Cerebrospinal fluid findings in adult patients with autism spectrum disorder

Introduction:

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties with social interaction, repetitive behavior, and additional features, such as sensual hypersensitivity and/or special interests. The precise etiology is unclear. Immunological mechanisms have been increasingly discussed in patients with ASD in this context, including maternal autoantibodies/infections, comorbid immunological diseases (e.g., gluten intolerance), evidence of microglia activation, or autoantibodies. Cerebrospinal fluid (CSF) diagnostics play an important role in the detection of immunological processes in the central nervous system.

Methods:

To rule out secondary organic diseases in these patients, in the meantime, we have performed CSF examinations in over 30 adult patients with ASD. In our clinic, we also offer electroencephalography and magnetic resonance imaging of the neurocranium. As part of another study, we created a mentally healthy control group of patients with pseudotumor cerebri. Now, we plan to retrospectively evaluate the CSF basis findings-including cell count, total protein, albumin quotient, IgG index, and oligoclonal bands-of patients with ASD and then compare them with the already established control collective.

Results:

We earlier found, for example, an intrathecal synthesis of glutamate decarboxylase 65 (GAD65) antibodies in two of these patients. Preliminary systemic results of CSF basis parameters will be presented at the joint AGNP-DGBP Congress 2019 in Berlin.

Conclusion:

The CSF findings may provide evidence for a secondary immunological genesis in a subgroup of patients with ASD. Initial clinical experience suggests that the measurement of GAD65 antibodies in certain patient groups with ASD may be considered.