Hierarchical Organization of Tau and Amyloid Deposits in the Cerebral Cortex
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Importance: Abnormal accumulation of tau and amyloid-β (Aβ) proteins in the human brain are 2 pathologic hallmarks of Alzheimer disease (AD). Because pathologic processes begin decades before the onset of the clinical manifestations, the study of the cortical distribution of early-stage pathologic alterations is critical in understanding the underpinnings of the disease. Objectives: To identify the in vivo brain spatial distributions of tau and Aβ deposits in a sample of cognitively normal participants in the Harvard Aging Brain Study, determine spatial patterns of pathologic alterations, and provide means for improved individual in vivo staging. Design, Setting, and Participants: Eighty-eight individuals from the general community underwent flortaucipir 18 T807 (18F-T807) and carbon 11-labeled Pittsburgh Compound B (11C-PiB) positron emission tomographic (PET) imaging. A voxel-level hierarchical clustering approach was used to obtain the main clustering partitions corresponding to the cortical distribution maps of 18F-T807 and 11C-PiB. Hierarchical relationships between areas of distinctive pathologic deposits were then studied. Using cerebellar gray reference, 18F-T807 data were expressed as standardized uptake value ratio, and 11C-PiB were given as distribution volume ratio. Main Outcomes and Measures: Main in vivo and hierarchically organized tau and Aβ deposits in the elderly brain. Results: Of the 88 study participants, 39 (44%) were men, with a mean (SD) age of 76.2 (6.2) years. The tau and Aβ maps both displayed optimal cortical partitions at 4 clusters. The tau deposits were grouped in the temporal lobe, distributed in heteromodal areas, medial and visual regions, and primary somatomotor cortex; the Aβ deposits were clustered in the heteromodal areas and rather patchy in distributed regions involving the primary cortices, medial structures, and temporal areas. Moreover, tau deposits in the temporal lobe and distributed heteromodal areas were tightly nested. Conclusions and Relevance: Tau and Aβ deposits in the elderly brain generally display well-defined hierarchical cortical relationships as well as overlaps between the principal clusters of both pathologic alterations in the heteromodal association regions. These findings represent systematic, large-scale mechanisms of early AD pathology.
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Amyloid plaques do not accumulate in discrete brain areas; they are relatively widespread across most regions of the neocortex, followed by the entorhinal cortex and hippocampus of Alzheimer's disease patients.
“Amyloid plaques do not accumulate in discrete brain areas. Rather, they are relatively widespread across most regions of the neocortex, followed by the entorhinal cortex and hippocampus of AD patients (Sepulcre et al., 2017; Thal et al., 2002).”
From Selective Neuronal Vulnerability in Alzheimer’s Disease: A Network-Based Analysis (2020) · cites this paper as Sepulcre et al., 2017
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- Authors
- Sepulcre, J., Grothe, M. J., Sabuncu, M., Chhatwal, J., Schultz, A. P., Hanseeuw, B., El Fakhri, G., Sperling, R., & Johnson, K. A.
- Affiliations
- Harvard University (US)
- German Center for Neurodegenerative Diseases (DE)
- Athinoula A. Martinos Center for Biomedical Imaging (US)
- Gordon Center for Medical Imaging, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Brigham and Women's Hospital (US)
- Corresponding author
- Sepulcre, Jorge
- ORCID
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2017-07-01
- Volume
- 74
- Issue
- 7
- Pages
- 813
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC5710537
- OpenAlex
- W2619717932
- Cited by
- 73
- References
- 54
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 9 · 2023: 4 · 2022: 7 · 2021: 8 · 2020: 9 · 2019: 8 · 2018: 16 · 2017: 3
- FWCI
- 8.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DIAL (Catholic University of Leuven) (submittedVersion)
- DZNE Pub (submittedVersion)
- Funders
- Alzheimer's Association (ZEN-10-174210)
- National Institute on Aging (K24AG035007, P01AG036694)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- amyloid-beta deposition, Alzheimer's disease, cerebral cortex, hierarchical clustering, flortaucipir PET, Pittsburgh compound B PET, temporal lobe, cognitively normal elderly
- MeSH terms
- Aged, Aged, 80 and over, Aging, Alzheimer Disease, Aniline Compounds, Cerebral Cortex, Cross-Sectional Studies, Female, Fluorine Radioisotopes, Humans, Male, Thiazoles, Amyloid beta-Peptides, tau Proteins, Positron-Emission Tomography, Benzothiazoles
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