Myelin-oligodendrocyte glycoprotein antibodies in adults with a neuromyelitis optica phenotype

Neurology. 2012 Sep 18;79(12):1273-7. doi: 10.1212/WNL.0b013e31826aac4e. Epub 2012 Aug 22.


Objectives: To report an association of myelin-oligodendrocyte glycoprotein (MOG) antibodies with aquaporin-4 (AQP4) antibody-seronegative neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) in adults.

Methods: We describe the clinical and serologic features of 4 adult patients with an NMO/NMOSD phenotype who had antibodies to MOG.

Results: Twenty-seven adult AQP4-seronegative NMO/NMOSD patients were tested for MOG antibodies. Four patients (3 male, 1 female) with severe optic neuritis and/or longitudinally extensive transverse myelitis were positive. All 4 made good recoveries with steroids or plasma exchange. Two patients experienced recurrence of symptoms when corticosteroids were withdrawn quickly but none have experienced further relapses over a mean follow-up of 12 months, although 3 patients remain on treatment. Imaging abnormalities resolved fully following clinical recovery and MOG antibody titers fell in all 4 patients. MOG antibodies were not found in 44 AQP4 antibody-positive NMO/NMOSD patients, 75 adult patients with multiple sclerosis, or 47 healthy individuals.

Conclusions: MOG antibody-associated NMO/NMOSD could account for some cases thought previously to be AQP4-seronegative NMO/NMOSD. Our 4 patients appear to have more favorable clinical outcomes than those with typical AQP4 antibody-mediated disease. However, further studies of NMO/NMOSD and other demyelinating conditions are required to help clarify the diagnostic and prognostic relevance of MOG antibodies.

MeSH terms

  • Adolescent
  • Adult
  • Aquaporin 4 / immunology
  • Autoantibodies / blood
  • Autoantibodies / immunology*
  • Female
  • Humans
  • Male
  • Myelin-Oligodendrocyte Glycoprotein / immunology*
  • Neuromyelitis Optica / blood
  • Neuromyelitis Optica / immunology*


  • Aquaporin 4
  • Autoantibodies
  • Myelin-Oligodendrocyte Glycoprotein