Another study also found that neuro-protective transcription factors such as repressor element 1 silencing transcription factor, low-density lipoprotein receptor-related protein 6, and heat shock factor 1 in NDEs from plasma decreased 2–10 years before the onset of clinical AD symptoms, implying a possible early pathogenic contribution of increased neuronal susceptibility to neurotoxic proteins in AD rather than higher levels of pathogenic proteins (Goetzl et al., 2015b). The gene discussed is LRP6; the disease is Alzheimer disease.