Clinical and radiological features of anti-MOG-associated cerebral cortical encephalitis
Multiple Sclerosis and Related Disorders, cilt.116, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 116
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.msard.2026.108011
- Dergi Adı: Multiple Sclerosis and Related Disorders
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Encephalitis, Magnetic resonance imaging, Myelin oligodendrocyte glycoprotein antibody–associated disease, Seizures
- Bursa Uludağ Üniversitesi Adresli: Evet
Özet
Objectives: Cerebral cortical encephalitis (CCE) is a recognized clinical phenotype of myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD), for which data regarding long-term disease course and optimal treatment strategies remain limited. Materials and Methods: In this multicenter observational study, patients with symptomatic cerebral cortical lesions fulfilling the 2023 MOGAD diagnostic criteria were included. Demographic characteristics, clinical presentation, radiological findings, laboratory results, treatment responses, and long-term outcomes were retrospectively collected and analyzed. Results: Twenty-four patients with anti-MOG-associated CCE were included. Median age at disease onset was 23 (IQR, 17) years, and 54.2% were male. Seizures occurred in 79.2% of patients, including status epilepticus in 31.6%. During follow-up, 62.5% experienced at least one relapse. Cortical lesions were predominantly unilateral (79.2%) and most frequently involved the frontal and parietal lobes, while spinal cord involvement was observed in 33.3% of cases. Follow-up MRI was available in 21 patients, with complete resolution of cortical abnormalities in 85.7%, partial resolution in 9.5%, and persistent abnormalities in 4.8%. Acute treatment at the first attack was administered to 22 patients, most commonly with intravenous methylprednisolone (IVMP) alone (63.6%). Maintenance immunotherapy was initiated in 75.0% of patients, most frequently with rituximab. Kaplan–Meier analysis demonstrated a median time to first relapse of 3.0 years (95% CI, 1.16–4.84). Among patients receiving maintenance immunotherapy, Kaplan–Meier analysis estimated relapse-free survival rates of 92.3% at 1 year, 63.3% at 3 years, and 47.5% at 5 years. Conclusion: Cerebral cortical encephalitis is a recognized clinical phenotype within the MOGAD spectrum, characterized predominantly by seizures and cortical MRI abnormalities. Although neurological recovery is generally favorable, relapses may occur during long-term follow-up, highlighting the importance of continued clinical surveillance.