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Prospective longitudinal atrophy in Alzheimer’s disease correlates with the intensity and topography of baseline tau-PET

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La Joie, Renaud, Visani, Adrienne V., Baker, Suzanne L., Brown, Jesse A., Bourakova, Viktoriya, Cha, Jungho, Chaudhary, Kiran, Edwards, Lauren +14 more·2020·Science Translational Medicine
DOI 10.1126/scitranslmed.aau5732PMC PMC7035952
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Abstract

β-Amyloid plaques and tau-containing neurofibrillary tangles are the two neuropathological hallmarks of Alzheimer's disease (AD) and are thought to play crucial roles in a neurodegenerative cascade leading to dementia. Both lesions can now be visualized in vivo using positron emission tomography (PET) radiotracers, opening new opportunities to study disease mechanisms and improve patients' diagnostic and prognostic evaluation. In a group of 32 patients at early symptomatic AD stages, we tested whether β-amyloid and tau-PET could predict subsequent brain atrophy measured using longitudinal magnetic resonance imaging acquired at the time of PET and 15 months later. Quantitative analyses showed that the global intensity of tau-PET, but not β-amyloid-PET, signal predicted the rate of subsequent atrophy, independent of baseline cortical thickness. Additional investigations demonstrated that the specific distribution of tau-PET signal was a strong indicator of the topography of future atrophy at the single patient level and that the relationship between baseline tau-PET and subsequent atrophy was particularly strong in younger patients. These data support disease models in which tau pathology is a major driver of local neurodegeneration and highlight the relevance of tau-PET as a precision medicine tool to help predict individual patient's progression and design future clinical trials.

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  • The distinguishing feature between Braak NFT stages V and VI is not just the presence of NFTs in V1, motor and sensory cortical areas, but more severe neurofibrillary degeneration and atrophy throughout the cortical mantle.

    “the distinguishing feature between Braak NFT stages V and VI is not just the presence of NFTs in the primary visual (V1), motor and sensory cortical areas, but more severe neurofibrillary degeneration21 and atrophy throughout the cortical mantle51”

    From Astrocyte transcriptomic changes along the spatiotemporal progression of Alzheimer’s disease (2024) · cites this paper as [51]

    The Results report cortical atrophy in patients with early-stage Alzheimer’s disease, and the Discussion reports an association between global cortical tau-PET signal and global cortical atrophy (pages unavailable). The paper does not compare Braak NFT stages V and VI or establish that more severe atrophy throughout the cortical mantle distinguishes them. Citation 51 is attached to the atrophy portion of the sentence, not the separate claim about neurofibrillary degeneration. (LLM, conf=0.79)

    Experimental — accuracy not yet measured

  • In 32 early AD participants, tau PET but not amyloid PET predicted the rate of subsequent brain atrophy.

    “Another study in 32 early AD participants showed that tau PET but not amyloid PET predicted the rate of subsequent brain atrophy showing that tau pathology is likely a major driver of neurodegeneration and has a role in precision medicine and future trials [197].”

    From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [197]

  • Tau pathology is likely a major driver of neurodegeneration.

    “Another study in 32 early AD participants showed that tau PET but not amyloid PET predicted the rate of subsequent brain atrophy showing that tau pathology is likely a major driver of neurodegeneration and has a role in precision medicine and future trials [197].”

    From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [197]

  • Jack et al. studied 59 cognitively unimpaired amyloid-negative, 37 cognitively unimpaired amyloid-positive and 30 cognitively impaired amyloid-positive participants over 12-15 months; tau PET signal did not increase in cognitively unimpaired amyloid-negative participants but did in the other groups.

    “Jack et al. 130 studied 59 cognitively unimpaired, amyloid-negative participants; 37 cognitively unimpaired amyloid-positive participants and 30 cognitively impaired amyloid-positive participants in a 12-15 month study.This study showed that in cognitively unimpaired amyloid-negative participants, tau PET signal did not increase, while it did in cognitively unimpaired amyloid-positive and cognitIV”

    From The amyloid hypothesis in Alzheimer disease: new insights from new therapeutics (2022) · cites this paper as [130]

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Authors
La Joie, R., Visani, A. V., Baker, S. L., Brown, J. A., Bourakova, V., Cha, J., Chaudhary, K., Edwards, L., Iaccarino, L., Janabi, M., Lesman-Segev, O. H., Miller, Z. A., Perry, D. C., O’Neil, J. P., Pham, J., Rojas, J. C., Rosen, H. J., Seeley, W. W., Tsai, R. M., Miller, B. L., Jagust, W. J., & Rabinovici, G. D.
Affiliations
  • Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
  • University of California, San Francisco (US)
  • Lawrence Berkeley National Laboratory (US)
ORCID
Venue
Science Translational Medicine
Publisher
American Association for the Advancement of Science (AAAS)
Published
2020-01
Volume
12
Issue
524
ISSN
  • 1946-6234 (ISSN-L)
  • 1946-6242
DOI
10.1126/scitranslmed.aau5732
PMC
PMC7035952
OpenAlex
W2998707549
Cited by
612
References
10
Citations by year
2026: 73 · 2025: 88 · 2024: 83 · 2023: 82 · 2022: 105 · 2021: 109 · 2020: 69
FWCI
66.56
Type
journal article
Language
en
Open access
Locations
  • Science Translational Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute on Aging (R01-AG045611, R01-AG034570, P50-AG023501)
  • Alzheimer’s Association (AARF-16-443577)
  • Tau Consortium
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
Alzheimer's disease, tau PET, brain atrophy, amyloid PET, neurofibrillary tangles, tau pathology, cortical thickness, disease progression, precision medicine
MeSH terms
Aged, Aged, 80 and over, Alzheimer Disease, Atrophy, Carbolines, Cerebral Cortex, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, tau Proteins, Positron-Emission Tomography

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