Study finds Four distinct subtypes of Alzheimer's disease
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Alzheimer's disease is characterized by the abnormal accumulation and spread of the tau protein in the brain. An international study can now show how tau spreads according to four distinct patterns that lead to different symptoms with different prognoses of the affected individuals. The study was published in Nature Medicine.

Alzheimer’s disease (AD) is characterized by the spread of tau pathology throughout the cerebral cortex. This spreading pattern was thought to be consistent, although recent work has demonstrated substantial variability in the population with AD.

Using tau-positron emission tomography scans from 1,612 individuals, researchers identified 4 distinct spatiotemporal trajectories of tau pathology, ranging in prevalence from 18 to 33%. They replicated previously described limbic-predominant and medial temporal lobe-sparing patterns, while also discovering posterior and lateral temporal patterns resembling atypical clinical variants of AD.

These ‘subtypes’ were stable during longitudinal follow-up and were replicated in a separate sample using a different radiotracer. The subtypes presented with distinct demographic and cognitive profiles and differing longitudinal outcomes. Additionally, network diffusion models implied that pathology originates and spreads through distinct corticolimbic networks in the different subtypes.

Together, the results suggest that variation in tau pathology is common and systematic, perhaps warranting a re-examination of the notion of ‘typical AD’ and a revisiting of tau pathological staging.

Source: https://doi.org/10.1038/s41591-021-01309-6
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