Mild to moderate Alzheimer dementia with insufficient neuropathological changes

  • Alberto Serrano-Pozo
  • , Jing Qian
  • , Sarah E. Monsell
  • , Deborah Blacker
  • , Teresa Gómez-Isla
  • , Rebecca A. Betensky
  • , John H. Growdon
  • , Keith A. Johnson
  • , Matthew P. Frosch
  • , Reisa A. Sperling
  • , Bradley T. Hyman

Research output: Contribution to journalArticlepeer-review

105 Scopus citations

Abstract

Recently, ∼16% of participants in an anti-Aβ passive immunotherapy trial for mild-to-moderate Alzheimer disease (AD) had a negative baseline amyloid positron emission tomography (PET) scan. Whether they have AD or are AD clinical phenocopies remains unknown. We examined the 2005-2013 National Alzheimer's Coordinating Center autopsy database and found that ∼14% of autopsied subjects clinically diagnosed with mild-to-moderate probable AD have no or sparse neuritic plaques, which would expectedly yield a negative amyloid PET scan. More than half of these "Aβ-negative" subjects have low neurofibrillary tangle Braak stages. These findings support the implementation of a positive amyloid biomarker as an inclusion criterion in future anti-Aβ drug trials. Ann Neurol 2014;75:597-601

Original languageEnglish
Pages (from-to)597-601
Number of pages5
JournalAnnals of Neurology
Volume75
Issue number4
DOIs
StatePublished - Apr 2014
Externally publishedYes

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