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August 02, 2016; 87 (5) Views & ReviewsOpen Access

A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers

Clifford R. Jack, David A. Bennett, Kaj Blennow, Maria C. Carrillo, Howard H. Feldman, Giovanni B. Frisoni, Harald Hampel, William J. Jagust, Keith A. Johnson, David S. Knopman, Ronald C. Petersen, Philip Scheltens, Reisa A. Sperling, Bruno Dubois
First published July 1, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002923
Clifford R. Jack Jr
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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David A. Bennett
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Kaj Blennow
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Maria C. Carrillo
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Howard H. Feldman
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Giovanni B. Frisoni
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Harald Hampel
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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William J. Jagust
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Keith A. Johnson
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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David S. Knopman
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Ronald C. Petersen
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Philip Scheltens
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Reisa A. Sperling
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Bruno Dubois
From the Departments of Radiology (C.R.J.) and Neurology (D.S.K., R.C.P.), Mayo Clinic, Rochester, MN; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; Clinical Neurochemistry Lab (K.B.), Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden; Alzheimer's Association (M.C.C.), Chicago, IL; Division of Neurology (H.H.F.), UBC Hospital Clinic for Alzheimer's Disease and Related Disorders, University of British Columbia, Vancouver, Canada; Memory Clinic (G.B.F.), University Hospitals and University of Geneva, Switzerland; IRCCS Fatebenefratelli (G.B.F.), The National Centre for Alzheimer's Disease, Brescia, Italy; Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM) (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France; Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Departments of Radiology and Neurology (K.A.J.), Massachusetts General Hospital, Harvard Medical School, Boston; Alzheimer Center and Department of Neurology (P.S.), Vrije Universiteit Amsterdam, the Netherlands; Center for Alzheimer Research and Treatment (R.A.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston; Centre des Maladies Cognitives et Comportementales (B.D.), Institut du Cerveau et de la Moelle épinière, Paris; and Université Pierre et Marie Curie-Paris 6 (B.D.), AP-HP, Hôpital de la Salpêtrière, Paris, France.
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Full PDF
Citation
A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers
Clifford R. Jack, David A. Bennett, Kaj Blennow, Maria C. Carrillo, Howard H. Feldman, Giovanni B. Frisoni, Harald Hampel, William J. Jagust, Keith A. Johnson, David S. Knopman, Ronald C. Petersen, Philip Scheltens, Reisa A. Sperling, Bruno Dubois
Neurology Aug 2016, 87 (5) 539-547; DOI: 10.1212/WNL.0000000000002923

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    Figure 1 Images of clinically normal individuals and participants with AD

    Individuals with AD dementia are clinically diagnosed participants in Mayo Alzheimer's Disease Research Center study while clinically normal individuals are participants in the Mayo Clinic Study of Aging. (A) FDG-PET of 75-year-old man with AD dementia. Hypometabolism in medial parietal and lateral temporal-parietal isocortex with relative preservation of frontal metabolism, which is characteristic of typical (multidomain amnestic) AD. (B) FDG-PET of clinically normal 71-year-old man. Uniform FDG uptake is present throughout the isocortex. (C) MRI of 71-year-old man with AD dementia. Atrophy is present in the medial temporal allocortex and the basal-lateral temporal isocortex, which is characteristic of typical (multidomain amnestic) AD. (D) MRI of clinically normal 71-year-old woman without atrophy. (E) Amyloid PET with Pittsburgh compound B of 71-year-old woman with AD dementia. Ligand uptake is seen throughout the isocortex. (F) Amyloid PET of clinically normal 93-year-old man showing no ligand uptake in the isocortex. AD = Alzheimer disease; FDG = [18F]-fluorodeoxyglucose.

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    Figure 2 Tau and amyloid PET imaging in AD

    A 79-year-old man with a clinical diagnosis of AD dementia. He is a participant in the Mayo Alzheimer's Disease Research Center study. (A, B) Coronal and axial tau PET images (AV1451) superimposed on MRI. (C, D) Coronal and axial Pittsburgh compound B PET images superimposed on MRI. The tau PET images (top) illustrate extensive tracer uptake in basal lateral temporal, parietal, and frontal isocortex with sparing of sensory motor and primary visual cortices. Off-target binding is seen in the basal ganglia, which is characteristic of this tracer. Although areas of spatial overlap between the tau and amyloid tracers are present, abundant amyloid tracer uptake is seen in the frontal lobes, but not with the tau tracer. Conversely, abundant uptake is seen in the medial temporal lobes with the tau ligand but not with the amyloid ligand. AD = Alzheimer disease.

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  • Article
    • Abstract
    • GLOSSARY
    • AD BIOMARKERS
    • THE A/T/N CLASSIFICATION SYSTEM
    • POSITIVE/NEGATIVE OR NORMAL/ABNORMAL BIOMARKER CUTPOINTS
    • ALTERNATIVES TO POSITIVE/NEGATIVE SCORING OF BIOMARKERS
    • ATYPICAL AD, CEREBROVASCULAR DISEASE, AND EXPANSION OF THE CORE A/T/N SYSTEM
    • APPLICATION OF THE A/T/N SYSTEM IN COGNITIVE AGING AND DEMENTIA RESEARCH: A/T/N/C
    • HOW DOES THE A/T/N SYSTEM RELATE TO EXISTING AD CLINICAL CLASSIFICATION SYSTEMS?
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
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  • All Imaging
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  • PET
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