Of note, atypical presentations, chronically progressive encephalitic symptoms with leukodystrophy-like pattern and brain atrophy on MRI, were also described in this study, which are expected to expand clinical and imaging phenotypes in MOGAD and to prompt the testing of MOG-ab in patients with chronically progressive encephalitic symptoms and leukodystrophy-like MRI pattern. This evidence concerns the gene MOG and Brain atrophy.