Beta-amyloid plaques and tau neurofibrillary tangles are the hallmark pathological findings in Alzheimer’s disease (AD).1 Unlike amyloid, the spatial distribution of tau correlates with specific clinical symptoms, domain-specific cognitive impairments, and dementia severity.2,3 While the burden and spatial distribution of tau have been extensively studied in relation to cognitive symptoms, the link between tau distribution and behavioral and emotional symptoms remains underexamined. Here, MAPT is linked to early-onset autosomal dominant Alzheimer disease.