Fatigue is a common symptom in myelin oligodendrocyte glycoprotein antibody disease

BACKGROUND: Unlike multiple sclerosis and neuromyelitis optica, the burden of fatigue in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is unclear. OBJECTIVE: To compare fatigue levels between people with MOGAD and household controls (HC) and explore factors associated with fatigue severity. METHODS: In a cross-sectional survey, data were collected from people with MOGAD and HC by utilizing an online questionnaire. Data elements included demographics, sleep quality measures, comorbidities, MOGAD characteristics, and fatigue severity measured by the Modified Fatigue Impact Scale (MFIS). We compared fatigue severity between MOGAD participants and HC and assessed the associations between demographic and disease characteristics and fatigue severity. RESULTS: There were 180/283 MOGAD and 61/126 HC respondents. Compared to HC, people with MOGAD reported more severe fatigue, as measured by the MFIS total score (49.3 vs. 36.5; p < 0.001), and a larger proportion of MOGAD participants (75.6% vs. 44.3%; p < 0.001) were classified as fatigued. Among MOGAD participants, higher age (p = 0.04), history of bilateral optic neuritis (p = 0.02), and current use of acute treatment (p = 0.04) were independently associated with higher fatigue. CONCLUSIONS: Fatigue is common in people with MOGAD, and a history of bilateral optic neuritis, comorbid conditions, and ongoing disease activity appear to contribute to fatigue severity.