Total brain volume is reduced in all neuroinflammatory conditions including neuromyelitis optica spectrum disorder (NMOSD), according to a new study published in the journal Multiple Sclerosis and Related Disorders. Patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have a higher rate of thalamic atrophy compared to those with multiple sclerosis (MS) and NMOSD and a higher rate of hippocampal atrophy compared to those with MS.

“Larger studies are needed to validate these findings and to investigate their clinical implications,” the authors of the study said. 

NMOSD and MOGAD share radiological similarities and both affect the optic nerves, spinal cord, and brainstem. Even though both diseases are considered relapsing diseases with clinical and radiographic stability between relapses, it is thought that tissue loss occurs in these conditions even in the absence of relapses.

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In order to compare global and regional brain volumes of MOGAD, MS, and NMOSD patients to that of healthy controls, a team of researchers led by Eyal Lotan, MD, PhD, from the Department of Radiology, New York University Langone Medical Center in New York, NY retrospectively reviewed the brain magnetic resonance imaging (MRI) data of all adult MOGAD and NMOSD patients in stable remission. They then compared this data to patients with MS as well as helathy controls.

A total of 24 patients with MOGAD, 47 patients with NMOSD, 40 patients with MS, and 37 healthy controls were included in the study. 

The results showed that the whole brain volume of patients with MOGAD, NMOSD, and MS was significantly lower than that of healthy controls. 

The researchers also analyzed a subset of 8 patients with MOGAD, 22 patients with NMOSD, and 34 patients with MS and found that there was a reduction not only in whole brain volume but also in cortical gray matter volume over time. There was no statistically significant difference between patients with different diseases.


Lotan I, Billiet T, Ribbens A, et al. Volumetric brain changes in MOGAD: A cross-sectional and longitudinal comparative analysis. Mult Scler Relat Disord. Published online December 10, 2022. doi:10.1016/j.msard.2022.104436