Figure 3

Hypothalamic pathology in ALS including TDP-43 immunostain examples from six different ALS patients (five pathologic, one normal). (A) Representative LFB/PAS-hematoxylin-stained section at intermediate magnification demonstrating large neurons and myelinated fiber bundle within the lateral hypothalamic area (LHA). (B) NCIs in the LHA of two different patients (both at 400 ×, scale bar is 20 microns), including a patient with dense, filamentous inclusions (inset). (C) Representative LFB/PAS-hematoxylin-stained section at low power magnification demonstrating the medial mammillary nucleus (MMN) of the mammillary body and the fasciculus mammillaris princeps (fmp), representing the common origin of the mammillotegmental and mammillothalamic tracts. (D) Numerous NCIs (black arrows) and rare GCIs (white arrow) within the MMN (200 ×, scale bar is 50 microns). (E) NCIs within the lateral tuberal nucleus (200 ×) and NCIs, including many granular preinclusions, within ventromedial hypothalamus at the tuberal level (400 ×) (F). (G) Characteristic low power magnification appearance on LFB/PAS-hematoxylin-stained section of large, loosely cohesive neurons in the supraoptic nucleus (SON) overlying the optic tract (opt). (H) SON neurons (seen here at 100 ×, scale bar is 100 microns) did not demonstrate TDP-43 pathology and inclusions were likewise very infrequent in the large, secretory neurons of the paraventricular nucleus (not shown).