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. Author manuscript; available in PMC: 2020 Jan 4.
Published in final edited form as: N Engl J Med. 2018 Jan 11;378(2):169–180. doi: 10.1056/NEJMra1401483

Figure 1. Topography of multiple sclerosis lesions.

Figure 1.

Schematic of lesion location, calling out imaging and pathological examples, in the (A) periventricular white matter; (B) subpial cortex; (C) leptomeninges; (D) thalamus and pons; (E) spinal cord; (F) optic nerve; and (G) retina. (A, B, D) 7-tesla MRI of a 40-year-old woman with relapsing-remitting MS, with similar pathological findings (in different cases) highlighted by immunohistochemistry directed against myelin proteolipid protein. (C) 3-tesla post-gadolinium MRI of a 35-year-old woman with secondary progressive MS, with corresponding pathological findings in the meninges of a different case (hematoxylin and eosin stain). (E) 3-tesla MRI of a 60-year-old woman with relapsing-remitting MS and corresponding pathological findings in a different case (Luxol fast blue-periodic acid Schiff stain). (F) 3-tesla MRI of a 31-year-old woman with relapsing-remitting MS and corresponding pathological findings in a different case (anti-proteolipid protein immunohistochemistry). (G) Spectral-domain optical coherence tomography reconstruction showing thinning of the peripapillary retinal nerve fiber layer. The normal range of retinal thickness is shown in green, and for this particular individual (black line) the retina is thinner than 99% of control eyes. The bottom panel shows corresponding pathological findings in a different case (immunohistochemistry for Iba-1, a microglial marker, with hematoxylin counterstain). Lesions are denoted with arrows or circles.