Revision of Alzheimer's diagnostic criteria or relocation of the Potemkin village

Poul F. Høilund-Carlsen, Abass Alavi, Jorge R. Barrio, Rudolph J. Castellani, Tommaso Costa, Karl Herrup, Kasper P. Kepp, Rachael L. Neve, George Perry, Mona Elisabeth Revheim, Nikolaos K. Robakis, Stefano L. Sensi, Bryce Vissel

Research output: Contribution to journalReview articlepeer-review

Abstract

The recently announced revision of the Alzheimer's disease (AD) diagnostic ATN classification adds to an already existing disregard for clinical assessment the rejection of image-based in vivo assessment of the brain's condition. The revision suggests that the diagnosis of AD should be based solely on the presence of cerebral amyloid-beta and tau, indicated by the “A” and "T". The "N", which stands for neurodegeneration – detected by imaging – should no longer be given importance, except that A+ ± T + = AD with amyloid PET being the main method for demonstrating A+. We believe this is an artificial and misleading suggestion. It is artificial because it relies on biomarkers whose significance remains obscure and where the detection of “A” is based on a never-validated PET method using a tracer that marks much more than amyloid-beta. It is misleading because many patients without dementia will be falsely classified as having AD, but nonetheless candidates for passive immunotherapy, which may be more harmful than beneficial, and sometimes fatal.

Original languageEnglish
Article number102173
JournalAgeing Research Reviews
Volume93
DOIs
StatePublished - Jan 2024

Keywords

  • ATN classification
  • Alzheimer's disease
  • Amyloid-PET
  • Dementia
  • Revision

Fingerprint

Dive into the research topics of 'Revision of Alzheimer's diagnostic criteria or relocation of the Potemkin village'. Together they form a unique fingerprint.

Cite this