. Author manuscript; available in PMC: 2025 Feb 1.

Published in final edited form as: Neurol Clin. 2023 Aug 7;42(1):77–114. doi: 10.1016/j.ncl.2023.06.009

Table 3.

Recommendations and laboratory features of AQP4+NMOSD and MOGAD.

	AQP4+NMOSD	MOGAD
Antibody	AQP4-IgG1	MOG-IgG1
Sample
Serum	Yes (preferred)	Yes (preferred)
CSF	No (isolated CSF AQP4-IgG extremely rare)	Yes (≈10% isolated CSF MOG-IgG)
Test assay
Live CBA	Yes (gold standard)	Yes (gold standard)
Fixed CBA	Yes	Yes
Murine tissue-based assays	Intermediate sensitivity but very good specificity	May have white matter staining when CSF tested but very insensitive²⁴
ELISA	Good performance but reduced sensitivity and risk of false positives at low titer vs cell-based assays	Not recommended due to inconsistent results
Quantitative results important	No	Yes (risk of false positives at low titer)
Seroconversion important	No	Yes (relapse-risk)
CSF findings
Pleocytosis	++	++
High protein	++	++
Oligoclonal bands	+ (<20%)	+ (<20%)

Note that: “−“ indicates rare findings (<5%), “+” infrequent findings (5–30%), “++” common findings (30–69%), “+++” very common findings (>70%).

Abbreviations: AQP4=aquaporin-4; CBA=cell-based assay; CSF=cerebrospinal fluid; ELISA= enzyme linked immunosorbent assay; MOG=myelin oligodendrocyte glycoprotein; MOGAD=myelin-oligodendrocyte glycoprotein antibody-associated disease; AQP4+NMOSD= neuromyelitis optica spectrum disorder.