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Title: Suspected non-Alzheimer disease pathophysiology--concept and controversy
Austin Authors: Jack, Clifford R;Vos, Stephanie J B;Visser, Pieter J;Villemagne, Victor L ;van der Flier, Wiesje M;Sperling, Reisa A;Petersen, Ronald C;Mormino, Elizabeth C;Jagust, William;Frisoni, Giovanni B;Fagan, Anne M;Dickson, Dennis;Chételat, Gaël;Knopman, David S
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
INSERM, Université de Caen, EPHE, CHU de Caen, Caen, France
Department of Pathology, Mayo Clinic and Foundation, Jacksonville, Florida, USA
Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, Missouri, USA
University Hospitals and University of Geneva, Genève, Switzerland
Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California, USA
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, Netherlands
Department of Molecular Imaging and Therapy, Centre for PET, Austin Health, Heidelberg, Victoria, Australia
Department of Psychiatry and Neuropsychology, Institute of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
Issue Date: Feb-2016 2016-01-18
Publication information: Nature Reviews Neurology 2016; 12(2): 117-124
Abstract: Suspected non-Alzheimer disease pathophysiology (SNAP) is a biomarker-based concept that applies to individuals with normal levels of amyloid-β biomarkers in the brain, but in whom biomarkers of neurodegeneration are abnormal. The term SNAP has been applied to clinically normal individuals (who do not meet criteria for either mild cognitive impairment or dementia) and to individuals with mild cognitive impairment, but is applicable to any amyloid-negative, neurodegeneration-positive individual regardless of clinical status, except when the pathology underlying neurodegeneration can be reliably inferred from the clinical presentation. SNAP is present in ∼23% of clinically normal individuals aged >65 years and in ∼25% of mildly cognitively impaired individuals. APOE*ε4 is underrepresented in individuals with SNAP compared with amyloid-positive individuals. Clinically normal and mildly impaired individuals with SNAP have worse clinical and/or cognitive outcomes than individuals with normal levels of neurodegeneration and amyloid-β biomarkers. In this Perspectives article, we describe the available data on SNAP and address topical controversies in the field.
Journal: Nature Reviews Neurology
PubMed URL:
Type: Journal Article
Subjects: Alzheimers's disease
Cognitive ageing
Risk Factors
Appears in Collections:Journal articles

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