Childhood-Onset Epilepsy Is Associated With Amyloid Accumulation in Late Adulthood

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Childhood-onset epilepsy is associated with an earlier age at onset of amyloidosis and greater progressive amyloid accumulation in late adulthood, according to study results published in Neurology. The results provide new information about the long-term effects childhood epilepsy can have on the brain, which is significant for future follow-up studies.¹

The accumulation of beta-amyloid protein in the brain is an early pathological brain change in Alzheimer disease; however, the exact cause of amyloid accumulation is not well known. Additionally, previous research has demonstrated that in late middle age, an increased brain amyloid plaque load is present in individuals with childhood-onset epilepsy, but the process’s path is not known.^1,2

For this cohort study, the investigators monitored the health and social prognosis of individuals aged 60 to 65 years who had childhood epilepsy since the early 1960s and were originally recruited from a prospective population-based cohort from 1961 to 1964, as well as their matched controls since 1992. The current study included approximately 82% of the previous cohort. All patients were scanned with 11C-PIB-PET twice: once after at least 50 years, and then again after at least 55 years from the diagnosis.¹

At 55 years from diagnosis, approximately 31.4% (n = 11) of individuals from the epilepsy group and 11.4% (n = 4) from the control group had a visually abnormal 11C-PIB-PET scan (p = .039). Additionally, cortical brain 11C-PIB uptakes were higher and increased more from the 50-year follow-up in the patients with epilepsy compared with the controls. Overall, patients in the epilepsy group demonstrated a significantly higher and more widespread accumulation of amyloid within the brain. Further, patients in both groups were more likely to be female (epilepsy: 52.5%; controls: 54.3%) than male.¹

“The finding was the first of its kind globally, and it was unclear at that point whether the abnormal amyloid accumulation in the brain would continue, further predisposing these individuals to the development of memory disorders. This motivated our current study,” Juho Joutsa, MD, PhD, professor of neurology from the University of Turku, said in a news release.²

Additionally, the investigators observed that patients who had childhood-onset epilepsy were more likely to perform worse in cognitive tests compared to the controls. Interestingly, this was not necessarily linked to the amount of amyloid plaques, according to the authors.^1,2

The authors show optimism that this study can help provide extensive information about childhood epilepsy and its prognosis over decades. These findings can serve as a foundation about the very long-term effects of childhood epilepsy on the brain, emphasizing a need for future research.²

“This suggests that the amyloid accumulation in the brain has not yet led to memory disorders,” explained Joutsa in the news release. “This study is also an excellent example of what can be achieved scientifically through long-term commitment of both participants and researchers, as well as collaboration across disciplines and generations of researchers.”²

REFERENCES

1. Jousta J, Rinne JO, Niemi KJ, et al. Progression of Amyloid Accumulation in Late Adulthood Among People With Childhood-Onset Epilepsy. Neurology. 2025;104(3). doi:10.1212/WNL.0000000000210303

2. University of Turku. Childhood epilepsy may predispose to memory disorders later in life. January 22, 2025. Accessed January 24, 2025. https://www.eurekalert.org/news-releases/1071306