The aggregation of the tau protein is central to several
neurodegenerative
diseases, collectively known as tauopathies. High-resolution views
of tau tangles accumulated under pathological conditions in post-mortem
brains have been revealed recently by cryogenic electron microscopy.
One of the striking discoveries was that fibril folds are unique to
and homogeneous within one disease family, but typically different
between different tauopathies. It is widely believed that seeded aggregation
can achieve structural propagation of tau fibrils and generate pathological
fibril structures. However, direct molecular level measurement of
structural evolution during aggregation is missing. Here, we discuss
our perspective on the biophysical approaches that can contribute
to the ongoing debate regarding the prion-like propagation of tau
and the role of cofactors. We discuss the unique potential of double
electron–electron resonance (DEER)-based intramolecular distance
measurement, sensitive to two to several nanometers distances. DEER
can track the structural evolution of tau along the course of aggregation
from the completely disordered state, to partially ordered and highly
ordered fibril states, and has the potential to be a key tool to elucidate
the disease-specific tau aggregation pathways.