TRUE-MOGAD Score: A Novel Scoring System to Identify MOGAD Among Positive MOG-IgG Test Results
Journal: Neurology, Neuroimmunology & Neuroinflammation; April 1, 2026
Author(s): Andreu Vilaseca, Angeliki G Filippatou, Yana Said, Elia Sechi, Stephanie B Syc-Mazurek, Laura Cacciaguerra, Kai Guo, Nisa Vorasoot, Moritz Niederschweiberer, Smathorn Thakolwiboon, Jessica A Sagen, Sebastian A Lopez-Chiriboga, Jan-Mendelt Tillema, John J Chen, Sean J Pittock, Elias S Sotirchos, Eoin P Flanagan
A new scoring system for more accurate MOGAD diagnosis in patients with anti-MOG antibodies
Anti-MOG antibodies can often appear even in patients who don’t have MOGAD, leading to these patients being incorrectly diagnosed with MOGAD. This study aimed to develop a scoring system, called the TRUE -MOGAD score to help interpret levels of anti-MOG antibodies.
The study involved 215 who tested positive for anti-MOG antibodies between January 5, 2022 and 31 December, 2024 at Mayo Clinic Neuroimmunology Laboratory. Of these 144, were confirmed to have MOGAD based on the 2023 diagnostic criteria for MOGAD.
The new scoring system, called the TRUE-MOGAD Score, included points for the following features:
- Clear positive antibody levels or titres in the blood (where T in TRUE-MOGAD stands for titres),
- Recurrent episodes (3 or more) of optic neuritis (R for relapsing),
- Patients being under 18 years old when symptoms began (U for under 18 years)
- Brain inflammation or encephalitis (E for encephalitis)
- Specific MRI patterns expected in MOGAD (M for MRI)
- Specific patterns called oligoclonal bands in spinal fluid (O for oligoclonal bands)
- Slow worsening (G for gradually progressive) or suddenly starting (A for abrupt onset) of symptoms
- At least 1 lesion on the brain MRI disappearing over time (D for disappearance)
For patients who test positive for anti-MOG antibodies, the TRUE-MOGAD score is a practical tool that may help avoid an inaccurate diagnosis of MOGAD.
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