{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:58:08Z","timestamp":1790611088896,"version":"4.1.0"},"reference-count":75,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"abstract":"\n Importance<\/jats:title>\n Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a demyelinating disease distinct from multiple sclerosis (MS) and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD). Magnetic resonance imaging (MRI) is central to confirming attacks, defining lesion distribution, and excluding alternative diagnoses and is a key component of the 2023 MOGAD diagnostic criteria. However, its imaging spectrum and lesion evolution remain underrecognized in practice, and variability in imaging parameters can contribute to delayed diagnosis and suboptimal treatment.<\/jats:p>\n <\/jats:sec>\n \n Observations<\/jats:title>\n This article summarizes the hallmark MRI features of optic nerve, brain, and spinal cord involvement in MOGAD, including key findings from the 2023 diagnostic criteria, supported by illustrative figures and detailed tables. The characteristic evolution of MRI abnormalities in MOGAD is highlighted, including radiologic lag, lesion dynamics during acute attacks, and frequent T2-lesion resolution, contrasting with the persistent lesions typical of MS. A recommended MRI protocol for acute attacks is proposed, and the timing and utility of rebaselining MRI (ie, repeating the MRI to establish a new baseline) after onset are reviewed. The clinical course of MOGAD is of attack-related neuroinflammation evident clinically and radiologically, and asymptomatic radiological activity is rare, suggesting that surveillance MRI has less clinical utility than in MS and less value as a surrogate biomarker in clinical trials. MRI features that differentiate MOGAD from MS and AQP4+NMOSD are summarized and imaging red flags suggestive of alternative diagnoses are highlighted. Finally, emerging advanced imaging, artificial intelligence in MOGAD imaging, and the link between imaging and immunopathogenesis are reviewed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n MRI is central to MOGAD evaluation, and recognition of the characteristic imaging features and lesion dynamics outlined in this review can aid diagnosis. Application of the standardized MRI protocol summarized here can optimize use in clinical practice and promote harmonization across research studies. Future imaging and artificial intelligence applications may improve diagnosis, disease monitoring, and understanding of MOGAD pathogenesis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaneurol.2026.3196","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:30:41Z","timestamp":1790609441000},"source":"Crossref","is-referenced-by-count":0,"title":["MRI Characteristics of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease"],"prefix":"10.1001","author":[{"given":"Eoin P.","family":"Flanagan","sequence":"first","affiliation":[{"name":"Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota"},{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda L.","family":"Banwell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cacciaguerra","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Carnero Contentti","sequence":"additional","affiliation":[{"name":"Neuroimmunology Unit, Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina"},{"name":"CENRos, Neuroimmunology Clinic, INECO Neurociencias Oro\u00f1o, Rosario, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota"},{"name":"Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Cortese","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Neuroscience, University of Siena, Italy"},{"name":"Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland"},{"name":"Multiple Sclerosis Centre, Departments of Neurology, Clinical Research and Biomedicine, University Hospital and University Basel, Basel, Switzerland"},{"name":"Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital Basel and University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Fadda","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, 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Research Institute and Hospital of National Cancer Center, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Jury\u0144czyk","sequence":"additional","affiliation":[{"name":"Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kshitij","family":"Mankad","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Marignier","sequence":"additional","affiliation":[{"name":"Service de Neurologie, Scl\u00e9rose en Plaques, Pathologies de la My\u00e9line et Neuro-Inflammation, and Centre de R\u00e9f\u00e9rence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, H\u00f4pital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France"},{"name":"Centre de Recherche en Neurosciences de Lyon, Lyon, France"},{"name":"Universit\u00e9 Claude Bernard Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Messina","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[{"name":"Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarshini","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Translational Neuroimmunology Group, Kids Neuroscience Centre and ANZAC Research Institute, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Neurology, Concord Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Rovira","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Department of Radiology (IDI), Hospital Universitari Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elia","family":"Sechi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Sassari, Sardinia, 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