Nature Communications (Jun 2024)

Postmortem imaging reveals patterns of medial temporal lobe vulnerability to tau pathology in Alzheimer’s disease

  • Sadhana Ravikumar,
  • Amanda E. Denning,
  • Sydney Lim,
  • Eunice Chung,
  • Niyousha Sadeghpour,
  • Ranjit Ittyerah,
  • Laura E. M. Wisse,
  • Sandhitsu R. Das,
  • Long Xie,
  • John L. Robinson,
  • Theresa Schuck,
  • Edward B. Lee,
  • John A. Detre,
  • M. Dylan Tisdall,
  • Karthik Prabhakaran,
  • Gabor Mizsei,
  • Maria Mercedes Iñiguez de Onzono Martin,
  • Maria del Mar Arroyo Jiménez,
  • Monica Mũnoz,
  • Maria del Pilar Marcos Rabal,
  • Sandra Cebada Sánchez,
  • José Carlos Delgado González,
  • Carlos de la Rosa Prieto,
  • David J. Irwin,
  • David A. Wolk,
  • Ricardo Insausti,
  • Paul A. Yushkevich

DOI
https://doi.org/10.1038/s41467-024-49205-0
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 16

Abstract

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Abstract Our current understanding of the spread and neurodegenerative effects of tau neurofibrillary tangles (NFTs) within the medial temporal lobe (MTL) during the early stages of Alzheimer’s Disease (AD) is limited by the presence of confounding non-AD pathologies and the two-dimensional (2-D) nature of conventional histology studies. Here, we combine ex vivo MRI and serial histological imaging from 25 human MTL specimens to present a detailed, 3-D characterization of quantitative NFT burden measures in the space of a high-resolution, ex vivo atlas with cytoarchitecturally-defined subregion labels, that can be used to inform future in vivo neuroimaging studies. Average maps show a clear anterior to poster gradient in NFT distribution and a precise, spatial pattern with highest levels of NFTs found not just within the transentorhinal region but also the cornu ammonis (CA1) subfield. Additionally, we identify granular MTL regions where measures of neurodegeneration are likely to be linked to NFTs specifically, and thus potentially more sensitive as early AD biomarkers.