Aβ deposition is associated with increases in soluble and phosphorylated tau that precede a positive Tau PET in Alzheimer's disease

Niklas Mattsson-Carlgren, Emelie Andersson, Shorena Janelidze, Rik Ossenkoppele, Philip Insel, Olof Strandberg, Henrik Zetterberg, Howard J. Rosen, Gil Rabinovici, Xiyun Chai, Kaj Blennow, Jeffrey L. Dage, Erik Stomrud, Ruben Smith, Sebastian Palmqvist, Oskar Hansson*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The links between β-amyloid (Aβ) and tau in Alzheimer's disease are unclear. Cognitively unimpaired persons with signs of Aβ pathology had increased cerebrospinal fluid (CSF) phosphorylated tau (P-tau181 and P-tau217) and total-tau (T-tau), which increased over time, despite no detection of insoluble tau aggregates [normal Tau positron emission tomography (PET)]. CSF P-tau and T-tau started to increase before the threshold for Amyloid PET positivity, while Tau PET started to increase after Amyloid PET positivity. Effects of Amyloid PET on Tau PET were mediated by CSF P-tau, and high CSF P-tau predicted increased Tau PET rates. Individuals with MAPT mutations and signs of tau deposition (but without Aβ pathology) had normal CSF P-tau levels. In 5xFAD mice, CSF tau increased when Aβ aggregation started. These results show that Aβ pathology may induce changes in soluble tau release and phosphorylation, which is followed by tau aggregation several years later in humans.

Original languageEnglish
Article numbereaaz2387
JournalScience Advances
Issue number16
Publication statusPublished - Apr 2020

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