Tau-induced atrophy drives functional connectivity disruption in Alzheimer's disease

Abstract

Alzheimer's disease involves progressive tau accumulation and spread, leading to regional brain atrophy and disruption of large-scale functional networks. While tau propagation and tissue degeneration have been widely modeled, how atrophy dynamics translate into functional connectivity (FC) degradation remains unclear. Here, we develop a multiphysics framework integrating anisotropic tau reaction-diffusion, finite-deformation biomechanics, and network modeling to link tau-driven atrophy with FC changes. Model fidelity is evaluated by quantitatively comparing simulated atrophy patterns with imaging-derived measurements. Using longitudinal structural and functional MRI, we identify an approximately linear relationship between regional atrophy rates and FC change. We then construct an atrophy-informed structural network degradation matrix from model-predicted region-specific atrophy rates and embed it into a neural oscillation model to predict FC disruption. Our results show that (i) the coupled reaction-diffusion-biomechanical model reproduces observed regional atrophy, (ii) regional atrophy rates parsimoniously predict longitudinal FC changes, and (iii) the atrophy-informed degradation matrix captures the direction and relative magnitude of regional FC disruption. By converting tau-driven atrophy into predictive FC trajectories, the proposed framework offers a clinically interpretable avenue for forecasting disease progression and informing trial design.