Can Folic Acid prevent autism? And/or relieve symptoms for ongoing cases?

It is a well known fact that simply by taking essential vitamins and folic acid prior and especially during pregnancy, helps prevent spina bifida, neural tube defects etc. And according to a new study, folic acid may also reduce the risk of autism spectrum disorder.

Autism Birth Cohort Study, a subset of the Norwegian Mother and Child Cohort Study (MoBa), followed 85,176 babies to determine whether their mother’s use of folic acid supplements influenced an autism spectrum disorder. At the end of a follow-up period, 270 children were diagnosed with autism spectrum disorder: 114 with autistic disorder (0.13 percent), 56 with Asperger Syndrome (0.07 percent) and 100 with PDD-NOS, or pervasive developmental disorder – not otherwise specified (0.12 percent). Women who had taken folic acid supplements in early pregnancy han 40% reduced risk of having a child with autistic disorder than women who had not taken the supplement. No reduction in risk was shown for Asperger syndrome or PDD- NOS. Although the study does not establish cause – effect link, it does show association between the use of folic acid supplements and a lower risk of autistic disorder. The study is published Feb 13. in the Journal of the American Medical Association.

A different study, by Dr. Richard Frye, on the impact of a daily treatment of folic acid on ASD- related symptoms is currently being conducted.

The Hypothesis is that a folic acid will improve folate metabolism in the brain, oxidative stress and mitochondrial function in children with autism, resulting in specific health improvements for patients with autism, a discovery that would be very beneficial for the autism community.

Dr. Frye’s current proposal can potentially provide strong evidence for a folic acid intervention and will provide insight into the subgroups of children with ASD who would benefit from folic acid.  The primary goal is to improve language for those with ASD (which is measured by the receptive and expressive CELF language index). Preliminary studies have suggested that a folinic acid intervention is associated with receptive and expressive language improvements. For example, in a case-series of 44 children with ASD and the folate receptor alpha autoantibody, treatment with high-dose folinic acid (2 mg/kg/day divided twice a day; maximum dose 50mg / day) improved communication, attention, and stereotypical behavior in many children with ASD.

Folate is an essential B vitamin required for normal neurodevelopment.  Defects in folate metabolism can cause secondary physiological abnormalities, some of which have been associated with ASD.  In this study, Dr. Frye and his team aim to study several physiological mechanisms associated with folate abnormalities in children with ASD: the folate receptor alpha autoantibody that reduce folate transport across the blood-brain barrier, low glutathione redox status, mitochondrial dysfunction and genetic polymorphisms. Most importantly, ASD patients with these physiological mechanisms have shown improvement in ASD symptoms with a folic acid intervention.

The goal of the study is to extend these preliminary findings by documenting response to a folic acid intervention in a double-blind placebo-controlled manner and test whether the folic receptor alpha autoantibody titers, glutathione status, mitochondrial function and genetic polymorphisms predict response to a folic acid intervention. If any of these measures of physiological dysfunction predict response to the intervention, such titers could provide a biomarker to identify a subset of children with ASD that may benefit from a folic acid intervention and may even predict the development of ASD symptoms in high risk siblings during the presymptomatic period.

Using these biomarkers, it may be possible that children with ASD who optimally respond to the folic acid intervention can be readily identified early after diagnosis or even during the pre-symptomatic period.

The study is being conducted at the Arkansas Children’s Hospital and it has S. Jill James, PhD and Stepan Melnky, MD, PhD as co-investigators and in collaboration with Dr Edward Quadros, Ph.D. at SUNY Downstate in Brooklyn, NY.

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