Autoantibodies against myelin oligodendrocyte glycoprotein in a subgroup of patients with psychotic symptoms

Nikita A. van de Burgt¹Laila Kulsvehagen²Marina Mané Damas¹Luc Lutz³Anne-Catherine Lecourt³Clara Montserrat^4,5Anita Vinke⁶Cem I Küçükali⁷Shenghua Zong¹Carolin Correia-Hoffmann^1,8,9Emiliano González-Vioque¹⁰Celso Arango¹⁰Nicole Leibold¹Mario Losen¹Peter Cornelis Molenaar¹Erdem Tüzün⁷Nico J.M. van Beveren^11,12Anna Mane Santacana^4,5Rob P.W. Rouhl⁶Therese Van Amelsvoort¹Anne-Katrin Pröbstel^13*Pilar Martinez^1*

• ¹Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands, Netherlands
• ²Departments of Neurology, Biomedicine, and Clinical Research and Research Center for Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital of Basel, Basel, Basel-Stadt, Switzerland
• ³Departments of Neurology, Biomedicine, and Clinical Research, and Research Center for Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital of Basel, Basel, Basel-Stadt, Switzerland
• ⁴Institut de Neuropsiquiatria i Addiccions (INAD), Barcelona, Catalonia, Spain
• ⁵Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain, Madrid, Spain
• ⁶Department of Neurology, Maastricht University Medical Centre, Maastricht, Netherlands, Netherlands
• ⁷Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Türkiye
• ⁸Algarve Biomedical Center Research Institute, University of Algarve, Faro, Faro, Portugal
• ⁹Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Faro, Portugal
• ¹⁰Department of Child and Adolescent Psychiatry, Hospital General Universitario, Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
• ¹¹Department of Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
• ¹²Department of Neuroscience, Erasmus Medical Center, Rotterdam, Netherlands
• ¹³Departments of Neurology, Biomedicine, and Clinical Research, and Research Center for Neuroimmunology and Neuroscience Basel (RC2NB), University of Basel, Basel, Switzerland

The presence of autoantibodies against myelin oligodendrocyte glycoprotein (MOG) is a hallmark of MOG antibody-associated disease (MOGAD), a recently defined demyelinating disease entity presenting with core clinical features of optic neuritis, myelitis, and acute disseminated encephalomyelitis. Although MOG antibodies have also been described in a small number of patients with other conditions, including mental disorders, their prevalence and clinical specificity in patients with isolated psychotic symptoms remain unclear. We screened sera from 262 patients with at least one psychotic episode and 166 control subjects for the presence of MOG antibodies of the immunoglobulin G (IgG) isotype with a live cell-based assay.Serum reactivity to additional antigens was assessed by immunohistochemistry. Four patients, representing 1.5% of the patient cohort, and one control individual, representing. 0.6% of the healthy control cohort, were seropositive for MOG-IgG antibodies. Of the four MOG-IgG seropositive patients, three experienced visual hallucinations. Overall, MOG antibodies were detected at a low frequency in patients with psychotic episodes. While we cannot exclude the possibility of false-positive results or seroconversion due to secondary myelin damage, the association with visual hallucinations in three out of four MOG-IgG seropositive patients may point toward an underlying autoimmune etiology.