ReviewNature reviews. Neurology2021
Developing the ATX(N) classification for use across the Alzheimer disease continuum.
Review in Nature reviews. Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 205 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
205 citing papers in PubMed, 9 syntheses or guidelines pooled it, 289 citations in OpenAlex.
- Efficacy Measures Used in Alzheimer Disease Clinical Trials Between 2015 and 2025: A Systematic Review.Neurology · 2026Pooled it
- Plasma Biomarkers for Alzheimer's Disease Across the Continuum: A Systematic Review of SIMOA-Based Studies.Cellular and molecular neurobiology · 2026Pooled it
- Synaptic biomarkers in Alzheimer's disease dementia and mild cognitive impairment: A systematic review and meta-analysis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Pooled it
- Practical Brain MRI Guidelines for Anti-Aβ Antibody Treatment in Early Symptomatic Alzheimer's Disease.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025Guideline
- Practical brain MRI guidelines for anti-Aβ antibody treatment in early symptomatic Alzheimer's disease.Japanese journal of radiology · 2025Guideline
- Cerebrospinal fluid biomarkers of neuroinflammation and postoperative neurocognitive disorders in patients undergoing orthopedic surgery: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Pooled it
- Association between blood-based protein biomarkers and brain MRI in the Alzheimer's disease continuum: a systematic review.Journal of neurology · 2024Pooled it
- Systematic review ofFrontiers in aging neuroscience · 2023Pooled it
- Plasma tau proteins for the diagnosis of mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis.Frontiers in aging neuroscience · 2022Pooled it
- The TREM2 agonistic antibody AL002 in early Alzheimer's disease: a phase 2 randomized trial.Nature medicine · 2026Trial
- Biofluid biomarker changes following treatment with sabirnetug (ACU193) in INTERCEPT-AD, a phase 1 trial in early Alzheimer's disease.The journal of prevention of Alzheimer's disease · 2025Trial
- Effects of Supplementation with a Microalgae Extract fromNutrients · 2024Trial
- Combining plasma phospho-tau and accessible measures to evaluate progression to Alzheimer's dementia in mild cognitive impairment patients.Alzheimer's research & therapy · 2022Trial
- Speech clocks decode dementia phenotypes, social exposome, and biological aging.Science advances · 2026Article
- Blood-based biomarkers and early diagnosis of Alzheimer's disease.Neural regeneration research · 2026Article
- Retinal proteomics in neurodegeneration: Insights into ocular and brain disorders.Neural regeneration research · 2026Article
- Bacopa monnieri and Alzheimer's disease: mechanistic convergence, cognitive outcomes and translational perspectives.Inflammopharmacology · 2026Review
- A comprehensive German claims data analysis of care pathways, risk factors and comorbidities among acetylcholinesterase inhibitor initiators in Alzheimer's disease.Scientific reports · 2026Article
- Review
- Tau dysfunction in alzheimer's disease: molecular and cellular mechanisms, genetic modulation, and therapeutic perspectives.Molecular biology reports · 2026Review
145 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Breakthroughs in the development of highly accurate fluid and neuroimaging biomarkers have catalysed the conceptual transformation of Alzheimer disease (AD) from the traditional clinical symptom-based definition to a clinical-biological construct along a temporal continuum. The AT(N) system is a symptom-agnostic classification scheme that categorizes individuals using biomarkers that chart core AD pathophysiological features, namely the amyloid-β (Aβ) pathway (A), tau-mediated pathophysiology (T) and neurodegeneration (N). This biomarker matrix is now expanding towards an ATX(N) system, where X represents novel candidate biomarkers for additional pathophysiological mechanisms such as neuroimmune dysregulation, synaptic dysfunction and blood-brain barrier alterations. In this Perspective, we describe the conceptual framework and clinical importance of the existing AT(N) system and the evolving ATX(N) system. We provide a state-of-the-art summary of the potential contexts of use of these systems in AD clinical trials and future clinical practice. We also discuss current challenges related to the validation, standardization and qualification process and provide an outlook on the real-world application of the AT(N) system.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.