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

MOG-ab associated disorders (MOGAD) are a recently characterised demyelinating condition that affects children and adults. Due to its recent discovery, the effect that MOGAD has on children’s cognitive abilities is only just being understood. Some children with MOGAD, particularly those with Acute Disseminated Encephalomyelitis and Neuromyelitis Optica Spectrum Disorder phenotypes, experience impairment on tests of intellect, long-term memory, working memory and processing speed. Other young people with MOGAD have normal range cognitive performance. Some studies suggest cognitive difficulties only emerge over time and are linked to relapses. Brain lesions do not have a simple relationship to cognitive change and are found in those with and without cognitive impairment. All studies reviewed are limited by small sample size but suggest that children with MOGAD are at risk of cognitive impairment. Future research is required with sufficient power to determine the cognitive profile of a large sample of children with MOGAD. The role of disease variables on cognitive outcome should also be investigated. Paediatric patients with MOGAD require regular neuropsychological monitoring using screening and comprehensive neuropsychological assessment. This will allow the correct supports and neurorehabilitation strategies to be offered to these young people and guard against academic and occupational underachievement.