Biochemical staging of tau pathology

Tau pathology in Alzheimer's disease progresses along a pathway which is  progressive, hierarchical, sequential, invariable. This pathway explains perfectly well the different cognitive impairments that develop along these stages.

A similar mechanism of progression is observed in PSP and CBD, but along other neuronal networks.

Determining the factors that fuel tau spreading will give us targets and tools for slowing down all tauopathies.

In Alzheimer's disease (AD), there is a progressive spreading of neurofibrillary degeneration (tau pathology) in specific brain areas, while the amyloid burden is diffuse, heterogeneous and in all brain areas.

The spreading of tau pathology is stereotypical, affecting successively 10 brain areas, that defines 10 stages. 

These stages allow to distinguish precisely, at the biochemical level, "usual" or "normal" cerebral aging from infraclinical AD.

The biochemical pathway of neurofibrillary degeneration in aging and Alzheimer's disease. Delacourte et al. Neurology. 1999 Apr 12;52(6):1158-65.

1. Stage 0
2. Stage1
3. Stage 2
4. Stage 3
5. Stage 4
6. Stage 5
7. Stage 6
8. Stage 7
9. Stage 8
10. Stage 9
11. Stage 10

powerpoint presentation on the web:the 10 stages of tauopathy in AD

Relationship of tau stages with Ab deposition

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