To describe the MUCCA values in MOGAD and compare them to MS, NMOSD, and HC. 

Relatively little is known about how the mean upper cervical cord area (MUCCA) changes in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) compared to Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), and healthy controls (HC).

We retrospectively reviewed the NYU Multiple Sclerosis Care Center database to identify all adult MOGAD patients with available brain MRI performed in stable remission and compared them with NMOSD and MS patients and HC. Cross-sectional MUCCA from T1 brain MRI scans was quantified using icobrain ms+(version 5.15.0) and normalized for head size. A linear modeling analysis was used to evaluate the impact of covariates on cross-sectional MUCCA. The covariates were age, T1 slice thickness, sex, and group.  Post hoc testing was conducted using estimated marginal means (EMMEANS) to evaluate group differences while controlling for covariates.

20 MOGAD patients, 37 AQP4+ NMOSD patients, 40 MS patients, and 31 HC were included in the analysis. Age, sex, and group showed significant effects on MUCCA measurements. The EMMEANS of MUCCA values were lower for the NMOSD group (86.1±1.5), followed by MOGAD (89.3±1.7), MS (90.3±1.2), and HC (91.6±1.5). Pairwise comparison between groups showed no statistically significant differences between the MOGAD and other groups. In contrast, a statistically significant difference between the NMOSD and HC groups and a trend towards significance between the NMOSD and MS groups were observed. 

Our proof of concept study shows the feasibility of calculating cervical volume loss from routine brain MRI using automated software. While greater spinal cord tissue loss is evident in NMOSD, the degree of spinal cord tissue loss in MOGAD is lower and not significantly different compared to MS and HC. Additional analyses on a larger cohort are underway.