@article{f12751475ef54c93be23020cb93583c3,
title = "Four distinct trajectories of tau deposition identified in Alzheimer{\textquoteright}s disease",
abstract = "Alzheimer{\textquoteright}s disease (AD) is characterized by the spread of tau pathology throughout the cerebral cortex. This spreading pattern was thought to be fairly consistent across individuals, although recent work has demonstrated substantial variability in the population with AD. Using tau-positron emission tomography scans from 1,612 individuals, we identified 4 distinct spatiotemporal trajectories of tau pathology, ranging in prevalence from 18 to 33%. We 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 {\textquoteleft}subtypes{\textquoteright} 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, our results suggest that variation in tau pathology is common and systematic, perhaps warranting a re-examination of the notion of {\textquoteleft}typical AD{\textquoteright} and a revisiting of tau pathological staging.",
author = "{The Alzheimer{\textquoteright}s Disease Neuroimaging Initiative} and Vogel, {Jacob W.} and Young, {Alexandra L.} and Oxtoby, {Neil P.} and Ruben Smith and Rik Ossenkoppele and Strandberg, {Olof T.} and {La Joie}, Renaud and Aksman, {Leon M.} and Grothe, {Michel J.} and Yasser Iturria-Medina and Michael Weiner and Paul Aisen and Ronald Petersen and Jack, {Clifford R.} and William Jagust and Trojanowki, {John Q.} and Toga, {Arthur W.} and Laurel Beckett and Green, {Robert C.} and Saykin, {Andrew J.} and John Morris and Shaw, {Leslie M.} and Enchi Liu and Tom Montine and Thomas, {Ronald G.} and Michael Donohue and Sarah Walter and Devon Gessert and Tamie Sather and Gus Jiminez and Danielle Harvey and Matthew Bernstein and Nick Fox and Paul Thompson and Norbert Schuff and Charles DeCArli and Bret Borowski and Jeff Gunter and Matt Senjem and Prashanthi Vemuri and David Jones and Kejal Kantarci and Chad Ward and Koeppe, {Robert A.} and Norm Foster and Reiman, {Eric M.} and Kewei Chen and Chet Mathis and Beau Ances and Kyle Womack",
note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.",
year = "2021",
month = may,
doi = "10.1038/s41591-021-01309-6",
language = "English",
volume = "27",
pages = "871--881",
journal = "Nature medicine",
issn = "1078-8956",
number = "5",
}