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. 2022 Jul 11;13:946180. doi: 10.3389/fneur.2022.946180

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Copyright © 2022 Shiraishi, Umemura, Nakayama, Yamada, Shijo and Hashimoto.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Pathological findings of the brain biopsy. (A) Hematoxylin and eosin (HE) stains showed gliosis with widespread infiltration of inflammatory cells without neoplastic tissue. Perivascular inflammation was absent (arrowhead). (B) High-magnification HE showed diffuse foamy macrophage infiltration associated with reactive astrocytes (arrowheads). (C) CD68-immunostaining revealed clusters of macrophages. (D,E) Klüver–Barrera staining demonstrated myelin loss with myelin-laden macrophages (arrowheads). (F) Phosphorylated neurofilament immunostaining revealed axonal fragmentation and spheroids (arrowheads). The axonal loss was milder than myelin loss. Scale bars: (A) 100 μm. (B–E) 20 μm. (F) 10 μm.