Neuromyelitis optica spectrum disorder (NMOSD) is a severe form of inflammation of the central nervous system (CNS) including acute myelitis, optic neuritis and brain syndrome. Currently, the classification of NMOSD relies on serologic testing, distinguishing between seropositive or seronegative anti-aquaporin-4 antibody (AQP4) status. However, the situation has recently grown more intricate with the identification of patients exhibiting the NMOSD phenotype and myelin oligodendrocyte glycoprotein antibodies (MOGAD). NMOSD is primarily recognized as a relapsing disorder; MOGAD can manifest with either a monophasic or relapsing course. Significant symptomatic inflammatory CNS injuries with stability in clinical findings outside the acute phase are reported in both diseases. Nevertheless, recent studies have proposed the existence of a subclinical pathological process, revealing longitudinal changes in brain and spinal cord atrophy. Within this context, we summarise key studies investigating brain and spinal cord measurements in adult NMOSD and MOGAD. We also explore their relationship with clinical aspects, highlight differences from multiple sclerosis (MS), and address future challenges. This exploration is crucial for determining the presence of chronic damage processes, enabling the customization of therapeutic interventions irrespective of the acute phase of the disease.

中文翻译：

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NMOSD 和 MOGAD 中的脑和脊髓萎缩：当前证据和未来前景

视神经脊髓炎谱系障碍 (NMOSD) 是一种严重的中枢神经系统 (CNS) 炎症，包括急性脊髓炎、视神经炎和脑综合征。目前，NMOSD 的分类依赖于血清学检测，区分血清阳性或血清阴性抗水通道蛋白 4 抗体 (AQP4) 状态。然而，随着表现出 NMOSD 表型和髓磷脂少突胶质细胞糖蛋白抗体 (MOGAD) 的患者的鉴定，情况最近变得更加复杂。 NMOSD 主要被认为是一种复发性疾病； MOGAD 可以表现为单相病程或复发病程。两种疾病均报告有明显的症状性炎症性中枢神经系统损伤，且在急性期之外的临床表现稳定。然而，最近的研究提出了亚临床病理过程的存在，揭示了大脑和脊髓萎缩的纵向变化。在此背景下，我们总结了调查成人 NMOSD 和 MOGAD 大脑和脊髓测量的关键研究。我们还探讨了它们与临床方面的关系，强调与多发性硬化症 (MS) 的差异，并应对未来的挑战。这一探索对于确定慢性损伤过程的存在至关重要，从而无论疾病的急性期如何，都能定制治疗干预措施。