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We used tau positron emission tomography\u2010magnetic resonance (PET\u2010MR) to analyze a key region of the olfactory circuit, the piriform cortex, in comparison to the adjacent medial temporal lobe.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Using co\u2010registered magnetic resonance imaging (MRI) and <jats:sup>18<\/jats:sup>F\u2010PI\u20102620 tau PET\u2010MR scans in 94 older adults, we computed tau uptake in the piriform\u2010periamygdaloid cortex, amygdala, entorhinal\u2010perirhinal cortices, and hippocampus.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We found an ordinal cross\u2010sectional increase in piriform cortex tau uptake with increasing disease severity (amyloid\u2010negative controls, amyloid\u2010positive controls, mild cognitive impairment [MCI] and AD), comparable to entorhinal\u2010perirhinal cortex. Amyloid\u2010positive controls showed significantly greater tau uptake than amyloid\u2010negative controls. Negative correlations were present between memory performance and piriform uptake. Piriform uptake was not elevated in cognitively unimpaired Parkinson's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>Cross\u2010sectionally, there is an early increase in tau uptake in the piriform cortex in AD but not in Parkinson's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Positron emission tomography\u2013magnetic resonance (PET\u2010MR) analysis of the piriform cortex sheds light on its role as a potential early region affected by neurodegenerative disorders underlying olfactory dysfunction.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Uptake of tau tracer was elevated in the piriform cortex in Alzheimer's disease (AD) and mild cognitive impairment (MCI) but not in Parkinson's disease (PD).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Memory performance was worse with greater piriform uptake.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/dad2.70040","type":"journal-article","created":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T09:45:41Z","timestamp":1732355141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Elevated tau in the piriform cortex in Alzheimer's but not Parkinson's disease using PET\u2010MR"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8585-1634","authenticated-orcid":false,"given":"Hossein","family":"Moein Taghavi","sequence":"first","affiliation":[{"name":"Department of Radiology Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahta","family":"Karimpoor","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University School of Medicine Stanford California 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