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The biological processes underlying this phenomenon remain poorly understood. We searched the PubMed\/MEDLINE, Web of Science and CAPES databases to synthesise post\u2010mortem brain tissue findings that differ between symptomatic and asymptomatic\n                    <jats:sc>AD<\/jats:sc>\n                    . Thirty\u2010four studies met the predefined eligibility criteria. Multiple reports described lower levels of oligomeric A\u03b2 and p\u2010tau in ASYMAD, with reduced accumulation at synapses. Consistent with synaptic resilience, ASYMAD showed preserved expression of markers and proteomic signatures linked to synaptic function, homeostasis and plasticity. Further analyses supported preserved parenchymal architecture and dendritic and axonal morphology in ASYMAD. Some authors also described compensatory adaptations, including neuronal hypertrophy, increased neurogenesis and cellular antioxidant responses in ASYMAD brains. Additional findings indicated partial resistance to disruption of brain glucose, polyunsaturated fatty acid and one\u2010carbon\/polyamine metabolism. Glial and immune findings suggested a profile characterised by increased glial reactivity in specific regions and disease stages, alongside preserved glial homeostasis and lower cytokine expression in other contexts. In conclusion, although this review identified multiple processes potentially associated with the ASYMAD phenotype, the current evidence remains largely descriptive. Additionally, this synthesis is limited by substantial methodological heterogeneity and inconsistencies in data reporting. Future research should prioritise standardised clinicopathological definitions, pathology stage matching between ASYMAD and symptomatic AD groups, systematic assessment of mixed pathologies and further replication of exploratory findings to better elucidate the mechanisms underlying clinical resilience to\n                    <jats:sc>AD<\/jats:sc>\n                    neuropathology.\n                  <\/jats:p>","DOI":"10.1111\/nan.70077","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:17:11Z","timestamp":1778293031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Asymptomatic Versus Symptomatic Alzheimer's Disease Neuropathology: A Systematic Review of Differences Reported in Post\u2010Mortem Studies"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9941-2351","authenticated-orcid":false,"given":"Thiago Guilherme R\u00eago","family":"Barros","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio Integrado de Pesquisas em Patologia, Departamento de Patologia, Faculdade de Medicina Universidade Federal de Juiz de Fora  Juiz de Fora Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-2378","authenticated-orcid":false,"given":"Laura Barbosa","family":"Grossi","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Integrado de Pesquisas em Patologia, Departamento de Patologia, Faculdade de Medicina Universidade Federal de Juiz de Fora  Juiz de Fora Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2282-8238","authenticated-orcid":false,"given":"Maria Let\u00edcia","family":"da Silva Campos","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Integrado de Pesquisas em Patologia, Departamento de Patologia, Faculdade de Medicina Universidade Federal de Juiz de Fora  Juiz de Fora Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9657-3675","authenticated-orcid":false,"given":"Israel Bem\u2010Hur Netto","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Integrado de Pesquisas em Patologia, Departamento de Patologia, Faculdade de Medicina Universidade Federal de Juiz de Fora  Juiz de Fora Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9621-5422","authenticated-orcid":false,"given":"Ant\u00f4nio L\u00facio","family":"Teixeira","sequence":"additional","affiliation":[{"name":"The Glenn Biggs Institute for Alzheimer's &amp; 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