Delayed olfactory fMRI adaptation associated with plasma p-tau217 in Alzheimer's disease continuum

In 168 participants, olfactory fMRI adaptation was delayed in p-tau217-positive subjective cognitive decline and mild cognitive impairment, associated with plasma p-tau217 levels.

• In p-tau217-SCD, primary olfactory cortex adaptation was delayed to the 1.0% odor condition, while hippocampus was preserved and parietal lobe dysregulated. p-tau217+ SCD and MCI groups showed delayed adaptation across all regions.
• Olfactory adaptation alterations were associated with plasma p-tau217 levels and olfactory memory (p_unc 0.05), and p-tau217 partially mediated that relationship.
• Concentration effects could not be separated from time-related factors; independent confirmation is needed for the ROC discrimination findings.

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