitivity of 76% and a specificity of 81%. Conclusions: Age, headache, longitudinally extensive lesions, and QALB were all independently associated with disease severity. The severity of neurological impairment could be evaluated utilizing a scoring model with a cut-off value of 4.