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Cacciaguerra’s criteria. Difference between MS, NMO and MOG

Posted: Tue Jul 21, 2020 1:26 am
by frodo
Evaluation of brain and spinal cord lesion distribution criteria at disease onset in distinguishing NMOSD from MS and MOG antibody-associated disorder ... 8520939008


To validate the recently proposed imaging criteria in distinguishing aquaporin-4 antibody (AQP4-ab)-seropositive neuromyelitis optica spectrum disorder (NMOSD) from multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody-associated disorder (MOG-AD) at disease onset in a Chinese population.


We enrolled 241 patients in this retrospective study, including 143 AQP4-ab-seropositive NMOSD, 73 MS, and 25 MOG-AD. Cacciaguerra’s criteria were described as fulfillment of at least 2/5 conditions including
  • the absence of the combined juxtacortical/cortical lesions,
  • the presence of longitudinal extensive transverse myelitis (LETM) lesions,
  • the presence of periependymal-lateral ventricles lesions,
  • the absence of Dawson’s fingers lesions, and
  • the absence of periventricular lesions.

Fulfillment of at least 3/5 conditions was able to differentiate NMOSD from MS with a good diagnostic performance (accuracy = 0.92, sensitivity = 0.91, specificity = 0.93), yet failed to differentiate NMOSD from MOG-AD. LETM lesions showed the highest accuracy (0.78), sensitivity (0.70), and specificity (0.97) for NMSOD.


Our research suggested the utility of Cacciaguerra’s criteria in a Chinese population at disease onset. A better diagnostic performance in NMOSD could be attained with at least 3/5 conditions fulfilled. Yet their utility in distinguishing NMOSD from MOG-AD was limited.