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Suspected non-AD pathology in mild cognitive impairment
Laura E M Wisse1, Nirali Butala2, Sandhitsu R Das1
1Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Neurobiology of Aging
|October 1, 2015
Summary
Suspected non-Alzheimer's disease (AD) pathology (SNAP) patients show neurodegeneration linked to cerebrovascular disease, not amyloidosis. These mild cognitive impairment (MCI) patients have distinct cognitive and biomarker profiles.
Area of Science:
- Neurology
- Neuroscience
- Gerontology
Background:
- Mild cognitive impairment (MCI) is a heterogeneous condition.
- Suspected non-Alzheimer's disease (AD) pathology (SNAP) represents a distinct MCI subtype.
- Understanding SNAP's characteristics is crucial for diagnosis and treatment.
Purpose of the Study:
- To characterize mild cognitive impairment (MCI) patients with suspected non-Alzheimer's disease (AD) pathology (SNAP).
- To analyze longitudinal outcomes, cognitive function, biofluid markers, and neuroimaging in SNAP patients.
- To compare SNAP patients with other MCI groups and amyloid-negative controls.
Main Methods:
- Utilized data from 361 MCI participants in the ADNI-GO/2 study.
- Defined "amyloid positive" (AMY+) by abnormal amyloid-beta 42 levels.
- Defined "neurodegeneration positive" (NEU+) by hippocampal volume or FDG-PET hypometabolism.
Main Results:
- SNAP patients (AMY-NEU+) were older than NEU- groups but similar to AMY- controls.
- SNAP patients showed a lower conversion rate to AD compared to AMY+NEU+ MCI.
- SNAP-MCI exhibited larger white matter hyperintensity volumes and worse cognitive performance than AMY-NEU- MCI.
Conclusions:
- Cerebrovascular disease and hippocampal pathologies likely underlie SNAP-MCI neurodegeneration and cognitive decline.
- Subthreshold cerebral amyloidosis is unlikely to be the primary driver in SNAP-MCI.
- SNAP represents a distinct MCI profile requiring further investigation.
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