In the preclinical stage, it may be difficult to distinguish Aβ-associated atrophy from age-related volume loss or early atrophy from other neurodegenerative conditions, and it emerges later than Aβ and tau pathologies.1 Some studies support AD-specific cortical thinning occurs in preclinical AD,2,3 while others found no cross-sectional difference4 or even increased cortical thickness.5 These mixed findings could be due to methodological and technical differences across studies, heterogeneity in the preclinical phase, or inadequate sample size.6,7. Here, MAPT is linked to Alzheimer disease.