Carstensen, M.; Pedersen, J. T.; Carstensen, J.

This comment addresses the potential influence of sample size on the conclusions drawn from a study investigating the beneficial effects of neuropathology in Alzheimer\'s disease (AD). By examining the existing literature and employing statistical reasoning, we argue that an increase in sample size by factor of 2-4 would have led the authors to arrive at a different conclusion. Contrary to expectations, their findings unexpectedly contribute to the prevailing trend of positive results regarding the advantageous impacts of neuropathology in AD, with nine out of ten of their immunohistochemistry experiments showing a consistent approximate 30 % reduction of amyloid plaque. We demonstrate that the quantity and quality of the data presented by Soula et al. 2023 do not support the paper\'s conclusions on amyloid neuropathology. Based on a thorough statistical analysis of the available data, we therefore submit that given a larger sample size, the conclusion would have been positive towards possible improvements in neuropathology.