Sex-Specific Associations of α-Synuclein Pathology With Tau Accumulation

Is α-synuclein pathology differentially associated with tau accumulation in women and men across the Alzheimer disease continuum?In this cohort study of 415 participants from the Alzheimer’s Disease Neuroimaging Initiative who underwent longitudinal tau positron emission tomography, women with positive α-synuclein seed amplification assay results had significantly faster tau accumulation than all other groups, whereas men with positive results did not differ significantly from men with negative results.These findings suggest that α-synuclein copathology in women is associated with faster tau accumulation, supporting sex-specific biomarker interpretation and trial stratification in Alzheimer disease.

Corresponding Author: Elijah Mak, PhD, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (mak.elijah@mayo.edu).

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