{
  "abstract": "Background Psychiatric comorbidities are increasingly recognised in demyelinating diseases, yet their frequency and timing in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are not well defined. We aimed to characterise the spectrum and temporal pattern of psychiatric illness in MOGAD and compare to multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) with aquaporin-4 antibody (AQP4-IgG).Methods We conducted a cross-sectional study of patients with MOGAD (n=388), age-matched and sex-matched MS (n=257) and AQP4-IgG-positive NMOSD (n=58) evaluated at Mayo Clinic (1991–2025). Psychiatric diagnoses, timing relative to the first attack and patient-reported outcomes were extracted from electronic health records (EHRs). Complementary analyses were conducted using the NeuroBlu real-world EHR database.Results Among 388 patients with MOGAD, 54.8% had ≥1 psychiatric disorder, most commonly anxiety (47.7%), depression (36.6%) and attention-deficit/hyperactivity disorder (ADHD, 9%). After the first attack, 33.3% of patients with MOGAD developed a new psychiatric disorder, often within the first year. MOGAD showed a lower frequency of depression versus MS (36.6% vs 47.5%, p=0.02) but similar rates of anxiety and ADHD. Temporal patterns differed: psychiatric disorders often appeared years before onset in MS but clustered shortly after onset in MOGAD. NeuroBlu analyses supported high rates of psychiatric disorders across the three conditions.Conclusion Psychiatric comorbidities are common in MOGAD, particularly depression and anxiety, typically emerging close after onset, whereas in MS they often preceded onset by years. These findings underscore the need for routine psychiatric screening in MOGAD and highlight unresolved questions regarding whether, and to what extent, MOG-IgG-mediated inflammatory demyelination contributes to psychiatric vulnerability.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Moritz Niederschweiberer"
    },
    {
      "affiliations": [
        "Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Cicek Bakir"
    },
    {
      "affiliations": [
        "Neurology, Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Medicine, Khon Kaen University, Nai Mueang, Thailand"
      ],
      "name": "Nisa Vorasoot"
    },
    {
      "affiliations": [
        "Neurology, Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Laura Cacciaguerra"
    },
    {
      "affiliations": [
        "Neurology, Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Jan-Mendelt Tillema"
    },
    {
      "affiliations": [
        "Neurology, Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Andreu Vilaseca"
    },
    {
      "affiliations": [
        "Neurology, Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Neurology, Mayo Clinic Health System, La Crosse, Wisconsin, USA"
      ],
      "name": "Smathorn Thakolwiboon"
    },
    {
      "affiliations": [
        "Neurology, Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Albert Aboseif"
    },
    {
      "affiliations": [
        "Neurology, Ophthalmology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Stephanie B Syc-Mazurek"
    },
    {
      "affiliations": [
        "Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "William A Rees"
    },
    {
      "affiliations": [
        "Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Michael R Basso"
    },
    {
      "affiliations": [
        "Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Neurology, Mayo Clinic, Jacksonville, Florida, USA"
      ],
      "name": "A Sebastian Lopez-Chiriboga"
    },
    {
      "affiliations": [
        "Neurology, Mayo Clinic, Scottsdale, Arizona, USA"
      ],
      "name": "Dean M Wingerchuk"
    },
    {
      "affiliations": [
        "Neurology, Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "W Oliver Tobin"
    },
    {
      "affiliations": [
        "Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA",
        "Mayo Clinic Minnesota Children’s Center, Rochester, Minnesota, USA"
      ],
      "name": "Paul E Croarkin"
    },
    {
      "affiliations": [
        "Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Jessica Sagen"
    },
    {
      "affiliations": [
        "Neurology, Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Sean J Pittock"
    },
    {
      "affiliations": [
        "Neurology, Ophthalmology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "John J Chen"
    },
    {
      "affiliations": [
        "Neurology, Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Eoin P Flanagan"
    }
  ],
  "title": "Psychiatric comorbidities cluster early after onset in MOGAD: a cross-sectional comparative study with MS and NMOSD",
  "uid": "55187a7b-1141-5f65-af8a-7f0d34a943af"
}