Childhood-onset epilepsy could be associated with accelerated brain ageing, according to a new study published in JAMA Neurology. According to the authors, childhood onset epilepsy could therefore be considered a neurobiological predisposition to cognitive disorders in later life.In order to determine whether adults with a history of childhood-onset epilepsy have an increased risk of accelerated cognitive impairment in later life, researchers led by Dr Matti Sillanpää at the University off Turku in Finland analysed 41 adults with childhood-onset epilepsy who were followed for more than 50 years from the onset of the condition, and 46 matched controls.They found that people with childhood-onset epilepsy had increased levels of amyloid loads in their brain. Amyloids are protein fragments that accumulate in the brain with age. While in a healthy brain these proteins are broken down and eliminated, in brain disorders such as Alzheimer’s disease, they stick together and form amyloid plaques which are neurotoxic.Interestingly, the researchers of the presents study found that people who carried a certain type of genetic variant called ε4 in their apolipoprotein E (APOE) gene had a particularly increased risk of having amyloid load in their brain in late middle age, as measured by positron emission tomography (PET) scan.They concluded that APOE ε4 could be a biomarker indicating accelerated brain ageing  in people with epilepsy.“Childhood-onset epilepsy appears to be associated with increased amyloid accumulation in late middle age, even among individuals in remission without antiepileptic drug therapy for decades,” the authors wrote. “The findings suggest a link between epilepsy, APOE genotype, and amyloid pathology”They added that these findings prompt more research into brain ageing in people with epilepsy and that further follow-up with frequent amyloid assessments are needed to confirm these results.Author: Dr Özge Özkaya