Posterior Accumulation of Tau and Concordant Hypometabolism in an Early-Onset Alzheimer's Disease Patient with Presenilin-1 Mutation

It is unclear whether the distribution of tau pathology differs between cases with early-onset familial Alzheimer's disease (AD) and sporadic AD. We present positron emission tomography (PET) data from a young patient with a presenilin-1 mutation (Thr116Asn). F-18-flutemetamol PET showed a distribution of amyloid-beta fibrils similar to sporadic AD. However, the pattern of tau pathology, revealed using F-18-AV1451 PET, showed higher uptake in posterior cingulate, precuneus, parietal and occipital cortices compared to late-onset sporadic AD. Further, the tau pathology, but not amyloid pathology, exhibited a very clear inverse relationship with F-18-fluorodeoxyglucose-metabolism, indicating neuronal hypometabolism in regions affected by tau aggregates.