Takeaway
New silent brain lesions developed in some patients with anti-MOG antibody-related disease (MOGAD) and did not predict clinical relapse; they were less frequent in children with MOGAD than in children with multiple sclerosis (MS) and were rare in children with antibody-negative non-MS demyelination.
Why this matters
Approximately 25% of children with monophasic or relapsing MOGAD experience clinical relapse, but it is unknown whether they develop new silent magnetic resonance imaging (MRI) lesions and whether these lesions predict clinical relapse. Understanding these relationships will optimize MRI frequency and decision-making concerning chronic immune therapies in children.