Spending days, weeks or even months working on an experiment, aiming for perfect results makes science feel like art. Just as painters obsess over every brushstroke to create a masterpiece, scientists execute protocols meticulously to generate data that is clean and befitting of their expectations. This is especially true when the results are visual. Magnified and annotated images of brain, lung, liver and stomach tissues reveal what our cells and proteins are up to. These images are more than data; they’re canvases of our biological reality that shape how we understand health, develop treatments and deliver care.
But what happens when these glimpses into the human body are altered to tell a desired story, not our reality?
Charles Piller’s Doctored answers this question. As a self-described look into “Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s,” Piller investigates how manipulated data—specifically digitally doctored images—has distorted Alzheimer’s research for decades. The cost: misguided drug development, wasted resources and a betrayal of trust among patients, caregivers and clinicians.
Alzheimer’s disease is a devastating neurodegenerative condition that affects over seven million Americans. It damages the brain tissues, impairing cognition, causing memory loss and stealing one’s sense of self. Despite haunting humanity for centuries, with Aristotle even describing how it causes “memory and love to cease,” and billions spent by governments and pharmaceutical companies, progress towards a cure has been painfully slow.
At the heart of the stagnation, Piller argues, is the amyloid cascade hypothesis: the idea that sticky plaques of a protein called amyloid-beta trigger inflammation in the brain, leading to neuronal cell death and cognitive decline. Drugs like Aduhelm and Leqembi were approved by the FDA based on their ability to remove these plaques. However, both have shown minimal cognitive benefit, and have been linked to serious side effects, including brain swelling and bleeding. Despite these disappointing outcomes, the amyloid hypothesis continues to monopolize the field’s funding, drug development and clinical priorities.
In 2022, Piller published an exposé titled “Blots on a Field,” which investigated Simufilam, a drug developed by Cassava Sciences that was seeking approval for late-stage clinical trials. The company claimed Simufilam blocked the formation of sticky amyloid deposits and reduced inflammation in brain tissues. The evidence was found in images generated by an experimental technique called Western blot which identifies proteins in biological samples by size and structure. However, Dr. Matthew Schrag, a neurologist and researcher familiar with the technique, voiced concerns over duplicated bands, unnatural edges, odd shadows and inconsistent backgrounds—clear signs the images had been doctored.
Alarmed by the possibility the drug might be approved based on fraudulent data, Schrag filed a complaint with the FDA. He then was recruited by Piller to uncover widespread image manipulation across the Alzheimer’s field. The investigation led them to a worrisome figure in Alzheimer’s literature: Dr. Sylvain Lesné.
In 2006, under the supervision of renowned Alzheimer’s researcher Dr. Karen Ashe at the University of Minnesota, Lesné published a paper in Nature claiming to identify a novel amyloid-beta protein that directly impaired memory in rats. The paper went on to be widely cited across the field and solidified the amyloid hypothesis. But Schrag found signs of result-changing image manipulation throughout Lesné’s works—most worryingly in highly cited articles promoting treatments targeting the new protein. Nobel laureate Dr. Thomas Südhof noted the implications of the revelations: “the immediate, obvious damage is wasted […] funding and wasted thinking in the field.” Piller stresses that entire careers in research have been built on faulty findings. Meanwhile, promising alternative hypotheses were sidelined and patients were exposed to clinical trials based on fraudulent data, raising serious ethical and safety concerns.
To assess the scale of the problem, Piller and Schrag, alongside forensic image analysts, launched a follow-up investigation titled “Other Blots.” They flagged 571 papers with suspected image doctoring, collectively cited over 77,600 times, including 487 citations in active patents. These papers had a significant influence on the direction of Alzheimer’s research and clinical decision-making, proving how misconduct at the bench can ripple outward into industry and patient care.
But exposing widespread fraud comes at a cost. Schrag voices concerns over junior scientists listed on suspect papers having their careers derailed, even if they weren’t responsible for the misconduct. It’s a consequence of being “in the wrong place at the wrong time,” Schrag explains. If these students were to speak up they may face retaliation by influential figures in the field. Additionally, although Dr. Ashe was not engaged in data manipulation, she faced years of dwindling funding, support and emotional insecurity following the aftermath of her collaborator, Lesné’s, public downfall. She said “It was like losing a limb […] I lost part of my reputation. It will never grow back.” Piller also recalled how a friend of his warned that too much misconduct coverage could lead the public to see science as a “cesspool of corruption.”
Another issue Piller says contributes to the problem is that accountability is rare. Universities often conduct year-long investigations only to dismiss accusations. Journals delay retractions. Authors themselves deny wrongdoing without providing evidence. Piller writes, “It’s like a world without police or prosecutors.” But the importance of speaking up doesn’t escape Piller or Schrag, with Schrag concluding “It’s hard to ignore what’s happening when it involves patients who have put a lot of trust in those who run clinical experiments.”
Despite its sobering revelations, Piller offers some hope. Following the scrutinization of the amyloid hypothesis, new directions in Alzheimer’s research are emerging, including research into the role of viral infections and the potential of weight-loss drugs to reduce brain inflammation. To continue moving the field forward, Schrag suggests stronger publishing oversight and a cultural shift away from the “publish or perish” mentality. This may discourage the submission of manipulated findings and the adoption of a single unopposed theory in the field.
Ultimately, Doctored reminds us that what happens at the bench has the potential to affect the course of people’s lives. And while science, like art, is shaped by human hands, it is judged by truth, not beauty. As Schrag says, “You can’t cheat to cure a disease. Biology doesn’t care.”
Yasmin Anning
Latest posts by Yasmin Anning (see all)
- Doctored (2025) by Charles Piller - January 25, 2026
