The long distance relationship of regional amyloid burden and tau pathology spread

Introduction: Consistent with the amyloid-cascade-hypothesis, we tested whether regional amyloid burden is associated with tau pathology increases in spatially independent brain regions and whether functional connectivity serves as a mediator bridging the observed spatial gap between these pathologies. Methods: Data of 98 amyloid-positive and 35 amyloid-negative subjects with baseline amyloid (18F-AV45) and longitudinal tau (18F-AV1451) PET were selected from ADNI. Annual tau change maps were computed. All images were z-transformed using the amyloid-negative subjects as reference. Z-maps of baseline amyloid and annual tau change were submitted to a parallel independent component analysis in GIFT, yielding six component pairs linking spatial patterns of baseline amyloid to longitudinal tau increase. Next, we used the region of maximum coefficient per component as seeds for functional connectivity analyses in a healthy control dataset. This resulted in six pairs of amyloid and tau seed-based networks (SBN). The spatial overlap between these SBNs and components (amyloid OR tau change) and the combined component pairs (amyloid AND tau change) were quantified. Results: Amyloid SBNs presented greater spatial overlap with their respective amyloid components (24%-54%) than tau SBNs with the respective tau change components (16%-40%). However, the spatial combination of amyloid and tau component pairs showed highest spatial overlap with the amyloid SBNs (up to 62% vs. 39% for the tau SBNs). Conclusion: Mechanistically, regional associations of amyloid and tau pathology may be driven by underlying large-scale functional networks. Functional connections may thereby transmit soluble amyloid to remote brain regions within the same network, likely triggering tau aggregation. ### Competing Interest Statement The authors have declared no competing interest.