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Hemispheric asymmetry of tau pathology is related to asymmetric amyloid deposition in Alzheimer’s Disease

Toomas Erik Anijärv (), Rik Ossenkoppele, Ruben Smith, Alexa Pichet Binette, Lyduine E. Collij, Harry H. Behjat, Jonathan Rittmo, Linda Karlsson, Khazar Ahmadi, Olof Strandberg, Danielle Westen, Jacob W. Vogel, Erik Stomrud, Sebastian Palmqvist, Niklas Mattsson-Carlgren, Nicola Spotorno () and Oskar Hansson ()
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Toomas Erik Anijärv: Lund University
Rik Ossenkoppele: Lund University
Ruben Smith: Lund University
Alexa Pichet Binette: Lund University
Lyduine E. Collij: Lund University
Harry H. Behjat: Lund University
Jonathan Rittmo: Lund University
Linda Karlsson: Lund University
Khazar Ahmadi: Ruhr University Bochum
Olof Strandberg: Lund University
Danielle Westen: Lund University
Jacob W. Vogel: Lund University
Erik Stomrud: Lund University
Sebastian Palmqvist: Lund University
Niklas Mattsson-Carlgren: Lund University
Nicola Spotorno: Lund University
Oskar Hansson: Lund University

Nature Communications, 2025, vol. 16, issue 1, 1-15

Abstract: Abstract The distribution of tau pathology in Alzheimer’s disease (AD) shows remarkable inter-individual heterogeneity, including hemispheric asymmetry. However, the factors driving this asymmetry remain poorly understood. Here we explore whether tau asymmetry is linked to i) reduced inter-hemispheric brain connectivity (potentially restricting tau spread), or ii) asymmetry in amyloid-beta (Aβ) distribution (indicating greater hemisphere-specific vulnerability to AD pathology). We include 452 participants from the Swedish BioFINDER-2 cohort with evidence of both Aβ pathology (CSF Aβ42/40 or neocortical Aβ-PET) and tau pathology (temporal tau-PET), categorising them as left asymmetric (n = 102), symmetric (n = 306), or right asymmetric (n = 44) based on temporal lobe tau-PET uptake distribution. We assess edge-wise inter-hemispheric functional (RSfMRI; n = 318) and structural connectivity (dMRI; n = 352) but find no association between tau asymmetry and connectivity. In contrast, we observe a strong association between tau and Aβ laterality patterns based on PET uptake (n = 233; β = 0.632, p

Date: 2025
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DOI: 10.1038/s41467-025-63564-2

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