{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:26:32Z","timestamp":1789392392605,"version":"build-2803163510"},"reference-count":57,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Increasing evidence suggests that the trajectory of Alzheimer\u2019s disease (AD) pathologies, such as amyloid and tau, differ between the sexes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Given the higher susceptibility of females to dementia, we aimed to investigate the sex differences in the primary accumulation of tau and its subsequent spread to later cortical brain regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 315 participants in this study: 221 cognitively unimpaired individuals with normal amyloid (n\u2009=\u2009140, A- CU) or abnormal amyloid (n\u2009=\u200981, A+\u2009CU), and 94 cognitively impaired individuals with abnormal amyloid (A+\u2009CI). Each individual received two to six tau positron emission tomography (PET) scans using the [18F]-Flortaucipir (FTP) tracer. Linear regression analyses were performed to assess sex-specific tau spreading throughout the Braak stages among three clinical groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median (interquartile range) age of all samples was 73.5 (68 to 78.2) years. In total, 170 participants (54%) were female. In the A+\u2009CU group, females exhibited higher tau-PET SUVR levels in all Braak I, III-IV, and V-VI. We found that the spreading pattern of tau may vary by sex and AD stages. In the A+\u2009CI individuals, there was an observed interaction between the female sex and baseline tau SUVRs in Braak stages III-IV (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001 and Bonferroni-corrected\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0023), affecting longitudinal accumulation of tau in later Braak stages V-VI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings found a sex-specific pattern of tau spreading from Braak stages III-IV to V-VI in A+\u2009CI older adults. This disadvantage may indicate that females might experience faster tau spreading and quicker disease progression when the condition develops to more advanced disease stages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251406131","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:19:25Z","timestamp":1768295965000},"page":"1153-1162","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Sex-specific patterns in tau spreading throughout the Braak stages in the Alzheimer\u2019s disease spectrum"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8291-4141","authenticated-orcid":false,"given":"Xiwu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Wenzhou Seventh People\u2019s Hospital, Wenzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3441-7245","authenticated-orcid":false,"given":"Teng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4427-6387","authenticated-orcid":false,"given":"Bojian","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Wenzhou Seventh People\u2019s Hospital, Wenzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6551-5921","authenticated-orcid":false,"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hangzhou Shansier Medical Technologies Co., Ltd., Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1865-7514","authenticated-orcid":false,"given":"Wenjun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Research and Development, Hangzhou Shansier Medical Technologies Co., Ltd., Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Alzheimer\u2019s Disease Neuroimaging Initiative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32205-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13859"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-023-01205-w"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2016.01.028"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2021.101544"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa399"},{"key":"e_1_3_3_8_2","article-title":"Relationships between plasma biomarkers, tau PET, FDG PET, and volumetric MRI in mild to moderate Alzheimer's disease patients","volume":"10","author":"Matthews DC","year":"2024","unstructured":"Matthews DC, Kinney JW, Ritter A, et al. Relationships between plasma biomarkers, tau PET, FDG PET, and volumetric MRI in mild to moderate Alzheimer's disease patients. Alzheimers Dement (N Y) 2024; 10: e12490.","journal-title":"Alzheimers Dement"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26460"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-34129-4"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00308809"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-023-01178-w"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-006-0127-z"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/NEN.0b013e318232a379"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-017-1740-8"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284182"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx171"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.3346"},{"key":"e_1_3_3_19_2","article-title":"Longitudinal tau aggregation, atrophy, and cognitive decline in Alzheimer's disease","volume":"21","author":"Singleton EH, Mattsson-Carlgren N, Pichet Binette A, et al","year":"2025","unstructured":"Singleton EH, Mattsson-Carlgren N, Pichet Binette A, et al. Longitudinal tau aggregation, atrophy, and cognitive decline in Alzheimer's disease. Alzheimers Dement 2025; 21: e70435.","journal-title":"Alzheimers Dement"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aaw6404"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2011.11.033"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214041"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa327"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25878"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaa025"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.4693"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1920-1"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13432"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13844"},{"key":"e_1_3_3_30_2","article-title":"Sex-specific association of depressive symptom trajectories with cognitive decline and clinical progression in mild cognitive impairment","volume":"21","author":"Wang X","year":"2025","unstructured":"Wang X, Ye T, Zhou W, Zhang J. Sex-specific association of depressive symptom trajectories with cognitive decline and clinical progression in mild cognitive impairment. Alzheimers Dement 2025; 21: e70548.","journal-title":"Alzheimers Dement"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad397"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXG.0000000000200043"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy059"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181cb3e25"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.05.001"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14165"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14167"},{"key":"e_1_3_3_38_2","unstructured":"ADNI Procedure Manual https:\/\/adni.loni.usc.edu\/wp-content\/uploads\/2024\/02\/ADNI_General_Procedures_Manual.pdf."},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.05.004"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2016.08.005"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2017.10.024"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24711"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24517"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-021-00836-1"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23650"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.07.003"},{"key":"e_1_3_3_47_2","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2014","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing, 2014."},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7139.1236"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.021"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06196-2"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002570"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz206"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0032-9"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnz005"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1042\/CS20230317"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.70083"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac285"},{"key":"e_1_3_3_58_2","volume-title":"StatPearls","author":"Le H","year":"2025","unstructured":"Le H, Lui F, Lui MY., Aphasia. StatPearls. Treasure Island (FL): StatPearls Publishing LLC., 2025."}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877251406131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877251406131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877251406131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:09:50Z","timestamp":1777370990000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877251406131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":57,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/13872877251406131"],"URL":"https:\/\/doi.org\/10.1177\/13872877251406131","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]}}}