Progression of Amyloid Accumulation in Late Adulthood Among People With Childhood-Onset Epilepsy.

Joutsa, Juho; Rinne, Juha O; Niemi, Kalle J; Karrasch, Mira; Parkkola, Riitta K; Saunavaara, Jani; Helin, Semi P; Hermann, Bruce P et al. · Neurology · 2025

prospective_cohort · Level II

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Abstract

Previous research has demonstrated increased brain amyloid plaque load in individuals with childhood-onset epilepsy in late middle age. However, the trajectory of this process is not yet known. The aim of this study was to determine whether individuals with a history of childhood-onset epilepsy show progressive brain aging in amyloid accumulation in late adulthood (Turku Adult Childhood-Onset Epilepsy study, TACOE). Adults from a prospective population-based cohort of individuals with childhood-onset epilepsy, originally recruited 1961-1964, together with matched controls, were scanned with [<sup>11</sup>C]PIB PET twice: after at least 50 years (TACOE-50) and again after at least 55 years (TACOE-55) from the diagnosis. At TACOE-55, 31.4% (11/36, mean age 63.3 years, 52.8% female) of individuals from the epilepsy group and 11.4% (4/35, 63.1 year, 54.3%) of controls had a visually abnormal [<sup>11</sup>C]PIB scan (<i>p</i> = 0.039). At TACOE-55, cortical brain [<sup>11</sup>C]PIB uptakes were higher and increased more from TACOE-50 in the epilepsy compared with the control group (<i>p</i> < 0.05). In voxelwise whole-brain analyses, the epilepsy group showed significantly higher and more widespread brain amyloid accumulation (<i>p</i><sub>FWE</sub> < 0.05). The results demonstrate that childhood-onset epilepsy is associated with an earlier age at onset of amyloidosis and greater progressive amyloid accumulation in late adulthood.

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