To summarize the current evidence on the prevalence and clinical significance of antibodies against myelin oligodendrocyte glycoprotein (MOG) in the cerebrospinal fluid (CSF) of patients with MOG antibody-associated disease (MOGAD).

Antibodies against MOG are essential for the current diagnostic criteria of MOGAD, but evidence regarding the prevalence and clinical utility of MOG antibodies in the CSF of these patients is scarce.

We searched five databases (PubMed, Embase, Scopus, Web of Science, and Google Scholar) up to September 2024. Observational studies evaluating anti-MOG antibody titers in the CSF of MOGAD patients were included. A meta-analysis using a random-effects model to estimate pooled effects was planned for each outcome, with a narrative synthesis provided when meta-analysis was not possible. The Newcastle-Ottawa scale was used to assess the risk of bias, and the GRADE criteria were applied to evaluate the certainty of evidence.

We found that anti-MOG antibodies in the CSF are have positive titers in the majority of patients with MOGAD, with a higher prevalence in adults. However, the very low certainty of the evidence and the small number of studies suggest that further research is needed to corroborate these findings.