Cited by 778Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCancer-related cognitive impairment studies

Tau pathology and neurodegeneration contribute to cognitive impairment in Alzheimer’s disease

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Bejanin, Alexandre, Schonhaut, Daniel R, La Joie, Renaud, Kramer, Joel H, Baker, Suzanne L, Sosa, Natasha, Ayakta, Nagehan, Cantwell, Averill +9 more·2017·Brain

Abstract

Neuropathological and in vivo studies have revealed a tight relationship between tau pathology and cognitive impairment across the Alzheimer's disease spectrum. However, tau pathology is also intimately associated with neurodegeneration and amyloid pathology. The aim of the present study was therefore to assess whether grey matter atrophy and amyloid pathology contribute to the relationship between tau pathology, as measured with 18F-AV-1451-PET imaging, and cognitive deficits in Alzheimer's disease. We included 40 amyloid-positive patients meeting criteria for mild cognitive impairment due to Alzheimer's disease (n = 5) or probable Alzheimer's disease dementia (n = 35). Twelve patients additionally fulfilled the diagnostic criteria for posterior cortical atrophy and eight for logopenic variant primary progressive aphasia. All participants underwent 3 T magnetic resonance imaging, amyloid (11C-PiB) positron emission tomography and tau (18F-AV-1451) positron emission tomography, and episodic and semantic memory, language, executive and visuospatial functions assessment. Raw cognitive scores were converted to age-adjusted Z-scores (W-scores) and averaged to compute composite scores for each cognitive domain. Independent regressions were performed between 18F-AV-1451 binding and each cognitive domain, and we used the Biological Parametric Mapping toolbox to further control for local grey matter volumes, 11C-PiB uptake, or both. Partial correlations and causal mediation analyses (mediation R package) were then performed in brain regions showing an association between cognition and both 18F-AV-1451 uptake and grey matter volume. Our results showed that decreased cognitive performance in each domain was related to increased 18F-AV-1451 binding in specific brain regions conforming to established brain-behaviour relationships (i.e. episodic memory: medial temporal lobe and angular gyrus; semantic memory: left anterior temporal regions; language: left posterior superior temporal lobe and supramarginal gyrus; executive functions: bilateral frontoparietal regions; visuospatial functions: right more than left occipitotemporal regions). This pattern of regional associations remained essentially unchanged-although less spatially extended-when grey matter volume or 11C-PiB uptake maps were added as covariates. Mediation analyses revealed both direct and grey matter-mediated effects of 18F-AV-1451 uptake on cognitive performance. Together, these results show that tau pathology is related in a region-specific manner to cognitive impairment in Alzheimer's disease. These regional relationships are weakly related to amyloid burden, but are in part mediated by grey matter volumes. This suggests that tau pathology may lead to cognitive deficits through a variety of mechanisms, including, but not restricted to, grey matter loss. These results might have implications for future therapeutic trials targeting tau pathology.

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Authors
Bejanin, A., Schonhaut, D. R., La Joie, R., Kramer, J. H., Baker, S. L., Sosa, N., Ayakta, N., Cantwell, A., Janabi, M., Lauriola, M., O’Neil, J. P., Gorno-Tempini, M. L., Miller, Z. A., Rosen, H. J., Miller, B. L., Jagust, W. J., & Rabinovici, G. D.
Affiliations
  • University of California, San Francisco (US)
  • Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
  • Lawrence Berkeley National Laboratory (US)
Corresponding author
Bejanin, Alexandre
Venue
Brain
Published
2017-10-07
Volume
140
Issue
12
Pages
3286-3300
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2763470121
Cited by
778
References
14
Citations by year
2026: 87 · 2025: 100 · 2024: 111 · 2023: 81 · 2022: 97 · 2021: 106 · 2020: 85 · 2019: 79 · 2018: 26 · 2017: 2 · 2013: 1
FWCI
43.14
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Brain (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute on Aging (R01-AG045611, R01-AG034570, P50-AG023501, P01-AG019724, U01-AG052943)
  • National Institute of Neurological Disorders and Stroke (R01-NS050915, K24-DC015544)
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 › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
tau pathology, Alzheimer's disease, cognitive impairment, gray matter atrophy, amyloid pathology, 11C-PiB PET, posterior cortical atrophy, logopenic variant primary progressive aphasia, episodic memory, semantic memory, language, executive function, visuospatial ability, brain-behavior relationship, mediation
MeSH terms
Aged, Alzheimer Disease, Amyloid, Aniline Compounds, Brain, Carbolines, Carbon Radioisotopes, Female, Fluorine Radioisotopes, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Regression Analysis, Thiazoles, Case-Control Studies, tau Proteins, Aphasia, Primary Progressive, Positron-Emission Tomography, Benzothiazoles, Cognitive Dysfunction

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