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50/100

✓ Peer-reviewed alzhub usefulness score 50 out of 100. Brain scans and imaging

Topic: Amyloid, tau and blood-test diagnosis

Background To date, there have been no reports of individuals who have been characterized longitudinally using clinical and cognitive measures and who transitioned from cognitive normality to early symptomatic Alzheimer disease (AD) during a period when both cerebrospinal fluid (CSF) markers and Pittsburgh Compound B (PiB) amyloid imaging were obtained. Objective To determine the temporal relationships of clinical, cognitive, CSF, and PiB amyloid imaging markers of AD. Design Case report. Setting Alzheimer disease research center. Participant Longitudinally assessed 85-year-old man in a memory and aging study who was cognitively normal at his initial and next 3 annual assessments. Main outcome measures Serial clinical and psychometric assessments over 6 years in addition to PiB imaging with positron emission tomography (PET) and CSF biomarker assays before autopsy. Results Decline in measures of episodic memory and, to a lesser degree, working memory began at about age 88 years. PiB PET amyloid imaging was negative at age 88(1/2) years, but at age 89(1/2) years there was reduced amyloid beta 42 and elevated levels of tau in the CSF. Beginning at age 89 years, very mild cognitive and functional decline reported by his collateral source resulted in a diagnosis of very mild dementia of the Alzheimer type. After death at age 91 years, the autopsy revealed foci of frequent neocortical diffuse amyloid beta plaques sufficient to fulfill Khachaturian neuropathologic criteria for definite AD, but other neuropathologic criteria for AD were not met because only sparse neuritic plaques and neurofibrillary tangles were present. Postmortem biochemical analysis of the cerebral tissue confirmed that PiB PET binding was below the level needed for in vivo detection. Conclusion Clinical, cognitive, and CSF markers consistent with AD may precede detection of cerebral amyloid beta using amyloid imaging agents such as PiB that primarily label fibrillar amyloid beta plaques.

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APA 7th

Cairns, N. J., Ikonomovic, M. D., Benzinger, T., Storandt, M., Fagan, A. M., Shah, A. R., et al. (2009). Absence of Pittsburgh compound B detection of cerebral amyloid beta in a patient with clinical, cognitive, and cerebrospinal fluid markers of Alzheimer disease: a case report. Archives of neurology. https://doi.org/10.1001/archneurol.2009.279

Vancouver

Cairns NJ, Ikonomovic MD, Benzinger T, Storandt M, Fagan AM, Shah AR, et al. Absence of Pittsburgh compound B detection of cerebral amyloid beta in a patient with clinical, cognitive, and cerebrospinal fluid markers of Alzheimer disease: a case report. Archives of neurology. 2009. doi:10.1001/archneurol.2009.279. PMID: 20008664.

BibTeX

@article{cairns2009-20008664,
  author  = {Cairns, N. J. and Ikonomovic, M. D. and Benzinger, T. and Storandt, M. and Fagan, A. M. and Shah, A. R. and Reinwald, L. T. and Carter, D. and others},
  title   = {{Absence of Pittsburgh compound B detection of cerebral amyloid beta in a patient with clinical, cognitive, and cerebrospinal fluid markers of Alzheimer disease: a case report}},
  journal = {Archives of neurology},
  year    = {2009},
  doi     = {10.1001/archneurol.2009.279},
  pmid    = {20008664},
  url     = {https://doi.org/10.1001/archneurol.2009.279}
}

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Key findings

Results Decline in measures of episodic memory and, to a lesser degree, working memory began at about age 88 years.
After death at age 91 years, the autopsy revealed foci of frequent neocortical diffuse amyloid beta plaques sufficient to fulfill Khachaturian neuropathologic criteria for definite AD, but other neuropathologic criteria for AD were not met because only sparse neuritic plaques and neurofibrillary tangles were present.

Why it matters

This case report followed a man from normal cognition to very mild Alzheimer's dementia: his memory began to decline at about age 88, a PiB amyloid PET scan at 88½ was negative, and his spinal fluid at 89½ showed low amyloid-β42 and high tau. At autopsy after his death at 91 he had frequent diffuse amyloid plaques meeting one set of criteria for definite Alzheimer's, but only sparse neuritic plaques and tangles. It is a documented example of an amyloid scan coming back negative in a patient with clinical, cognitive and spinal-fluid markers of Alzheimer's.

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Study details

Study designcase report
Evidence strengthLow

How this study scored 50/100

Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Archives of neurology)
Journal's citation record	3 / 4	Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29)
Study design	0 / 12	Design recorded as “case report”, which our rubric does not rank (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2009 — within 20 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (pubmed indexes it as a clinical or observational study)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 205 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	10.8 citations a year over 19 year(s) since 2009
Impact for its field and year	4 / 6	Cited 13.5× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 28 other studies in this library
Still being cited	1 / 4	Cited 9 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author John C. Morris: h-index 209 (OpenAlex, whole career)
Institution's track record	2 / 3	Washington University in St. Louis: institution h-index 1,962 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 20008664)
Free to read	0 / 2	Behind a paywall — scores zero
Total	50 / 100	—

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