Plasma biomarker tests for Alzheimer disease are becoming increasingly reliable, which enables implementation in clinical settings in which cerebrospinal fluid analysis and PET scans are unavailable. However, a new study shows that some patients have discordant plasma and PET biomarker results. Clinicians need clear guidance to identify and manage patients who do not fit into standard clinical or biological categories.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$32.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$189.00 per year
only $15.75 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Gordon, B. A. et al. Tau PET in autosomal dominant Alzheimer’s disease: relationship with cognition, dementia and other biomarkers. Brain 142, 1063–1076 (2019).
Yun, J. et al. Temporal dynamics and biological variability of Alzheimer biomarkers. JAMA Neurol. 82, 384–396 (2025).
Jack, C. R. Jr et al. Revised criteria for the diagnosis and staging of Alzheimer’s disease. Nat. Med. 30, 2121–2124 (2024).
Verberk, I. M. W. et al. Development of thresholds and a visualization tool for use of a blood test in routine clinical dementia practice. Alzheimers Dement. 20, 6115–6132 (2024).
Barthélemy, N. R. et al. A soluble phosphorylated tau signature links tau, amyloid and the evolution of stages of dominantly inherited Alzheimer’s disease. Nat. Med. 26, 398–407 (2020).
O’Connor, A. et al. Plasma phospho-tau181 in presymptomatic and symptomatic familial Alzheimer’s disease: a longitudinal cohort study. Mol. Psychiatry 26, 5967–5976 (2021).
van Maurik, I. S. et al. Biomarker-based prognosis for people with mild cognitive impairment (ABIDE): a modelling study. Lancet Neurol. 18, 1034–1044 (2019).
Vermunt, L. et al. Age- and disease-specific reference values for neurofilament light presented in an online interactive support interface. Ann. Clin. Transl. Neurol. 9, 1832–1837 (2022).
Ashton, N. J. et al. Alzheimer disease blood biomarkers in patients with out-of-hospital cardiac arrest. JAMA Neurol. 80, 388–396 (2023).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
C.E.T. has research contracts with Acumen, ADx Neurosciences, AC-Immune, Alamar, Aribio, Axon Neurosciences, Beckman-Coulter, BioConnect, Bioorchestra, Brainstorm Therapeutics, C2N diagnostics, Celgene, Cognition Therapeutics, EIP Pharma, Eisai, Eli Lilly, Fujirebio, Instant Nano Biosensors, Novo Nordisk, Olink, PeopleBio, Quanterix, Roche, Toyama and Vivoryon. She is editor-in-chief of Alzheimer Research and Therapy, and serves on the editorial boards of Molecular Neurodegeneration, Alzheimer’s & Dementia, Neurology: Neuroimmunology & Neuroinflammation and Medidact Neurologie/Springer, and serves on committees to define guidelines for cognitive disturbances and acute neurology in the Netherlands. She has had consultancy and/or speaker contracts with Aribio, Biogen, Beckman-Coulter, Cognition Therapeutics, Eli Lilly, Merck, Novo Nordisk, Olink, Roche and Veravas. L.V. declares no competing interests.
Rights and permissions
About this article
Cite this article
Teunissen, C.E., Vermunt, L. Implications of AD plasma and PET biomarker discordance. Nat Rev Neurol 21, 295–296 (2025). https://doi.org/10.1038/s41582-025-01091-w
Published:
Issue date:
DOI: https://doi.org/10.1038/s41582-025-01091-w