SNAPを知る―アルツハイマー病を中心とした認知症診断の歴史と現況
アルツハイマー病（AD）を中心とした認知症診断の歴史と現状を概観し，SNAP（suspected non-Alzheimer’s disease pathophysiology）について解説した。SNAPは認知機能正常例ないし軽度認知機能障害例で，βアミロイド陰性（A－）かつ神経変性，神経損傷を認める（N＋），というバイオマーカーに規定された概念である。高齢者全体の20～30％を占め，A＋N＋の場合よりも認知症に至るリスクが低いとされる。SNAPの病理学的背景はPART（primary age-related tauopathy）をはじめ複数にわたる。タウをはじめとする新たなバイオマーカー開発...
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| Published in | Higher Brain Function Research Vol. 45; no. 1; pp. 11 - 19 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本高次脳機能学会
31.03.2025
Japan Society for Higher Brain Function |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1348-4818 1880-6554 |
| DOI | 10.2496/hbfr.45.11 |
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| Abstract | アルツハイマー病（AD）を中心とした認知症診断の歴史と現状を概観し，SNAP（suspected non-Alzheimer’s disease pathophysiology）について解説した。SNAPは認知機能正常例ないし軽度認知機能障害例で，βアミロイド陰性（A－）かつ神経変性，神経損傷を認める（N＋），というバイオマーカーに規定された概念である。高齢者全体の20～30％を占め，A＋N＋の場合よりも認知症に至るリスクが低いとされる。SNAPの病理学的背景はPART（primary age-related tauopathy）をはじめ複数にわたる。タウをはじめとする新たなバイオマーカー開発を反映したためか，National Institute of Alzheimer’s and Ageing Associationによる2024年のADの生物学的診断基準にはSNAPという用語が登場しないが，ADの疾患修飾薬が実用化された現在，臨床現場ではSNAPの概念は有用であると思われる。 |
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| AbstractList | アルツハイマー病（AD）を中心とした認知症診断の歴史と現状を概観し，SNAP（suspected non-Alzheimer’s disease pathophysiology）について解説した。SNAPは認知機能正常例ないし軽度認知機能障害例で，βアミロイド陰性（A－）かつ神経変性，神経損傷を認める（N＋），というバイオマーカーに規定された概念である。高齢者全体の20～30％を占め，A＋N＋の場合よりも認知症に至るリスクが低いとされる。SNAPの病理学的背景はPART（primary age-related tauopathy）をはじめ複数にわたる。タウをはじめとする新たなバイオマーカー開発を反映したためか，National Institute of Alzheimer’s and Ageing Associationによる2024年のADの生物学的診断基準にはSNAPという用語が登場しないが，ADの疾患修飾薬が実用化された現在，臨床現場ではSNAPの概念は有用であると思われる。 The history and present status of the diagnosis of dementia, focusing on Alzheimer’s disease (AD), is reviewed, and hereby the concept of suspected non-Alzheimer’s disease pathophysiology (SNAP) is discussed. Historically, the diagnosis of AD has depended on both clinical and pathological findings. However, the recent development of biomarkers, which can predict the neuropathological diagnosis, has contributed to the biological diagnosis of AD. SNAP is a biomarker-based condition defined by a normal level of amyloid-β (Aβ) protein and abnormal levels of markers of neurodegeneration or neuronal injury. Individuals with SNAP have a lower risk of developing dementia in the future than that of individuals with abnormal levels of both Aβ protein markers and markers of neurodegeneration or neuronal injury. The pathological background of SNAP is heterogeneous and includes primary age-related tauopathy. In a report on the biological diagnosis of AD based on biomarker findings, by the National Institute of Alzheimer’s and Ageing Association published in 2024, the term SNAP was not present. Since the first publication introducing the concept of SNAP in 2012, many biomarkers, particularly for tau proteinopathy, have been identified, besides those for β -amyloidosis, and both are believed to be essential factors in the pathophysiology of AD. In contrast, biomarkers for neurodegeneration or neuronal injury have been thought to be non-specific. Therefore, some researchers believe that the concept of SNAP is outdated. However, I believe that this concept can be useful in the clinical setting, because currently, biomarkers for β -amyloidosis can be routinely measured to facilitate the adaptation of disease-modifying therapy for patients with AD. Incorporating biomarker-driven insights into routine practice can enhance diagnostic accuracy, improve treatment targeting, and advance personalized care in neurodegenerative diseases. アルツハイマー病（AD）を中心とした認知症診断の歴史と現状を概観し，SNAP（suspected non-Alzheimer’s disease pathophysiology）について解説した。SNAPは認知機能正常例ないし軽度認知機能障害例で，βアミロイド陰性（A－）かつ神経変性，神経損傷を認める（N＋），というバイオマーカーに規定された概念である。高齢者全体の20～30％を占め，A＋N＋の場合よりも認知症に至るリスクが低いとされる。SNAPの病理学的背景はPART（primary age-related tauopathy）をはじめ複数にわたる。タウをはじめとする新たなバイオマーカー開発を反映したためか，National Institute of Alzheimer’s and Ageing Associationによる2024年のADの生物学的診断基準にはSNAPという用語が登場しないが，ADの疾患修飾薬が実用化された現在，臨床現場ではSNAPの概念は有用であると思われる。 |
| Author | 石原, 健司 |
| Author_FL | Ishihara Kenji |
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| Author_xml | – sequence: 1 fullname: 石原, 健司 organization: 旭神経内科リハビリテーション病院 |
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| Copyright | 2025 一般社団法人 日本高次脳機能学会 |
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| DocumentTitleAlternate | What is “SNAP”? Historical Review of the Diagnosis of Alzheimer’s Disease |
| DocumentTitle_FL | What is “SNAP”? Historical Review of the Diagnosis of Alzheimer’s Disease |
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| Publisher | 一般社団法人 日本高次脳機能学会 Japan Society for Higher Brain Function |
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| References_xml | – reference: 25) Román GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, Moody DM, O’Brien MD, Yamaguchi T, Grafman J, Drayer BP, Bennett DA, Fisher M, Ogata J, Kokmen E, Bermejo F, Wolf PA, Gorelick PB, Bick KL, Pajeau AK, Bell MA, DeCarli C, Culebras A, Korczyn AD, Bogousslavsky J, Hartmann A, Scheinberg P. Vascular dementia：diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993；43：250-260. doi：10.1212/wnl.43.2.250 – reference: 31) Wisse LEM, de Flores R, Xie L, Das SR, McMillan CT, Trojanowski JQ, Grossman M, Lee EB, Irwin D, Yushkevich PA, Wolk DA；Alzheimer’s Disease NeuroImaging Initiative. Pathological drivers of neurodegeneration in suspected non-Alzheimer’s disease pathophysiology. 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| Snippet | アルツハイマー病（AD）を中心とした認知症診断の歴史と現状を概観し，SNAP（suspected non-Alzheimer’s disease pathophysiology）について解説した。SNAPは認知機能正常... The history and present status of the diagnosis of dementia, focusing on Alzheimer’s disease (AD), is reviewed, and hereby the concept of suspected... |
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| SubjectTerms | Alzheimer’s disease biomarker SNAP suspected non-Alzheimer’s disease pathophysiology (SNAP) アルツハイマー病 バイオマーカー |
| Title | SNAPを知る―アルツハイマー病を中心とした認知症診断の歴史と現況 |
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