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성균관대학교 의과대학, 삼성의료원

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Clin. Nucl. Med., Mar 03 2025, | https://doi.org/10.1097/RLU.0000000000005793 Distinct Characteristics of Suspected Non-Alzheimer Pathophysiology in Relation to Cognitive Status and Cerebrovascular Burden

Chun, Min Young MD, PhD^*,†,‡; Park, Yu Hyun PhD^*,§,∥; Kim, Hee Jin MD, PhD^*,∥,¶,#; Na, Duk L. MD, PhD^*,∥; Kim, Jun Pyo MD, PhD^*,∥; Seo, Sang Won MD, PhD^{*,∥,¶,#,**}; Jang, Hyemin MD, PhD^*,††

^*Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
^†Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine
^‡Department of Neurology, Yonsei University College of Medicine
^§Neuroscience Center, Samsung Medical Center
^∥Alzheimer’s Disease Convergence Research Center, Samsung Medical Center
^¶Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University
^#Department of Digital Health, SAIHST, Sungkyunkwan University
^**Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Gangnam-gu
^††Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea

M.Y.C. and Y.H.P. contributed equally to this work as co-first authors.
H.J. and S.W.S. contributed equally to this article as co-corresponding authors.
Correspondence to: Sang Won Seo, MD, PhD, ; Hyemin Jang, MD, PhD

Abstract

This study investigated the prevalence and clinical characteristics of suspected non-Alzheimer disease pathophysiology (SNAP) across varying cognitive statuses and cerebral small vessel disease (CSVD) burden. We included 1992 participants with cognitive status categorized as cognitively unimpaired, mild cognitive impairment, or dementia. β-amyloid (Aβ, A) positivity was assessed by Aβ PET, and neurodegeneration (N) positivity was determined through hippocampal volume. Participants were further divided by the presence or absence of severe CSVD. The clinical and imaging characteristics of A-N+ (SNAP) group were compared with those of the A-N- and A+N+ groups. SNAP participants were older and had more vascular risk factors compared with A-N- and A+N+ in the CSVD(-) cohort. SNAP and A+N+ showed similar cortical thinning. At the dementia stage, SNAP had a cognitive trajectory similar to A+N+ in the CSVD(-) cohort. However, SNAP exhibited less cognitive decline than A+N+ in the CSVD(+) cohort. SNAP is characterized by distinct clinical and imaging characteristics; however, it does not necessarily indicate a benign prognosis, particularly at the dementia stage. These findings highlight the need to assess SNAP in relation to the cognitive stage and CSVD presence to better understand its progression and guide interventions.

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형식Research article
게재일2025년 03월 (BRIC 등록일 2025-03-04)
연구진국내 연구진
분야 의약학 > 응용의학

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