Dysregulated coordination of MAPT exon 2 and exon 10 splicing underlies different tau pathologies in PSP and AD

Acta Neuropathol. 2022 Feb;143(2):225-243. doi: 10.1007/s00401-021-02392-2. Epub 2021 Dec 7.


Understanding regulation of MAPT splicing is important to the etiology of many nerurodegenerative diseases, including Alzheimer disease (AD) and progressive supranuclear palsy (PSP), in which different tau isoforms accumulate in pathologic inclusions. MAPT, the gene encoding the tau protein, undergoes complex alternative pre-mRNA splicing to generate six isoforms. Tauopathies can be categorized by the presence of tau aggregates containing either 3 (3R) or 4 (4R) microtubule-binding domain repeats (determined by inclusion/exclusion of exon 10), but the role of the N-terminal domain of the protein, determined by inclusion/exclusion of exons 2 and 3 has been less well studied. Using a correlational screen in human brain tissue, we observed coordination of MAPT exons 2 and 10 splicing. Expressions of exon 2 splicing regulators and subsequently exon 2 inclusion are differentially disrupted in PSP and AD brain, resulting in the accumulation of 1N4R isoforms in PSP and 0N isoforms in AD temporal cortex. Furthermore, we identified different N-terminal isoforms of tau present in neurofibrillary tangles, dystrophic neurites and tufted astrocytes, indicating a role for differential N-terminal splicing in the development of disparate tau neuropathologies. We conclude that N-terminal splicing and combinatorial regulation with exon 10 inclusion/exclusion is likely to be important to our understanding of tauopathies.

Keywords: Alzheimer's disease; Isoforms; MAPT; Neuropathology; Progressive supranuclear palsy; Splicing.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alternative Splicing / genetics
  • Alzheimer Disease / genetics*
  • Alzheimer Disease / pathology*
  • Brain / pathology
  • Exons / genetics
  • Humans
  • Neurons / pathology
  • Protein Isoforms
  • Supranuclear Palsy, Progressive / genetics*
  • Supranuclear Palsy, Progressive / pathology*
  • Tauopathies / genetics
  • Tauopathies / pathology
  • tau Proteins / genetics*


  • MAPT protein, human
  • Protein Isoforms
  • tau Proteins