Climate Change as a Neurological Risk Factor Across the Lifespan
Climate change affects neurological health earlier and more profoundly than previously thought. Environmental factors influence brain development during pregnancy, shaping long-term disease risks.
“The brain listens to its environment even before birth,” emphasized Prof. Justyna Paprocka from the Medical University of Silesia during her presentation at the EAN Congress 2026. She illustrated, through a fictional patient biography, how climate influences neurological development from the fetal stage to adulthood.
Prenatal Phase: Environmental Factors Intervening in Early Brain Development
During pregnancy, heat, air pollution, and other environmental factors impact essential neurobiological processes like neurogenesis, neuronal migration, and synaptogenesis. Early exposures leave measurable effects:
- Structural changes in the brain,
- Altered connectivity,
- Increased risk of neurodevelopmental disorders.
The first 1,000 days of life are critical, presenting both a “window of opportunity” and a “window of vulnerability.” Specifically, prenatal air pollution has been linked to cognitive deficits and speech developmental disorders in early childhood.
Air Pollution and Heat: Measurable Effects on Brain Structure
Research shows that air pollution is associated with structural changes such as:
- Reduced hippocampal volume,
- Altered white matter,
- Decreased integrity of neuronal connections.
Heat also directly impacts brain development. Current data indicate:
- Impairments in learning and cognition,
- Increased risk of neural tube defects at high temperatures,
- Poorer language development with early heat exposure.
Both prenatal and postnatal exposure phases are significant here.
Long-Term Programming: Environment as a Predictor of Later Disease
A central finding from the lecture is that environmental influences not only act in the short term but biologically program the brain. This programming affects:
- Stress axis regulation,
- Myelination,
- Cognitive reserve,
- Emotional stability.
Clinically relevant is the fact that neurological symptoms often emerge decades later, such as migraines, sleep disorders, or cognitive impairments.
Climate Factors as Triggers for Neurological Disorders
Besides long-term effects, environmental factors also contribute to the acute risk of neurological diseases. Data examples reveal:
- Heat increases epilepsy-related hospitalizations by approximately 23% on the same day.
- Cold can lead to a delayed up to fourfold increase in seizure rates.
Infectious diseases also show correlations:
- Temperature variability is a risk factor for meningitis and encephalitis.
- Climatic conditions influence the incidence of infectious diseases.
Regarding headaches, evidence suggests a connection with humidity and weather conditions, although the evidence remains heterogeneous.
Common Pathophysiological Mechanisms
The effects of climatic influences can be traced back to various central mechanisms:
- Neuroinflammation,
- Oxidative stress,
- Vascular dysfunction,
- Disruption of synaptic development,
- Stress axis dysregulation.
These mechanisms operate throughout the lifespan, linking early life exposures to later disease risks.
Clinical Blind Spot: Environmental Factors Are Rarely Considered
In clinical practice, a significant gap exists between cause and manifestation. “We rarely recognize which environmental factors shaped the vulnerability of the brain decades earlier,” stated Paprocka. Consequently, a vital aspect of disease genesis often remains unaddressed, both in diagnostics and prevention.
Limited Study Landscape, Yet a Consistent Trend
The lecturer highlighted the limitations of the available data:
- Heterogeneous study designs,
- Small sample sizes (especially among children),
- Divergent definitions of exposure.
Despite these constraints, a consistent overall picture emerges: climatic factors significantly affect neurological health.
Call for a Paradigm Shift in Neurology
The central conclusion of the lecture goes beyond individual risk factors: “Climate-related influences are lifelong modifiers of brain health.” This shifts the focus from purely curative neurology to a more preventive perspective. Going forward, considering environmental and climatic factors may become an integral part of neurological risk assessment, particularly in primary care and pediatrics.
