Association of Longitudinal Changes in Cerebrospinal Fluid Total Tau and Phosphorylated Tau 181 and Brain Atrophy With Disease Progression in Patients With Alzheimer Disease

Key Points Question How do different proposed measurements of tau brain pathologic abnormalities (ie, levels of phosphorylated tau 181 in the cerebrospinal fluid [CSF]) and neurodegeneration (ie, total tau levels in the CSF and brain atrophy) change over the course of Alzheimer disease? Findings This cohort study of 465 participants with dominantly inherited Alzheimer disease found that the rates of change for CSF levels of total tau and phosphorylated tau 181 had a different pattern across the course of Alzheimer disease. The association between the rates of change of CSF levels of total tau and phosphoryated tau 181 and brain atrophy varied by disease stage. Meaning These results may provide a better understanding of the dynamics of Alzheimer disease and have important implications as trials targeting tau brain pathologic abnormalities move forward.

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