Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Glutamatergic synapse in autism: a complex story for a complex disorder

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder whose pathophysiological mechanisms are still unclear. Hypotheses suggest a role for glutamate dysfunctions in ASD development, but clinical studies investigating brain and peripheral glutamate levels showed heterogenous results leading to hypo- and hyper-glutamatergic hypotheses of ASD. Recently, studies proposed the implication of elevated mGluR5 densities in brain areas in the pathophysiology of ASD. Thus, our objective was to characterize glutamate dysfunctions in adult subjects with ASD by quantifying (1) glutamate levels in the cingulate cortex and periphery using proton magnetic resonance spectroscopy and metabolomics, and (2) mGluR5 brain density in this population and in a validated animal model of ASD (prenatal exposure to valproate) at developmental stages corresponding to childhood and adolescence in humans using positron emission tomography. No modifications in cingulate Glu levels were observed between individuals with ASD and controls further supporting the difficulty to evaluate modifications in excitatory transmission using spectroscopy in this population, and the complexity of its glutamate-related changes. Our imaging results showed an overall increased density in mGluR5 in adults with ASD, that was only observed mostly subcortically in adolescent male rats prenatally exposed to valproic acid, and not detected in the stage corresponding to childhood in the same animals. This suggest that clinical changes in mGluR5 density could reflect the adaptation of the glutamatergic dysfunctions occurring earlier rather than being key to the pathophysiology of ASD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Quantification of the brain Glu and Glx levels and Glu sub-metabolomes in the serum and urines in individuals with ASD and controls.
Fig. 2: Translational brain imaging of mGluR5 using [18F]FPEB brain in adults with ASD and in an animal model of ASD compared to controls.

Similar content being viewed by others

References

  1. Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018;392:508–20.

    Article  Google Scholar 

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

  3. Chiarotti F, Venerosi A. Epidemiology of autism spectrum disorders: a review of worldwide prevalence estimates since 2014. Brain Sci. 2020;10:274.

    Article  Google Scholar 

  4. Coghlan S, Horder J, Inkster B, Mendez MA, Murphy DG, Nutt DJ. GABA system dysfunction in autism and related disorders: from synapse to symptoms. Neurosci Biobehav Rev. 2012;36:2044–55.

    Article  CAS  Google Scholar 

  5. Rubenstein JLR, Merzenich MM. Model of autism: increased ratio of excitation/inhibition in key neural systems: model of autism. Genes Brain Behav. 2003;2:255–67.

    Article  CAS  Google Scholar 

  6. Yizhar O, Fenno LE, Prigge M, Schneider F, Davidson TJ, O’Shea DJ, et al. Neocortical excitation/inhibition balance in information processing and social dysfunction. Nature. 2011;477:171–8.

    Article  CAS  Google Scholar 

  7. Rojas DC. The role of glutamate and its receptors in autism and the use of glutamate receptor antagonists in treatment. J Neural Transm. 2014;121:891–905.

    Article  CAS  Google Scholar 

  8. Vyas Y, Cheyne JE, Lee K, Jung Y, Cheung PY, Montgomery JM. Shankopathies in the developing brain in autism spectrum disorders. Front Neurosci. 2021;15:775431.

    Article  Google Scholar 

  9. Eltokhi A, Santuy A, Merchan-Perez A, Sprengel R. Glutamatergic dysfunction and synaptic ultrastructural alterations in schizophrenia and autism spectrum disorder: evidence from human and rodent studies. IJMS. 2020;22:59.

    Article  Google Scholar 

  10. Carlsson ML. Hypothesis: is infantile autism a hypoglutamatergic disorder? Relevance of glutamate—serotonin interactions for pharmacotherapy. J Neural Transm. 1998;105:525.

    Article  CAS  Google Scholar 

  11. Fatemi SH. The hyperglutamatergic hypothesis of autism. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:911.

    Article  CAS  Google Scholar 

  12. Shigemoto R, Nomura S, Ohishi H, Sugihara H, Nakanishi S, Mizuno N. Immunohistochemical localization of a metabotropic glutamate receptor, mGluR5, in the rat brain. Neurosci Lett. 1993;163:53–57.

