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How modular brain network architecture shapes this process and the ensuing cognitive decline remains incompletely understood. We tested whether the efficiency with which tau epicenters access cross\u2010network communication pathways modulates A\u03b2\u2010driven tau propagation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We combined baseline\/longitudinal amyloid\/tau positron emission tomography (PET) data across two independent AD cohorts (\n                      <jats:italic>N\u00a0<\/jats:italic>\n                      =\u00a0490) with multimodal connectomics data. We quantified epicenter broadcast capacity (EBC), capturing whether tau epicenters preferentially access regions supporting cross\u2010network communication or within\u2010network communication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Higher EBC was associated with faster A\u03b2\u2010related global tau accumulation, greater spatial tau spread, and steeper cognitive decline. Effects were driven by stronger epicenter communication with cross\u2010network connectors, whereas preferential within\u2010network routing was associated with relative containment of tau spread.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>We identify a mechanism through which epicenter connectivity biases A\u03b2\u2010driven tau propagation toward brain\u2010wide broadcast or regional containment, helping explain heterogeneity in disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71617","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:38:31Z","timestamp":1783532311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modular brain networks shape amyloid\u2010driven tau spread and cognitive decline"],"prefix":"10.1002","volume":"22","author":[{"given":"Fabian","family":"Hirsch","sequence":"first","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Frontzkowski","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"},{"name":"Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Steward","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian N.","family":"Roemer\u2010Cassiano","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"},{"name":"Department of Neurology University Hospital, LMU Munich  Munich Germany"},{"name":"Max Planck School of Cognition  Leipzig Germany"},{"name":"Department of Clinical Neurosciences University of Cambridge School of Clinical Medicine  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davina","family":"Biel","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research (ISD) University Hospital, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Palleis","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital, LMU Munich  Munich Germany"},{"name":"German 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