Suspected non-Alzheimer disease pathophysiology - concept and controversy

被引：222

作者：

Jack, Clifford R., Jr. ^{[1
]}

Knopman, David S. ^{[2
]}

Chetelat, Gael ^{[3
]}

Dickson, Dennis ^{[4
]}

Fagan, Anne M. ^{[5
]}

Frisoni, Giovanni B. ^{[6
,7
]}

Jagust, William ^{[8
]}

Mormino, Elizabeth C. ^{[9
]}

Petersen, Ronald C. ^{[2
]}

Sperling, Reisa A. ^{[9
]}

van der Flier, Wiesje M. ^{[10
]}

Villemagne, Victor L. ^{[11
]}

Visser, Pieter J. ^{[12
]}

Vos, Stephanie J. B. ^{[12
]}

机构：

[1] Mayo Clin & Mayo Fdn, Dept Radiol, Rochester, MN 55905 USA

[2] Mayo Clin & Mayo Fdn, Dept Neurol, 200 First St SW, Rochester, MN 55905 USA

[3] Univ Caen, CHU Caen, EPHE, INSERM,U1077, F-14032 Caen, France

[4] Mayo Clin & Mayo Fdn, Dept Pathol, 4500 San Pablo Rd South, Jacksonville, FL 32224 USA

[5] Washington Univ, Sch Med, Knight Alzheimers Dis Res Ctr, Dept Neurol, 4488 Forest Pk Ave,Suite 101, St Louis, MO 63108 USA

[6] Univ Hosp, Rue Gabrielle Perret Gentil 4, CH-1205 Geneva, Switzerland

[7] Univ Geneva, Rue Gabrielle Perret Gentil 4, CH-1205 Geneva, Switzerland

[8] Univ Calif Berkeley, Helen Wills Neurosci Inst, Li Ka Shing Ctr 175, Berkeley, CA 94720 USA

[9] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Neurol, 221 Longwood Ave, Boston, MA 02115 USA

[10] Vrije Univ Amsterdam, Med Ctr, Alzheimer Ctr, Dept Neurol, Neurosci Campus Amsterdam,POB 7057, NL-1007 MB Amsterdam, Netherlands

[11] Austin Hlth, Ctr PET, Dept Mol Imaging & Therapy, 145 Studley Rd,POB 5555 Melbourne, Melbourne, Vic 3084, Australia

[12] Maastricht Univ, Inst Mental Hlth & Neurosci, Dept Psychiat & Neuropsychol, POB 616 MD Maastricht, NL-6200 MD Maastricht, Netherlands

来源：

NATURE REVIEWS NEUROLOGY | 2016年 / 12卷 / 02期

关键词：

MILD COGNITIVE IMPAIRMENT; POSITRON-EMISSION-TOMOGRAPHY; CEREBROSPINAL-FLUID BIOMARKERS; AMYLOID-BETA DEPOSITION; NATIONAL INSTITUTE; ASSOCIATION WORKGROUPS; DIAGNOSTIC GUIDELINES; HIPPOCAMPAL ATROPHY; OLDER PERSONS; NEUROPATHOLOGIC ASSESSMENT;

D O I：

10.1038/nrneurol.2015.251

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Suspected non-Alzheimer disease pathophysiology (SNAP) is a biomarker-based concept that applies to individuals with normal levels of amyloid-beta 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 similar to 23% of clinically normal individuals aged >65 years and in similar to 25% of mildly cognitively impaired individuals. APOE*epsilon 4 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-beta biomarkers. In this Perspectives article, we describe the available data on SNAP and address topical controversies in the field.

引用

页码：117 / 124

页数：8

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