Neocortical tau burden determines the degree of cognitive impairment in individuals with Braak stage V neurofibrillary degeneration - Scorecard - MDSpire

Neocortical tau burden determines the degree of cognitive impairment in individuals with Braak stage V neurofibrillary degeneration

  • By

  • Timothy E. Richardson

  • Jonathan Cherry

  • Shrishtee Kandoi

  • Susan K. Rohde

  • Madeline Uretsky

  • Fatima Tuz-Zahra

  • Kevin F. Bieniek

  • Kurt Farrell

  • Marco M. Hefti

  • Michael B. Miller

  • Yorghos Tripodis

  • Thor D. Stein

  • Carolina Maldonado-Díaz

  • Satomi Hiya

  • Thomas G. Beach

  • María M. Corrada

  • Brittany N. Dugger

  • Margaret E. Flanagan

  • Matthew P. Frosch

  • Marla Gearing

  • Lea T. Grinberg

  • Lawrence A. Hansen

  • Debra Hawes

  • Elizabeth Head

  • C. Dirk Keene

  • Julia Kofler

  • Edward B. Lee

  • Peter T. Nelson

  • Derek H. Oakley

  • Richard J. Perrin

  • Robert A. Rissman

  • Shahriar Salamat

  • Julie A. Schneider

  • Geidy E. Serrano

  • Andrew F. Teich

  • Juan C. Troncoso

  • Thomas Wisniewski

  • Randall L. Woltjer

  • John F. Crary

  • Dennis W. Dickson

  • Ann C. McKee

  • Jamie M. Walker

  • May 25, 2026

  • 0 min

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Clinical Scorecard: The Impact of Neocortical Tau Accumulation on Cognitive Dysfunction in Patients with Braak Stage V Neurofibrillary Changes

At a Glance

CategoryDetail
ConditionAlzheimer Disease (AD)
Key MechanismsNeurofibrillary tangles (NFTs) and β-amyloid (Aβ) plaques deposition
Target PopulationOlder adults, particularly those with Braak stage V neurofibrillary changes
Care SettingAlzheimer’s Disease Research Centers (ADRCs)

Key Highlights

  • AD is the most common neuropathologic finding underlying cognitive decline in older adults.
  • Approximately 7.2 million Americans aged 65 or older are affected by AD.
  • Cognitive impairment correlates with the level of Alzheimer disease neuropathologic change (ADNC).
  • Comorbid neurodegenerative pathologies can complicate the clinical picture of AD.
  • The Braak staging system may not fully account for variations in NFT burden or density.

Guideline-Based Recommendations

Diagnosis

  • Utilize the Braak staging system to assess neurofibrillary degeneration.

Management

  • Consider the presence of comorbid neurodegenerative pathologies in treatment planning.

Monitoring & Follow-up

  • Regular cognitive assessments should be conducted within 24 months of the last cognitive exam.

Risks

  • Cognitive resilience and reserve may affect clinical outcomes despite ADNC levels.

Patient & Prescribing Data

Individuals diagnosed with Braak NFT stage V

Cognitive trajectories vary significantly among individuals with similar ADNC levels.

Clinical Best Practices

  • Employ computer-assisted positive pixel counts for evaluating p-tau burden.
  • Assess both density and location of NFTs in relation to cognitive status.

Related Resources & Content

Original Source(s)

Neocortical tau burden determines the degree of cognitive impairment in individuals with Braak stage V neurofibrillary degeneration

  • by Timothy E. Richardson, Jonathan Cherry, Shrishtee Kandoi, Susan K. Rohde, Madeline Uretsky, Fatima Tuz-Zahra, Kevin F. Bieniek, Kurt Farrell, Marco M. Hefti, Michael B. Miller, Yorghos Tripodis, Thor D. Stein, Carolina Maldonado-Díaz, Satomi Hiya, Thomas G. Beach, María M. Corrada, Brittany N. Dugger, Margaret E. Flanagan, Matthew P. Frosch, Marla Gearing, Lea T. Grinberg, Lawrence A. Hansen, Debra Hawes, Elizabeth Head, C. Dirk Keene, Julia Kofler, Edward B. Lee, Peter T. Nelson, Derek H. Oakley, Richard J. Perrin, Robert A. Rissman, Shahriar Salamat, Julie A. Schneider, Geidy E. Serrano, Andrew F. Teich, Juan C. Troncoso, Thomas Wisniewski, Randall L. Woltjer, John F. Crary, Dennis W. Dickson, Ann C. McKee, Jamie M. Walker

  • May 25, 2026

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