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medRxiv (Medicine) 2026-06-19 00:00 DOI: HASH:42f679022b50da0695b51f74273d5e63

Grey- and white-matter resilience to tau, cognition and sex in Alzheimer's disease

Abstract

INTRODUCTION: Brain resilience to tau has been mainly studied in relation to grey matter, while its role in white matter remains unclear in Alzheimer's disease (AD). Sex may moderate associations between brain resilience and cognition. METHODS: We analyzed medial temporal lobe tau PET SUVR, entorhinal cortical thickness, cingulum-hippocampal mean diffusivity, and cognition in 205 amyloid-positive individuals from ADNI. Associations between grey- and white-matter resilience to tau and cognitive performance or decline were examined using linear and mixed-effects models, including sex interactions and stratified analyses. RESULTS: Higher grey-matter resilience to tau related to better cross-sectional memory and language performance (p

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