{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:48:07Z","timestamp":1790790487175,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p>The in vivo detection of mixed Alzheimer's disease (AD) and \u03b1\u2010synuclein (\u03b1Syn) pathology is important for clinical management and prognostic stratification. We investigated the contribution of \u03b1Syn pathology, detected by cerebrospinal fluid (CSF) seed amplification assay (\u03b1Syn SAA), on [18F]\u2010fluorodeoxyglucose positron emission tomography (FDG PET) pattern in subjects with amnestic mild cognitive impairment (aMCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We included 562 aMCI participants and 204 cognitively normal\u00a0controls (CN) with available \u03b1Syn SAA and cerebral metabolic rate for glucose utilization (rCMRgl) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>24% of aMCI cases were positive (+) for CSF \u03b1Syn SAA. Compared to CN, both \u03b1Syn+ and negative (\u2212) aMCI participants showed reductions in rCMRgl within AD typical regions. \u03b1Syn+ aMCI had lower rCMRgl within AD and dementia with Lewy bodies (DLB) typical regions compared to \u03b1Syn\u2212 aMCI, even after stratification according to the CSF AT(N) system.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>\u03b1Syn pathology contributes to a distinct FDG PET pattern in aMCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>\u03b1Syn pathology can be detected in vivo by CSF \u03b1Syn SAA.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>We investigated the FDG PET pattern in aMCI patients with CSF \u03b1Syn SAA positivity.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>\u03b1Syn+ aMCI showed a marked brain hypometabolism in AD and DLB typical 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