Childhood Epilepsy Linked to Increased Brain Amyloid

Recent research has uncovered an intriguing link between childhood epilepsy and the accumulation of brain amyloid later in life, potentially increasing the risk of developing late-onset brain amyloid disorders, such as Alzheimer’s disease. The study, published in the journal Neurology, sheds new light on how early neurological conditions could contribute to the later development of neurodegenerative diseases, offering insights into the long-term effects of childhood epilepsy.

Understanding Amyloid Accumulation and Alzheimer’s Disease

Beta-amyloid protein accumulation in the brain is widely regarded as one of the earliest signs of Alzheimer’s disease, a progressive neurodegenerative disorder that affects memory, cognition, and behavior. The build-up of amyloid plaques disrupts communication between brain cells and triggers inflammation, leading to cognitive decline. However, the precise cause of amyloid accumulation remains unclear, and the relationship between amyloid buildup and Alzheimer’s disease is complex.

Amyloid plaques are commonly detected in the brains of older adults, but not everyone with amyloid accumulation develops Alzheimer’s. As a result, researchers have been investigating the factors that might accelerate or predispose individuals to significant amyloid accumulation, with a particular focus on early-life neurological conditions.

The Study: Childhood Epilepsy and Brain Health Later in Life

The study in question was conducted by a team of researchers from the University of Turku, Åbo Akademi University, and the University of Wisconsin. The study relied on a unique, population-based cohort that traces the health outcomes of individuals who experienced childhood epilepsy. This cohort was first assembled by renowned neurologist Professor Matti Sillanpää, who has led the research group through decades of data collection, monitoring the health and social outcomes of children diagnosed with epilepsy as far back as the early 1960s.

Since its inception, the cohort has been studied progressively, with regular follow-up assessments conducted at intervals starting in 1992. The participants, now in their 60s, have been monitored for cognitive decline, health outcomes, and brain pathology. The most recent phase of the study, conducted around 2019, aimed to investigate the potential relationship between childhood epilepsy and amyloid accumulation in the brain as participants neared retirement or had already retired.

The Findings: Increased Amyloid in Epilepsy Patients

In earlier phases of the study, researchers discovered that individuals who had childhood epilepsy demonstrated a significantly higher accumulation of amyloid plaques in their brains compared to matched controls. This was the first study globally to report such findings, sparking further investigation into whether this abnormal accumulation of amyloid would continue to escalate with age and potentially increase the risk of developing Alzheimer’s or other related neurodegenerative diseases.

The follow-up study, conducted around seven years after the previous one (between 2013–2016), included a cohort of individuals aged 60–65. The study was composed of 36 participants with childhood-onset epilepsy and 35 controls. Remarkably, the researchers observed that nearly one-third of the patients with childhood epilepsy showed abnormal amyloid accumulation, compared to just 11% of the control group. Furthermore, over the seven-year period, individuals in the epilepsy group accumulated more amyloid in their brains than the controls.

Despite these findings, there was no significant difference in the cognitive performance between the two groups, suggesting that the amyloid plaques had not yet led to measurable memory deficits. This result offers an important insight: while childhood epilepsy appears to predispose individuals to increased amyloid accumulation, it may not necessarily result in immediate cognitive decline or memory disorders.

Amyloid Accumulation Does Not Immediately Lead to Memory Disorders

One of the critical observations from the study was the distinction between amyloid accumulation and cognitive impairment. Although the individuals with childhood epilepsy had more amyloid plaques in their brains, they did not show noticeable declines in cognitive function compared to the controls. The research suggests that while amyloid accumulation is linked to Alzheimer’s disease, it does not necessarily cause memory disorders immediately. This raises the possibility that other factors, such as inflammation or genetic predispositions, may also play a significant role in the progression from amyloid buildup to the cognitive symptoms of Alzheimer’s.

Professor Juho Joutsa, one of the key researchers involved in the study and a Professor of Neurology at the University of Turku, explained, “This suggests that the amyloid accumulation in the brain has not yet led to memory disorders.” He also emphasized the importance of continued monitoring of these individuals, as amyloid buildup could contribute to cognitive decline in the future.

The Unique Long-Term Cohort Study

What sets this study apart is the long-term nature of the cohort and the wealth of data it provides on the health outcomes of individuals with childhood epilepsy. The cohort, which has been followed for over 50 years, offers a rare opportunity to investigate how early-life neurological conditions can impact brain health later in life. The participants were born in the 1950s and 1960s and have been tracked throughout their lives, with detailed records of their health, seizures, social conditions, and brain function.

The study’s researchers have been able to combine modern neuroimaging techniques—such as positron emission tomography (PET) scans that detect amyloid plaques—with the extensive historical data on epilepsy and cognitive performance. This combination of advanced technology and long-term follow-up has provided unparalleled insights into the long-term effects of childhood epilepsy on the brain.

Scientific Collaboration Across Generations

Professor Joutsa, who joined the study as a recently graduated physician in the early 2010s, highlighted the significance of interdisciplinary collaboration and intergenerational continuity in scientific research. The study is an excellent example of how sustained commitment from both participants and researchers, as well as cooperation across different fields of expertise, can lead to groundbreaking discoveries in science.

The study also underscores the value of long-term research. In an era of rapidly advancing medical technologies and treatments, the ability to track and understand the long-term effects of diseases and neurological conditions is invaluable for the development of early detection methods and therapeutic interventions.

Implications for Alzheimer’s Disease and Future Research

The findings of this study may have important implications for understanding the pathophysiology of Alzheimer’s disease. While it is still unclear whether the amyloid accumulation in individuals with childhood epilepsy will eventually lead to Alzheimer’s or other neurodegenerative diseases, the research suggests that childhood epilepsy could be a significant risk factor for increased amyloid deposition in the brain later in life.

This raises several important questions for future research:

1. Does the early accumulation of amyloid in epilepsy patients accelerate the onset of Alzheimer’s disease or other cognitive disorders?
2. Are there any interventions that could delay or prevent amyloid buildup in individuals with a history of childhood epilepsy?
3. How do genetic factors or environmental influences interact with early neurological conditions to increase the risk of Alzheimer’s disease?

The answers to these questions could eventually lead to new strategies for diagnosing and treating Alzheimer’s, particularly for individuals with early-life neurological conditions like epilepsy.

Conclusion

This groundbreaking study adds a new layer of understanding to the complex relationship between childhood epilepsy and the later development of brain amyloid disorders. While it is too early to draw definitive conclusions about the risk of Alzheimer’s or similar diseases in individuals with childhood epilepsy, the study provides important evidence that early neurological conditions may play a significant role in shaping brain health later in life.

By continuing to monitor and study these individuals, researchers hope to uncover more about the long-term effects of childhood epilepsy and develop strategies to mitigate the risk of amyloid-related cognitive decline. This research highlights the importance of long-term studies in uncovering the hidden connections between early-life health conditions and later cognitive disorders. It also underscores the significance of collaboration across disciplines and generations to address the complex challenges of brain health and neurodegenerative diseases.

Reference: Juho Joutsa et al, Progression of Amyloid Accumulation in Late Adulthood Among People With Childhood-Onset Epilepsy, Neurology (2025). DOI: 10.1212/WNL.0000000000210303