Figure legends
Figure 1. Flow chart for patient inclusion and the exclusion criteria. NMDAR-ab, anti-N-methyl-d-aspartate receptor antibody; MOG-ab, myelin oligodendrocyte glycoprotein antibody (A). Graphical summary of clinical symptoms (B) and lesion distributions (C) in patients with MOG antibody-associated disease overlapped with anti-NMDAR encephalitis.
Figure 2. Altering of antibody endpoint titers in each clinical episode (A). Red dots represent serum MOG-ab, blue dots represent CSF NMDAR-ab. Comparison of MOG-ab and NMDAR-ab titers in second episode (first relapse) showed significant difference (** p < 0.01). Proportion of dominant symptoms in relapse courses (B).
Figure 3. Characteristic brain lesions of patients with MOG antibody-associated disease overlapped with anti-NMDAR encephalitis. Axial T2 sequence of MRI exhibited patchy or diffusive lesions involving bilateral frontal lobes of pat 7 (A), left basal ganglia and thalamus of pat 3 (B), right deep grey matter and corpus callosum of pat 7 (C), left hippocampus region of pat 3(D), bilateral midbrain of pat 4 (E), right pons and cerebellum of pat 3 (F), and medulla of pat 5 (G). T2-FLAIR hyper-intensity of coronial images (pat 7, pat 2) showed corpus callosum and cingulate gyrus involvements (H-I). Supratentorial and infratentorial lesions (red arrows) in pat 5 on T2-FLAIR indicated a warning sign of the overlapped disease (J).
Figure 4. Lesions of brain and spinal cord presented with contrast-enhancement. Pat 4 with diplopia and paraplegia showed lesions on brainstem, and longitudinal extensive transvers lesions on cervical and thoracic spinal cord (A-B), with multifocal streaky-like Gd-enhancement (C). Brain MRI of pat 6 with seizures and encephalitis after HSV-1 infection revealed large hyperintense lesions of frontal, temporal and insular cortex (not shown). The lesions gradually revolved after acyclovir and steroid treatment (D), but remarkable garland-like contrast enhancement was noted in extensive area of insular cortex, temporal cortex, cingulate gyrus, and juxtacortical white matter (E-F), which indicated BBB damage and vascular leakage.
Figure 5. Comparison of T lymphocyte subgroups before and after treatment of immunosuppressants. Circles represent T cells before treatment, triangles represent T cells after treatment. Comparison of CD3+ T cells (A), CD4+ T cells (B), CD8+ T cells (C) and CD4+/CD8+ ratio (D) in patients of MOGAD overlapping with NMDAR encephalitis (** p < 0.01 and *p < 0.05).