Differentiating MS from NMOSD

Patients are sometimes misdiagnosed with multiple sclerosis (MS) when they actually have neuromyelitis optica spectrum disorder (NMOSD), with aquaporin-4–positive disease (AQP4+) or myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD).

To differentiate MS from AQP4+ and MOGAD, investigators conducted a cross-sectional study that compared brain, spinal cord, and optic nerve MRI features among 91 patients in the UK: 31 with MS, 30 with AQP4+, and 30 with MOGAD.

Key results were as follows:

• White matter lesions were detected in more MS patients than NMOSD or MOGAD patients (100% vs. 83% or 27%, respectively).

• The central vein sign (CVS) within white matter lesions was detected in more MS patients than AQP4+ or MOGAD patients (10…