Amyloid-β spreads quickly and diffusely throughout the neocortex, a process which can begin decades prior to symptom onset.1,2 In amnestic Alzheimer’s disease, tau spread parallels clinical symptomatology and occurs in a stereotyped manner, following Braak staging.3 Cortical tau build-up typically begins in the entorhinal cortex, then spreads to the medial and lateral temporal cortices and cingulate gyrus, corresponding with the first overt cognitive changes. Here, MAPT is linked to early-onset autosomal dominant Alzheimer disease.