A network-level transport model of tau progression in the Alzheimer's brain.

One of the hallmarks of Alzheimer's disease (AD) is the accumulation and spread of toxic aggregates of tau protein. The progression of AD tau pathology is thought to be highly stereotyped, which is in part due to the fact that tau can spread between regions via the white matter tracts that connect them. Mathematically, this phenomenon has been described using models of 'network diffusion,' where the rate of spread of tau between brain regions is proportional to its concentration gradient and the amount of white matter between them. Although these models can robustly predict the progression of pathology in a wide variety of neurodegenerative diseases, including AD, an underexplored aspect of tau spreading is that it is governed not only by diffusion but also by active transport along axonal microtubules. Spread can therefore take on a directional bias, resulting in distinct patterns of deposition, but current models struggle to capture this phenomenon. Recently, we have developed a mathematical model of the axonal transport of toxic tau proteins that takes into account the effects tau exerts on the molecular motors. Here we describe and implement a macroscopic version of this model, which we call the Network Transport Model (NTM). A key feature of this model is that, while it predicts tau dynamics at a regional level, it is parameterized in terms of only microscopic processes such as aggregation and transport rates, i.e., differences in brain-wide tau progression can be explained by its microscopic properties. We provide numerical evidence that, as with the two-neuron model that the NTM extends, there are distinct and rich dynamics with respect to the overall rate of spread and the staging of pathology when we simulated the NTM on the hippocampal subnetwork. The theoretical insights provided by the NTM have broad implications for understanding AD pathophysiology more generally.