- Franzmeier, Nicolai;
- Brendel, Matthias;
- Beyer, Leonie;
- Slemann, Luna;
- Kovacs, Gabor G;
- Arzberger, Thomas;
- Kurz, Carolin;
- Respondek, Gesine;
- Lukic, Milica J;
- Biel, Davina;
- Rubinski, Anna;
- Frontzkowski, Lukas;
- Hummel, Selina;
- Müller, Andre;
- Finze, Anika;
- Palleis, Carla;
- Joseph, Emanuel;
- Weidinger, Endy;
- Katzdobler, Sabrina;
- Song, Mengmeng;
- Biechele, Gloria;
- Kern, Maike;
- Scheifele, Maximilian;
- Rauchmann, Boris-Stephan;
- Perneczky, Robert;
- Rullman, Michael;
- Patt, Marianne;
- Schildan, Andreas;
- Barthel, Henryk;
- Sabri, Osama;
- Rumpf, Jost J;
- Schroeter, Matthias L;
- Classen, Joseph;
- Villemagne, Victor;
- Seibyl, John;
- Stephens, Andrew W;
- Lee, Edward B;
- Coughlin, David G;
- Giese, Armin;
- Grossman, Murray;
- McMillan, Corey T;
- Gelpi, Ellen;
- Molina-Porcel, Laura;
- Compta, Yaroslau;
- van Swieten, John C;
- Laat, Laura Donker;
- Troakes, Claire;
- Al-Sarraj, Safa;
- Robinson, John L;
- Xie, Sharon X;
- Irwin, David J;
- Roeber, Sigrun;
- Herms, Jochen;
- Simons, Mikael;
- Bartenstein, Peter;
- Lee, Virginia M;
- Trojanowski, John Q;
- Levin, Johannes;
- Höglinger, Günter;
- Ewers, Michael
Tau pathology is the main driver of neuronal dysfunction in 4-repeat tauopathies, including cortico-basal degeneration and progressive supranuclear palsy. Tau is assumed to spread prion-like across connected neurons, but the mechanisms of tau propagation are largely elusive in 4-repeat tauopathies, characterized not only by neuronal but also by astroglial and oligodendroglial tau accumulation. Here, we assess whether connectivity is associated with 4R-tau deposition patterns by combining resting-state fMRI connectomics with both 2nd generation 18F-PI-2620 tau-PET in 46 patients with clinically diagnosed 4-repeat tauopathies and post-mortem cell-type-specific regional tau assessments from two independent progressive supranuclear palsy patient samples (n = 97 and n = 96). We find that inter-regional connectivity is associated with higher inter-regional correlation of both tau-PET and post-mortem tau levels in 4-repeat tauopathies. In regional cell-type specific post-mortem tau assessments, this association is stronger for neuronal than for astroglial or oligodendroglial tau, suggesting that connectivity is primarily associated with neuronal tau accumulation. Using tau-PET we find further that patient-level tau patterns are associated with the connectivity of subcortical tau epicenters. Together, the current study provides combined in vivo tau-PET and histopathological evidence that brain connectivity is associated with tau deposition patterns in 4-repeat tauopathies.