The tangle of intracellular neuronal fibers leads to neuronal disfunction and cell death.
NEUROFIBRILLARY TANGLE
"Tau oligomerization is responsible for the formation of neuronal tangles, which can lead to neuronal apoptosis."

Neurofibrillary tangles found in Alzheimer's disease are caused by hyperphosphorylation of tau.
Tau phosphorylation can occur at many sites, usually caused by kinases GSK3 and Cdk5, and leads to the decrease of microtubule binding ability.
Hyperphosphorylation leads to tau dissociation, followed by microtubule instability and tau oligomerization.
Neurofibrillary tangles are a collection of paired spiral filaments composed of hyperphosphorylated tau.
Tau protein can form virus like "seeds", which can spread from neurons to neurons.