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Severity of tauopathy differs between logopenic variant primary progressive aphasia individuals with or without a history of learning differences

Spina, S.; Miller, Z. A.; Jakab, S.; Tamagnini, M.; Mandelli, M. L.; Kritikos, L.; Pham, H.; Ramkrishnan, S.; Lin, M.; Kim, J.; Paredes, M.; Rosen, H. J.; Grinberg, L. T.; Seeley, W. W.; Miller, B. L.; Gorno-Tempini, M. L.

2026-03-10 neurology
10.64898/2026.03.03.26347280 medRxiv
Show abstract

OBJECTIVETo assess differences in the severity of Alzheimers disease neuropathological changes in disease epicenters of patients with logopenic variant PPA (lvPPA) with a history of learning differences/developmental dyslexia (LD) versus lvPPA patients without such history (non-LD). BACKGROUNDLearning differences, including developmental dyslexia, are overrepresented in the lvPPA population. It is not known whether a history of developmental differences is associated with a more severe phenotypic expression of Alzheimers disease pathology. DESIGN/METHODSWe quantified the cortical area fraction of phospho-tau immunohistochemistry (IHC) and beta-amyloid IHC in the angular gyrus and superior temporal gyrus of postmortem brains of 15 cases of lvPPA secondary to Alzheimers disease of which 9 non-LD cases (2 males and 7 females), and 6 LD cases (2 males and 4 females). Histological sections were digitally acquired, and foreground IHC-signal was automatically separated and thresholded to quantify the respective tau and beta-amyloid area fractions in each region. RESULTSThere were no differences in the mean age at death between the two groups. Disease duration was longer in the LD group (10.7 {+/-} 1.2 years) than in the non-LD group (8.1 {+/-} 0.8 years), p=0.09. When corrected for sex, age at death and Apo E4 carrier status, the LD group showed higher tau pathology burden in the superior temporal gyrus compared to the non-LD group (0.91% {+/-} 0.37, p=0.03). No differences in tau pathology burden between the groups were observed in the angular gyrus (0.39% {+/-} 0.41, p=0.37). There were no statistically significant differences in the area fraction of beta-amyloid between the two groups of patients in both the angular gyrus and the superior temporal gyrus. CONCLUSIONSOur data suggest that patients with lvPPA secondary to Alzheimers disease and a history of developmental differences have higher tau-pathology burden in the superior temporal gyrus compared to lvPPA-AD patients without such history.

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