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Tau · Network neuroscience

The same protein accumulates in hub regions in one disease and deep structures in another

Evidence: EmergingMore than one study points the same way, but the body is still thin. What the labels mean

Study published Jan 1, 2018. PaperFren added this explanation Sep 20, 2026.

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Short answer

Tau tracked the functional connectome in Alzheimer's disease but not in progressive supranuclear palsy, despite being the same protein.

What happened

Cope and colleagues measured tau with PET and resting-state functional connectivity in 17 patients with Alzheimer's disease, 17 with progressive supranuclear palsy and 12 age-matched controls. In Alzheimer's disease tau accumulated preferentially in highly connected hub regions (r = 0.48), and higher overall burden correlated with weakened cortical connection strength (r = −0.58). In progressive supranuclear palsy tau accumulated in deep brain structures and did not track the functional connectome.

Why it matters

The network-spread hypothesis — that pathology travels along functional connections — is usually tested in one disease at a time, where it cannot fail informatively. Testing it in two tauopathies at once gives it something to be wrong about, and it holds in one and not the other.

Evidence

Study type
Cross-sectional tau PET with resting-state functional connectivity across two tauopathies and controls
Sample
17 Alzheimer's disease, 17 progressive supranuclear palsy, 12 age-matched controls
Journal
Brain · peer reviewed
Replication
Not assessed in this corpus
Limitations
Cross-sectional, so no spread is observed over time. Small groups, and the PET ligand primarily binds aggregated tau, which constrains what the maps represent.

What this connects to

Sources

The 2 studies this explanation is built from, by the role each plays. Every source links to PaperFren’s explanation of it and to the original paper.

Primary study

  • How tau buildup shapes brain networks in dementia

    Cope TE, Rittman T, Borchert RJ, et al. · 2018 · Brain : a journal of neurology · 229 citations

    In Alzheimer's disease, tau builds up in highly connected brain hubs and weakens their connections, while in progressive supranuclear palsy, tau accumulates in deep brain structures and forces the cortex to use less efficient, indirect pathways.

    What it does not show

    Because the study design was cross-sectional rather than longitudinal, it cannot prove that tau spreads along functional connections over time or that connectivity changes are directly caused by tau accumulation. The PET imaging ligand primarily binds to aggregated tau tangles and cannot detect toxic, non-aggregated oligomeric tau forms. Additionally, the small cohort sizes (17 patients per disease group and 12 controls) limit the statistical power and generalizability of the findings. Finally, functional MRI has lower signal sensitivity in the deep subcortical brain areas where progressive supranuclear palsy pathology is concentrated.

    PaperFren explanationStudy with cards and a quizOriginal paper (DOI)cc by

Supporting evidence

  • How does brain inflammation affect connectivity and thinking in AD?

    Passamonti L, Tsvetanov KA, Jones PS, et al. · 2019 · The Journal of neuroscience : the official journal of the Society for Neuroscience · 187 citations

    Brain inflammation in Alzheimer's disease alters how large-scale networks communicate, and this disrupted connection directly relates to poorer cognitive performance.

    What it does not show

    First, the study is cross-sectional and correlational, meaning it cannot prove whether neuroinflammation causes network disruption and cognitive decline, or vice versa. Second, it relied on a relatively small sample size of patients, which may limit how well these findings generalize to larger, more diverse populations. Third, other key elements of Alzheimer's pathology, such as tau accumulation, were not fully mapped alongside neuroinflammation in this study, leaving their combined impact unclear.

    PaperFren explanationStudy with cards and a quizOriginal paper (DOI)cc by

Before

Network-based spread was proposed as a general principle for how misfolded proteins propagate, supported mainly by single-disease studies.

Now

The relationship is disease-specific rather than a property of tau. The design is cross-sectional so it cannot show spread over time, the groups are small, and the PET ligand binds aggregated tau with known off-target signal.