JNS Reviewer: Geier et al "Clearly Not Objective"

In response to my concerns regarding the recently published (online) autism-biomarker study by Geier et al in the Journal of Neurological Sciences, editor-in-chief Robert Lisak asked 2 "distinguished scientists"* to review the article, as well as my letter to the editor and the response of Geier et al. While the new reviewers did not recommend that the paper be retracted (for some inexplicable reason), they did have "significant concerns with parts of the paper," the study's methods, and the authors' interpretation, wrote Dr. Lisak.

Neither reviewer addressed my concerns about the specific metabolite values of Geier et al nor the possibility of subject overlap in a similar Neurochemical Research article; however, Reviewer #1 chided the authors for not providing norms for laboratory values, if available. Reviewer #2 expressed concerns with the authors' lack of intra-assay standards when measuring urinary porphyrins, how these values compare with those from normal controls, and sample collection (both blood and urine). Information regarding control subjects—such as the exact number, gender breakdown, and reasons for testing—were also lacking. Both reviewers stated that Geier et al should have matched subjects and controls for age and sex, when analyzing their results.

Both reviewers also suggested that Geier et al were far too eager to ascribe their results (specifically the presence of urinary porphyrin metabolites) solely to mercury toxicity. They did not consider other possibilities, such as immune conditions, infection, or exposure to other heavy metals. Geier et al did not control for these factors, Reviewer #2 noted, and concluded, "The authors are clearly not objective. They continually refer to the results as indicative of exposure to mercury...not so."

* These unnamed scientists did not originally peer review the manuscript before publication.