Intracellular accumulation of amyloid-ß is a marker of selective neuronal vulnerability in Alzheimer's disease.

Caramello, Alessia; Fancy, Nurun; Tournerie, Clotilde; Eklund, Maxine; Chau, Vicky; Adair, Emily; Papageorgopoulou, Marianna; Willumsen, Nanet et al. · Nat Commun · 2025

basic_science · Level V

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Abstract

Defining how amyloid-β and pTau together lead to neurodegeneration is fundamental to understanding Alzheimer's disease (AD). We used imaging mass cytometry to identify neocortical neuronal subtypes lost with AD in post-mortem brain middle temporal gyri from non-diseased and AD donors. Here we showed that L5,6 RORB<sup>+</sup>FOXP2<sup>+</sup> and L3,5,6 GAD1<sup>+</sup>FOXP2<sup>+</sup> neurons, which accumulate amyloid-β intracellularly from early Braak stages, are selectively vulnerable to degeneration in AD, while L3 RORB<sup>+</sup>GPC5<sup>+</sup> neurons, which accumulate pTau but not amyloid-β, are not lost even at late Braak stages. We discovered spatial associations between activated microglia and these vulnerable neurons and found that vulnerable RORB<sup>+</sup>FOXP2<sup>+</sup> neuronal transcriptomes are enriched selectively for pathways involved in inflammation and glycosylation and, with progression to AD, also protein degradation. Our results suggest that the accumulation of intraneuronal amyloid-β, which is associated with glial inflammatory pathology, may contribute to the initiation of degeneration of these vulnerable neurons.

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