Cerebrospinal fluid (CSF) total tau (t-tau) is considered a biomarker of neuronal degeneration alongside brain atrophy and fluid neurofilament light chain protein (NfL) in biomarker models of Alzheimer’s disease (AD). However, previous studies show that CSF t-tau correlates strongly with synaptic dysfunction/degeneration biomarkers like neurogranin (Ng) and synaptosomal-associated protein 25 (SNAP25). Here, we compare the association between CSF t-tau and synaptic degeneration and axonal/neuronal degeneration biomarkers in cognitively unimpaired and impaired groups from two independent cohorts. We observe a stronger correlation between CSF t-tau and synaptic biomarkers than neurodegeneration biomarkers in both groups. Synaptic biomarkers explain a greater proportion of variance in CSF t-tau levels compared to neurodegeneration biomarkers. Notably, CSF t-tau levels are elevated in individuals with abnormalities only in synaptic biomarkers, but not in individuals with abnormalities only in neurodegeneration biomarkers. Our findings suggest that CSF t-tau is a closer proxy for synaptic degeneration than for axonal/neuronal degeneration. CSF total tau (t-tau), often used as a marker of neuronal damage, is more strongly linked to synaptic degeneration. Here, the authors show that t-tau better reflects synaptic dysfunction than axonal or neuronal loss in Alzheimer’s disease.
CSF total tau as a proxy of synaptic degeneration
Carolina Soares,B. Bellaver,P. Ferreira,G. Povala,Cristiano Schaffer Aguzzoli,João Pedro Ferrari-Souza,Hussein Zalzale,F. Lussier,Francieli Rohden,Sarah Abbas,Guilherme Bauer-Negrini,Douglas Teixeira Leffa,A. Benedet,Rebecca E Langhough,T. Betthauser,Bradley T. Christian,Rachael E. Wilson,Dana L. Tudorascu,P. Rosa-Neto,T. Karikari,H. Zetterberg,K. Blennow,E. Zimmer,Sterling C Johnson,T. Pascoal
Published 2025 in Nature Communications
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- Publication year
2025
- Venue
Nature Communications
- Publication date
2025-08-29
- Fields of study
Biology, Medicine
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Semantic Scholar, PubMed
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