The clinical importance of suspected non-Alzheimer disease pathophysiology

IF 28.2 1区医学 Q1 CLINICAL NEUROLOGY

Nature Reviews Neurology Pub Date : 2024-05-09 DOI:10.1038/s41582-024-00962-y

Stephanie J. B. Vos, Aurore Delvenne, Clifford R. Jack Jr, Dietmar R. Thal, Pieter Jelle Visser

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Abstract

The development of biomarkers for Alzheimer disease (AD) has led to the origin of suspected non-AD pathophysiology (SNAP) — a heterogeneous biomarker-based concept that describes individuals with normal amyloid and abnormal tau and/or neurodegeneration biomarker status. In this Review, we describe the origins of the SNAP construct, along with its prevalence, diagnostic and prognostic implications, and underlying neuropathology. As we discuss, SNAP can be operationalized using different biomarker modalities, which could affect prevalence estimates and reported characteristics of SNAP in ways that are not yet fully understood. Moreover, the underlying aetiologies that lead to a SNAP biomarker profile, and whether SNAP is the same in people with and without cognitive impairment, remains unclear. Improved insight into the clinical characteristics and pathophysiology of SNAP is of major importance for research and clinical practice, as well as for trial design to optimize care and treatment of individuals with SNAP. Suspected non-AD pathophysiology (SNAP) is a biomarker-based concept that describes individuals with normal amyloid and abnormal tau and/or neurodegeneration biomarker status. This Review discusses the origins of the SNAP construct, along with its prevalence, diagnostic and prognostic implications, and underlying neuropathology.

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疑似非阿尔茨海默病病理生理学的临床重要性

阿尔茨海默病（AD）生物标志物的开发导致了疑似非 AD 病理生理学（SNAP）的起源--这是一种基于生物标志物的异质性概念，描述了淀粉样蛋白正常而 tau 和/或神经变性生物标志物异常的个体。在本综述中，我们将介绍 SNAP 概念的起源、流行程度、诊断和预后意义以及潜在的神经病理学。正如我们所讨论的那样，SNAP 可通过不同的生物标志物模式进行操作，这可能会以尚未完全理解的方式影响 SNAP 的患病率估计和报告特征。此外，导致 SNAP 生物标志物特征的潜在病因，以及 SNAP 在有认知障碍和无认知障碍的人群中是否相同，目前仍不清楚。更好地了解 SNAP 的临床特征和病理生理学对研究和临床实践以及试验设计至关重要，有助于优化对 SNAP 患者的护理和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature Reviews Neurology 医学-临床神经学

CiteScore

29.90

自引率

0.80%

发文量

138

审稿时长

6-12 weeks

期刊介绍： Nature Reviews Neurology aims to be the premier source of reviews and commentaries for the scientific and clinical communities we serve. We want to provide an unparalleled service to authors, referees, and readers, and we work hard to maximize the usefulness and impact of each article. The journal publishes Research Highlights, Comments, News & Views, Reviews, Consensus Statements, and Perspectives relevant to researchers and clinicians working in the field of neurology. Our broad scope ensures that the work we publish reaches the widest possible audience. Our articles are authoritative, accessible, and enhanced with clearly understandable figures, tables, and other display items. This page gives more detail about the aims and scope of the journal.