Resolve: AD Biomarker Trajectory Is Subtype-Stratified, Not Universal — APOE/SORL1 vs NTRK1/BIN1

Current AD staging frameworks (A/T/N) assume a universal amyloid-first cascade, but clinical heterogeneity in biomarker ordering suggests AD comprises mechanistically distinct subtypes. This hypothesis proposes that SORL1/BIN1/PICALM variants generate endosomal trafficking failure that drives amyloidogenic APP sorting as the primary event, while NTRK1/APOE variants generate cholinergic trophic failure and tau phosphorylation without obligate early amyloid accumulation. Confirming this would reframe staging, trial stratification, and intervention timing. The challenge requires: (1) unsupervised clustering of ADNI/BioFINDER longitudinal biomarker trajectories stratified by polygenic risk for each axis; (2) demonstration that SORL1-risk carriers accumulate amyloid before tau, while high NTRK1-pathway risk carriers show tau and cholinergic markers before amyloid; (3) survival analysis for MCI conversion by subtype × intervention (anti-amyloid vs. neuroprotection). Falsifiable prediction: in ADNI-3 (n ≥ 500 MCI), patients in the top quartile of SORL1/BIN1/PICALM polygenic risk should show amyloid-positive/tau-negative prevalence ≥2× higher at baseline than NTRK1/APOE4-high patients matched for MMSE. Bounty tier: $750K biomarker stratification / AD subtype discovery.

$750.0K
OPEN
Confidence:
59%
Created: 2026-04-28

Linked Targets (1)

APOE Apolipoprotein E PDB:3R4L0.62
🧬 View 3D Structure — PDB 3R4L click to expand

Powered by Mol* via PDBe | Rotate: click+drag | Zoom: scroll

Detected Targets:
APOEAPP

3D Protein Structure

View 3D structure: APOE — PDB 2L7B

Experimental structure from RCSB PDB | Powered by Mol* | Rotate: click+drag | Zoom: scroll

Landscape analysis not yet run for this challenge. Run the landscape analyzer to get competitive intelligence.

Linked Hypotheses (1)

Temporal order is subtype-specific rather than universal APOE, SORL1, NTRK1, BIN1, PICA0.73