Brain network dynamics determine tau presence while regional vulnerability governs tau load in Alzheimer’s disease

Brain network dynamics determine tau presence while regional vulnerability governs tau load in Alzheimer’s disease | Research Square Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Article Brain network dynamics determine tau presence while regional vulnerability governs tau load in Alzheimer’s disease Yu Xiao, Nicola Spotorno, Lijun An, Vincent Bazinet, Justine Hansen, and 15 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8687892/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract In Alzheimer’s disease (AD), tau pathology accumulates gradually throughout the brain, with clinical decline reflecting tau progression. A comprehensive understanding of, first, whether tau propagation is predominantly governed by connectome-based diffusion, regional vulnerability, or an interplay of both, and second, which types of brain connectivity or regional factors best explain tau propagation, remains crucial for advancing our understanding of AD progression. Here, we apply multi-scale, biologically informed disease progression simulations to human data, to disentangle the influence of local mechanisms on global tau progression patterns in AD. We find that whether tau reaches a brain region (presence) and how much tau accumulates there (load) are governed by different mechanisms. Tau presence patterns are highly consistent across the population, and can be largely explained through synaptic spread through white-matter networks and excitatory-inhibitory dynamics. Meanwhile tau load differs across people, and is driven by a combination of synaptic spread and intrinsic or extrinsic regional properties, including regional β-amyloid load, MAPT gene expression and regional blood flow. Finally, while distinct tau patterns in the population could each be explained by established AD mechanisms, our models highlight a role of distinct brain networks (parietal networks in MTL-sparing AD tau subtype) and neurotransmitter systems (cholinergic system in posterior subtype). Together, this work suggests that network dynamics likely determine the sequence of regional tau progression, while individual-specific tissue-vulnerability factors influence regional tau load. Biological sciences/Neuroscience/Diseases of the nervous system/Alzheimer's disease Biological sciences/Computational biology and bioinformatics/Computational models Alzheimer’s disease Disease progression Tau-PET Brain connectivity Model Full Text Additional Declarations Yes there is potential Competing Interest. OH is an employee of Lund University and Eli Lilly. NMC has received consultancy/speaker fees from Biogen, Eli Lilly, Owkin, and Merck. GS has received consultancy/speaker fees from Springer, Adium, and GE. JWV has received consultancy/speaker fees from Manifest Technologies. Supplementary Files SupplementaryInformation.pdf Supplementary materials (exclude Stable 4 and Stable 6) SupplementaryTable4PresenceLoadmdoelsperformance.xlsx Supplementary STable 4 SupplementaryTable6Subtypesmdoelsperformance.xlsx Supplementary STable 6 Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information

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