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Editorial
October 2016

Cause of Suspected Non–Alzheimer Disease PathophysiologyIf Not Tau Pathology, Then What?

Author Affiliations
  • 1Department of Psychiatry, McGill University, Montreal, Quebec, Canada
  • 2Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
  • 3Douglas Mental Health University Institute, PREVENT-AD Centre, Montreal, Quebec, Canada
JAMA Neurol. 2016;73(10):1177-1179. doi:10.1001/jamaneurol.2016.2842

Suspected non-Alzheimer pathophysiology (SNAP) is a biomarker-based concept suggested as a complement to the new National Institute on Aging–Alzheimer Association (NIA-AA) research criteria of preclinical Alzheimer disease (AD).1 The NIA-AA classifies individuals with preclinical AD into 1 of the following 3 stages: biomarker evidence of β-amyloid (Aβ) but no brain injury (stage 1), biomarker evidence of Aβ and brain injury (stage 2), and biomarker evidence of Aβ and brain injury, with subtle cognitive changes (stage 3). The term SNAP was introduced to capture cognitively normal individuals with evidence of AD-like brain injury in the absence of amyloidosis. As the name suggests, this group was initially hypothesized to have a non-AD pathophysiological process such as vascular disease or other types of neurodegenerative diseases.1

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