Over the course of the pathological cascade of Alzheimer’s disease (AD), misfolding and accumulation of both amyloid-beta (Aβ) and tau lead to profound changes in cortical microstructure.1 Such changes are, however, difficult to detect using conventional imaging prior to overt atrophy, measurable with morphological metrics from structural MRI. The gene discussed is MAPT; the disease is early-onset autosomal dominant Alzheimer disease.