Author Affiliations: New York University School of Medicine, New York.
In a recent paper published in the Archives of Neurology, Jack et al1 provided evidence in support of an hypothesized temporal ordering of selected biologic features of Alzheimer disease using surrogate biomarkers.
There are indisputable merits to their work. The authors reported on the prevalence of abnormal biomarker values for a large group of subjects representing 3 different stages of cognitive impairment. They used 2 well-defined cerebrospinal fluid and 1 magnetic resonance imaging biomarkers in a 1-year follow-up design. The presented cut values for abnormality were defined based on data independently validated at postmortem. However, despite these attributes, we believe for several reasons that the authors failed to deliver full support for their model.
Glodzik L, Galvin J, Pirraglia E, de Leon M. Ordering of Alzheimer Disease Biomarkers. Arch Neurol. 2012;69(3):414-415. doi:10.1001/archneurol.2011.2906