Neuropsychological outcomes in pediatric MOGAD: clinical practice and future research.

Abstract

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder (MOGAD) is a recently identified demyelinating condition affecting children and adults. Its impact on children's cognitive outcomes remains poorly understood but is a growing area of interest due to potential long-term implications. A systematic PubMed search was conducted to identify English-language studies that assessed cognition in individuals under 18 with MOGAD using neuropsychological tests, screening tools, or questionnaires. Children with MOGAD, particularly those with phenotypes such as AcuteDisseminated Encephalomyelitis (ADEM) and Neuromyelitis Optica SpectrumDisorder (NMOSD), often exhibit impairments in intellectual functioning, memory, processing speed, and working memory. However, some children maintain cognitive performance within the normal range. Cognitive difficulties are linked to disease relapses and may develop over time, although brain lesions do not consistently correlate with cognitive outcomes. Current studies, limited by small sample sizes, indicate that children with MOGAD are at risk for cognitive impairments. Regular neuropsychological monitoring is essential for pediatric MOGADpatients to identify and address cognitive challenges early, mitigating risks of academic and occupational underachievement. Multicentre multinational studies are needed to understand the cognitive profile of MOGAD better and assess the influence of disease-related variables on cognitive outcomes.