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Suspected Non-Alzheimer's Disease Pathophysiology (SNAP) and Its Pathological Backgrounds in the Diagnosis of Preclinical and Clinical Alzheimer's Disease Masahito Yamada 1 1Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences Keyword: アルツハイマー病 , SNAP , 非アルツハイマー病が疑われる病態生理 , アミロイドマーカー , 神経変性マーカー , 神経損傷マーカー , 原発性年齢関連タウオパチー , PART , Alzheimer's disease , AD , suspected non-Alzheimer's disease pathophysiology , amyloid markers , neurodegeneration markers , neuronal injury markers , primary age-related tauopathy pp.59-71
Published Date 2018/1/1
DOI https://doi.org/10.11477/mf.1416200951
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Abstract

Suspected non-Alzheimer's disease pathophysiology (SNAP) is a biomarker-based condition that is found in individuals with normal levels of amyloid-β protein (Aβ) markers (A−) and abnormal levels of markers of neurodegeneration or neuronal injury (N+). SNAP is found in 20-26% of cognitively normal (CN) individuals aged 65 years or older and 17-35% of individuals with mild cognitive impairment (MCI). Similarly, 7-39% of patients with clinically probable Alzheimer's disease (AD) dementia are negative for Aβ. The ε4 allele of the apolipoprotein E gene is underrepresented in individuals with SNAP compared with amyloid-positive (A+) groups. The progression of the cognitive impairments of individuals with SNAP was slower than that of A+N+ subjects who had a high likelihood of AD pathophysiology and faster than that of A−N− subjects. The pathological backgrounds of the individuals with SNAP were heterogeneous and included cerebrovascular disorders, mixed pathologies, and non-AD neurodegeneration, such as primary age-related tauopathy [PART, also known as senile dementia of the neurofibrillary tangle type (SD-NFT) (tangle-only dementia) at the dementia stage] and argyrophilic grain disease. Further clarification of SNAP is needed to better define the mechanisms underlying the progression of AD pathologies in older individuals.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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