The amyloid cascade hypothesis, which posits that amyloid-β accumulation is the key event in Alzheimer disease neurodegeneration, has dominated the field for 20 years. Recent findings, however, show that neuronal-injury biomarkers are independent of amyloid-β, calling for reconsideration of the pathological cascade and assessment of alternative therapeutic strategies.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
When the infectious environment meets the AD brain
Molecular Neurodegeneration Open Access 19 August 2022
-
Alzheimer’s Disease Prediction Using Attention Mechanism with Dual-Phase 18F-Florbetaben Images
Nuclear Medicine and Molecular Imaging Open Access 12 August 2022
-
Pre-symptomatic Caspase-1 inhibitor delays cognitive decline in a mouse model of Alzheimer disease and aging
Nature Communications Open Access 11 September 2020
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Knopman, D. S. et al. Neuronal injury biomarkers are not dependent on β-amyloid in normal elderly. Ann. Neurol. http://dx.doi.org/10.1002/ana.23816.
Jack, C. R. Jr et al. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol. 9, 119–128 (2010).
Sperling, R. A. et al. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 7, 280–292 (2011).
Jack, C. R. Jr et al. An operational approach to National Institute on Aging-Alzheimer's Association criteria for preclinical Alzheimer disease. Ann. Neurol. 71, 765–775 (2012).
Knopman, D. S. et al. Short-term clinical outcomes for stages of NIA-AA preclinical Alzheimer disease. Neurology 78, 1576–1582 (2012).
Jagust, W. J. & Landau, S. M. Apolipoprotein E, not fibrillar β-amyloid, reduces cerebral glucose metabolism in normal aging. J. Neurosci. 32, 18227–18233 (2012).
Reiman, E. M. et al. Brain imaging and fluid biomarker analysis in young adults at genetic risk for autosomal dominant Alzheimer's disease in the presenilin 1 E280A kindred: a case-control study. Lancet Neurol. 11, 1048–1056 (2012).
Bateman, R. J. et al. Clinical and biomarker changes in dominantly inherited Alzheimer's disease. N. Engl. J. Med. 367, 795–804 (2012).
Chételat, G. et al. Direct voxel-based comparison between grey matter hypometabolism and atrophy in Alzheimer's disease. Brain 131, 60–71 (2008).
La Joie, R. et al. Region-specific hierarchy between atrophy, hypometabolism, and β-amyloid (Aβ) load in Alzheimer's disease dementia. J. Neurosci. 32, 16265–16273 (2012).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Chételat, G. Aβ-independent processes—rethinking preclinical AD. Nat Rev Neurol 9, 123–124 (2013). https://doi.org/10.1038/nrneurol.2013.21
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneurol.2013.21