Soluble tau oligomers have been strongly implicated in the pathogenesis of neurodegenerative diseases such as Alzheimer disease (AD) and frontotemporal dementia (FTD). Research published in Nature Medicine now shows that soluble tau is acetylated at Lys174 in the human brain from the early stages of AD, and that inhibition of the acetyltransferase p300 ameliorates hippocampal atrophy and cognitive deficits in a transgenic mouse model of FTD. The authors conclude that Lys174 acetylation is a crucial determinant of tau oligomer accumulation and toxicity.