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Mild cognitive impairment with suspected nonamyloid pathology (SNAP): Prediction of progression

Anna Caroli1, Annapaola Prestia1, Samantha Galluzzi1

  • 1From the Medical Imaging Unit (A.C.), Biomedical Engineering Department, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Bergamo; LENITEM-Laboratory of Epidemiology Neuroimaging and Telemedicine (A.P., S.G., C.F., A.R., G.B.F.), IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Alzheimer Center and Department of Neurology (W.M.v.d.F., R.O., P.S.), Department of Epidemiology & Biostatistics (W.M.v.d.F.), Department of Radiology & Nuclear Medicine (B.V.B., F.B.), and Neurochemistry Laboratorium and Biobank, Department of Clinical Chemistry (C.T.), VU University Medical Center, Amsterdam, the Netherlands; PET-Center (A.E.W.), Section of Nuclear Medicine & PET, Department of Radiology, Oncology and Radiation Sciences, Uppsala University; Alzheimer Neurobiology Center (S.F.C., M.S., I.H.C., A.N.), Karolinska Institutet, Stockholm, Sweden; Wolfson Molecular Imaging Centre (S.F.C.), University of Manchester, UK; MedTech West (M.S.), Sahlgrenska University Hospital, University of Gothenburg, Sweden; Department of Neuropsychiatry (I.H.C.), School of Medicine, Chosun University, Gwangju, Republic of Korea; Department of Psychiatry and Psychotherapy (T.G.), Klinikum rechts der Isar, Technische Universitat Muenchen, Germany; Department of Geriatric Medicine (A.N.), Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Nuclear Medicine (A.D.), University of Cologne, Germany; and Departments of Internal Medicine and Psychiatry (G.B.F.), University Hospitals and University of Geneva, Switzerland.

Neurology
|January 9, 2015
PubMed
Abstract

Insights

Patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI) show a distinct progression risk. Neurodegeneration markers, not amyloid, predict cognitive decline in SNAP MCI.

Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Mild cognitive impairment (MCI) affects a significant portion of the aging population.
  • Identifying predictors of cognitive deterioration is crucial for early intervention.
  • Suspected non-Alzheimer disease pathology (SNAP) represents a distinct subtype of MCI.

Purpose of the Study:

  • To investigate predictors of progressive cognitive deterioration in patients with MCI.
  • To differentiate the progression profiles of patients with SNAP and other MCI subtypes.
  • To identify specific pathological markers associated with cognitive decline in MCI.

Main Methods:

  • 201 patients with MCI were assessed for amyloid pathology (CSF β-amyloid 42) and neurodegeneration (hippocampal volume, [18F]-fluorodeoxyglucose-PET).
  • Patients were categorized into four groups: A-N-, A+N-, SNAP (A-N+), and A+N+.
  • Clinical follow-up for up to 6 years identified progressive cognitive deterioration.

Main Results:

  • SNAP and A+N+ patients had a significantly higher risk of cognitive progression compared to A-N- patients.
  • SNAP patients exhibited more severe hippocampal atrophy and comparable hypometabolism to A+N+ patients.
  • In SNAP patients, greater hypometabolism correlated with a shorter time to progression.

Conclusions:

  • Patients with SNAP MCI possess a unique risk progression profile.
  • Neurodegenerative markers are key predictors of cognitive decline in SNAP MCI.
  • This study highlights the importance of differentiating MCI subtypes for understanding disease trajectory.

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