The topographical model of #MS = By Stephen Krieger, MD —
The topographical model of #MS is my career contribution, and it’s changed the conversation towards a unified view of MS. This is the 10th anniversary 
of the initial idea, Oct 2013, that led to the paper tinyurl.com/yxk83byt & all that followed. A on how it came together.
of the initial idea, Oct 2013, that led to the paper tinyurl.com/yxk83byt & all that followed. A 
on how it came together.
I’m often asked how the idea for the topographical model of #MS came about, and the short answer is: from listening to my patients. In MS sometimes reserve is full, but when it’s drained MS reveals itself above the surface. High & low tide; the disease hiding below the threshold.
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Taking a closer look at the first sketch, Oct 3rd 2013:
The concept was already there – lesions, submerged by functional reserve. The tank, draining slowly, as brain atrophy occurs. Note the draining spigot in the lower left corner, an early detail later cut from the model.
The concept was already there – lesions, submerged by functional reserve. The tank, draining slowly, as brain atrophy occurs. Note the draining spigot in the lower left corner, an early detail later cut from the model.
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