The Topographical Model of Multiple Sclerosis

MS Topography App

MS Topography — Disease Simulation App

Available in the App Store

Discover a ground breaking new way of looking at Multiple Sclerosis. MS Topography is an innovative disease simulation app that creates dynamic visualizations of untreated MS using the visual metaphor of a swimming pool. Created by Stephen C. Krieger, MD, an MS specialist/neurologist, this novel app encourages discussion between people living with and treating MS. This app depicts “disease topography,” mapped in the central nervous system, as a tool to better understand the variable way MS can develop and change over time, especially when left untreated. Suitable for people with MS, clinicians, and researchers alike, the MS Topography app shines a light on many complex aspects of MS.

Suggestions for how to use the MS Topography app in discussions

The MS Topography app can be used to empower people with MS through greater understanding of MS disease course. The dynamic visualizations of the various manifestations of the disease can help inspire shared-decision making between people with MS and their healthcare providers and encourage the development of goals for disease management and care. Understanding one’s individual disease “topography” can help underscore the importance of preventing the emergence of new disease activity as well as maximizing reserve, or a person’s ability to compensate for damage, by “keeping the tank full.” Consider utilizing the dynamic visualizations in this app to foster discussion about the following:

  • What is the difference between relapses and progression, and how do they contribute to the signs and symptoms of MS?
  • In what way does topography, or the location of lesions, determine the diverse manifestations of this disease?
  • Why do some lesions, seen on MRI, cause relapses/symptoms, while others are clinically silent and remain hidden under the surface?
  • How is a relapse different from a pseudo-relapse — the fluctuations of symptoms that are characteristic of a “bad MS day”?
  • What can people with MS do to help foster brain health and “keep the tank full”?
Note that the cases featured in this app represent the natural history of MS, if untreated. The information in the MS Topography app is not intended to replace discussions with clinicians and providers, but rather to provide a visual tool by which to enhance these conversations. If, as a person with MS, you are ever unsure about any of the information in this educational tool please discuss it with your healthcare provider.

App features

View 3D examples of how MS can affect certain locations of the central nervous system, depicted as individual maps of “disease topography” in the swimming pool model

Choose from 6 unique case examples, which depict mild MS, relapsing MS, and progressive MS to foster an understanding of the different forms of the disease

Read detailed notes explaining numerous aspects of MS in language that is clear and comprehensible

Customize your viewing options with the Quick Menu, including Top-view, which simulates an MRI

Use the Live Rotation feature to get a better view of the pool model showing disease activity in various areas of the central nervous system

Simulate how “overheating” or a pseudo-relapse reveals previous or new symptoms

Learn more via the robust Info/Help section with guidance on how to use the app and a glossary of MS terms to help understand the model

Access links to related articles and the scientific publication
Neurology: Neuroimmunology & Neuroinflammation


Neurology: Neuroimmunology & Neuroinflammation

The Topographical Model of Multiple Sclerosis: A Dynamic Visualization of Disease Course

Stephen C. Krieger, MD,1 Karin Cook, MA,2 Scott De Nino, MFA,2 Madhuri Fletcher, PhD2

1Corinne Goldsmith Dickinson Center for MS, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2Harrison and Star, New York, NY, United States.

Selected Press