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Adding the Topographical Information from Tau-PET to the A/T/(N) Framework: Steps Towards Staging AD in Vivo

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Abstract

Biomarkers have revolutionized the study and clinical diagnosis of Alzheimer’s disease (AD). While amyloid-β accumulation begins decades before the onset of clinical dementia in AD, tau pathology is more closely associated in both space and time to neurodegeneration and to clinical dysfunction. Correspondingly, tau-PET may prove useful in determining the severity of AD. Building on the biological research framework for AD, we review here methods and rationale to stage the severity of AD in vivo using the topographical distribution of tau-PET. We discuss how tau-PET can be used to detect early and subthreshold tau accumulation in medial temporal cortices prior to the onset of cognitive symptoms. Furthermore, tau-PET can be used to monitor the severity of AD as tau-PET spreads to association cortices and finally primary sensory cortices. We discuss the utility of tau-PET to monitor the progression of AD, the flexibility of potential approaches, and applications for clinical trials. In this regard, topographical information from tau-PET is a useful addition to the A/T/(N) framework.

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Funding

Funding: This research is supported by the Weston Brain Institute, Canadian Institutes of Health Research (CIHR) [MOP-11-51-31; RFN 152985, 159815, 162303], Canadian Consortium of Neurodegeneration and Aging (CCNA; MOP-11-51-31 -team 1), the Alzheimer’s Association [NIRG-12-92090, NIRP-12-259245], Brain Canada Foundation (CFI Project 34874; 33397), the Fonds de Recherche du Québec - Santé (FRQS; Chercheur Boursier, 2020-VICO-279314). TAP, P.R-N and SG are members of the CIHR-CCNA Canadian Consortium of Neurodegeneration in Aging. Colin J. Adair Charitable Foundation.JT is funded by the Canadian Institutes of Health Research doctoral award.

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Authors and Affiliations

  1. Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal, 6875 La Salle Blvd - FBC room 3149, Montreal, Canada, H4H 1R3

    J. Therriault, S. Gauthier & Pedro Rosa-Neto

  2. Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Canada

    J. Therriault, S. Gauthier & Pedro Rosa-Neto

  3. Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Canada

    J. Therriault, S. Gauthier & Pedro Rosa-Neto

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  1. J. Therriault
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  2. S. Gauthier
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  3. Pedro Rosa-Neto
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Correspondence to Pedro Rosa-Neto.

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Therriault, J., Gauthier, S. & Rosa-Neto, P. Adding the Topographical Information from Tau-PET to the A/T/(N) Framework: Steps Towards Staging AD in Vivo. J Prev Alzheimers Dis 10, 381–386 (2023). https://doi.org/10.14283/jpad.2023.52

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