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The cohort was divided into those harboring significant AD co\u2010pathology, either at autopsy (intermediate\/high AD neuropathologic change) or with CSF signature indicating AD co\u2010pathology (t\u2010tau\/A<jats:italic>\u03b2<\/jats:italic><jats:sub>1\u201042<\/jats:sub>\u00a0&gt;\u00a00.3) (LBD+AD, <jats:italic>N<\/jats:italic>\u00a0=\u00a019), and those without AD co\u2010pathology (LBD\u2212AD, <jats:italic>N<\/jats:italic>\u00a0=\u00a053). We also included a reference group of 25 patients with CSF biomarker\u2010confirmed amnestic AD. We investigated differences in MRI cortical thickness estimates between groups, and in the 21 autopsied LBD patients (LBD\u2212AD\u00a0=\u00a014, LBD+AD\u00a0=\u00a07), directly tested the association between antemortem MRI and post\u2010mortem burdens of tau, A<jats:italic>\u03b2<\/jats:italic>, and alpha\u2010synuclein using digital histopathology in five representative neocortical regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The LBD+AD group was characterized by cortical thinning in anterior\/medial and lateral temporal regions (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05 FWE\u2010corrected) relative to LBD\u2212AD. In LBD+AD, cortical thinning was most pronounced in temporal neocortex, whereas the AD reference group showed atrophy that equally encompassed temporal, parietal and frontal neocortex. In autopsied LBD, we found an inverse correlation with cortical thickness and post\u2010mortem tau pathology, while cortical thickness was not significantly associated with A<jats:italic>\u03b2<\/jats:italic> or alpha\u2010synuclein pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>LBD+AD is characterized by temporal neocortical thinning on MRI, and cortical thinning directly correlated with post\u2010mortem histopathologic burden of tau, suggesting that tau pathology influences the pattern of neurodegeneration in LBD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51183","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T19:39:24Z","timestamp":1603827564000},"page":"2342-2355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Tau pathology associates with in vivo cortical thinning in Lewy body disorders"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5404-8788","authenticated-orcid":false,"given":"Nicola","family":"Spotorno","sequence":"first","affiliation":[{"name":"Penn Frontotemporal Degeneration Center Department of Neurology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Coughlin","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia Philadelphia PA USA"},{"name":"Department of Radiology Penn Image Computing and Science Laboratory University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Olm","sequence":"additional","affiliation":[{"name":"Penn Frontotemporal Degeneration Center Department of Neurology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"},{"name":"Department of Neurosciences Health Sciences UC San Diego San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wolk","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia Philadelphia PA USA"},{"name":"Alzheimer's Disease Center Department of Neuropathology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev N.","family":"Vaishnavi","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia Philadelphia PA USA"},{"name":"Alzheimer's Disease Center Department of Neuropathology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Dahodwala","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Morley","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia Philadelphia PA USA"},{"name":"Parkinson's Disease Research Education and Clinical Center (PADRECC) Michael J. 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