OtherMolecular autism2023

Increased cerebral lactate levels in adults with autism spectrum disorders compared to non-autistic controls: a magnetic resonance spectroscopy study.

Simon Maier, Kathrin Nickel, Thomas Lange and 8 others

PMID 37978557

WHAT IT FOUND

Adults with autism showed slightly higher lactate levels in one brain region than controls, but only 9.4% had levels high enough to be flagged.

Brain lactate did not match blood lactate or predict symptom severity. This suggests a possible metabolic subgroup, not a universal marker.

Key findings

01Lactate concentrations in the posterior cingulate cortex were significantly higher in adults with ASD compared to non-autistic controls.

02Only 9.4% of participants with ASD had elevated brain lactate levels defined by control group norms, with none in the control group.

03There was no significant correlation between brain lactate levels and blood serum lactate levels.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study measured only one brain region, so lactate levels elsewhere are unknown. The difference in brain lactate between groups was small (Cohen's d = 0.404). Participants with ASD had higher anxiety levels before the scan, which could theoretically influence lactate, though no direct correlation was found. Diet and long-term physical activity were not controlled, both of which can affect lactate levels. The MRS technique cannot perfectly distinguish lactate from threonine, so the measure is a combined value.

Declared interests

Funded by the Deutsche Forschungsgemeinschaft and Universitätsklinikum Freiburg. No specific commercial conflicts of interest are listed in the provided text.

The easy way to misread this

Do not interpret the significant group difference as evidence that elevated brain lactate is a common feature of autism. Only 9.4% of the ASD group had levels considered elevated by control norms, and the overall effect size was small. This finding suggests a potential metabolic subgroup, not a universal diagnostic marker.

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The study

Participants
64 adults with ASD and 58 non-autistic controls analysed (from 71 recruited in each group)
Certainty of evidence
Low

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    Cite

    Simon Maier, Kathrin Nickel, Thomas Lange, et al. Increased cerebral lactate levels in adults with autism spectrum disorders compared to non-autistic controls: a magnetic resonance spectroscopy study. Molecular autism. 2023.

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