AbstractBackgroundSuspected Non Alzheimer Pathology (SNAP) is a biomarker‐defined syndrome that encompasses a group of individuals with neurodegeneration, but no evidence of amyloid deposition. However, it is still unclear whether SNAP represents distinct pathology separate from AD. We examined the differences in the volume and texture of key regions of interest (ROIs) in brain MRI between SNAP and AD to discuss the different causes of neurodegeneration.MethodWe enrolled all participants from dementia clinics of Seoul National University Bundang Hospital. We obtained three‐dimensional structural T1‐weighted magnetic resonance images of the participants using 3.0 Tesla Achieva Scanner and compared the texture and volume of ROIs between the groups using analysis of variance with Bonferroni post hoc comparisons.ResultThe SNAP group showed comparable volumes to the AD group in all ROIs. Compared with regional volume, regional texture showed different features between SNAP and AD. The SNAP group showed different texture in precuneus, posterior cingulate cortex, superior parietal cortex and inferior parietal cortex. In these regions, the entropy which reflects the randomness of spatial distribution of gray levels was higher in the AD group compared to the SNAP group.ConclusionThis study demonstrated that the texture change of SNAP was different from that of AD despite a similar volume change. In conclusion, our study suggests that MRI texture can be used for detection of microstructural changes in the early stage of the disease.