    Article  CAS  Google Scholar 

  13. Ferraguti F, Shigemoto R. Metabotropic glutamate receptors. Cell Tissue Res. 2006;326:483–504.

    Article  CAS  Google Scholar 

  14. Lee M, Martin GE, Berry-Kravis E, Losh M. A developmental, longitudinal investigation of autism phenotypic profiles in fragile X syndrome. J Neurodev Disord. 2016;8:47.

    Article  Google Scholar 

  15. Berry-Kravis E, Des Portes V, Hagerman R, Jacquemont S, Charles P, Visootsak J, et al. Mavoglurant in fragile X syndrome: results of two randomized, double-blind, placebo-controlled trials. Sci Transl Med. 2016;8:1–11.

  16. Youssef EA, Berry-Kravis E, Czech C, Hagerman RJ, Hessl D, Wong CY, et al. Effect of the mGluR5-NAM Basimglurant on behavior in adolescents and adults with fragile x syndrome in a randomized, double-blind, placebo-controlled trial: FragXis phase 2 results. Neuropsychopharmacology. 2018;43:503–12.

    Article  CAS  Google Scholar 

  17. Levenga J, Hayashi S, de Vrij FMS, Koekkoek SK, van der Linde HC, Nieuwenhuizen I, et al. AFQ056, a new mGluR5 antagonist for treatment of fragile X syndrome. Neurobiol Dis. 2011;42:311–7.

    Article  CAS  Google Scholar 

  18. Hagerman R, Jacquemont S, Berry-Kravis E, Des Portes V, Stanfield A, Koumaras B, et al. Mavoglurant in fragile x syndrome: results of two open-label, extension trials in adults and adolescents. Sci Rep. 2018;8:16970.

    Article  Google Scholar 

  19. Fatemi SH, Folsom TD, Kneeland RE, Liesch SB. Metabotropic glutamate receptor 5 upregulation in children with autism is associated with underexpression of both fragile x mental retardation protein and GABAA receptor beta 3 in adults with autism. Anat Rec. 2011;294:1635–45.

    Article  CAS  Google Scholar 

  20. Fatemi SH, Wong DF, Brašić JR, Kuwabara H, Mathur A, Folsom TD, et al. Metabotropic glutamate receptor 5 tracer [18F]-FPEB displays increased binding potential in postcentral gyrus and cerebellum of male individuals with autism: a pilot PET study. Cerebellum Ataxias. 2018;5:3.

    Article  Google Scholar 

  21. Brašić JR, Nandi A, Russell DS, Jennings D, Barret O, Martin SD, et al. Cerebral expression of metabotropic glutamate receptor subtype 5 in idiopathic autism spectrum disorder and fragile x syndrome: a pilot study. IJMS. 2021;22:2863.

    Article  Google Scholar 

  22. Semple BD, Blomgren K, Gimlin K, Ferriero DM, Noble-Haeusslein LJ. Brain development in rodents and humans: identifying benchmarks of maturation and vulnerability to injury across species. Prog Neurobiol. 2013;106–107:1–16.

    Article  Google Scholar 

  23. Hergueta T, Lecrubier Y, Sheehan D, Weiller E. Mini international neuropsychiatric interview French current DSM-IV. 2015. https://doi.org/10.13140/RG.2.1.2792.9440.

  24. First MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis. 2013;201:727–9.

    Article  Google Scholar 

  25. Lord C, Rutter M, Le Couteur A. Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord. 1994;24:659–85.

    Article  CAS  Google Scholar 

  26. Lord C, Risi S, Lambrecht L, Cook EH, Leventhal BL, DiLavore PC, et al. The autism diagnostic observation schedule–generic: a standard measure of social and communication deficits associated with the spectrum of autism. 2000;30:205–23.

  27. Wechsler D. Echelle d’intelligence de Wechsler pour adultes (WAIS-III). 3ème éd. Paris: ECPA; 2000.

  28. Wechsler D. Echelle d’intelligence de Wechsler pour adultes (WAIS-IV). 4ème éd. Paris: ECPA; 2011.

  29. Schopler E, Lansing MD, Reichler RJ, Marcus LM. PEP-3. Profil psycho-educatif. Evaluation fonctionnelle pour enfants autistes. de BoeckBruxelles, Belgique; 2020.

  30. Barfthelemy C, Roux S, Adrien JL, Hameuiy L, Gtieriis P, Garreau B, et al. Validation of the revised behavior summarized evaluation scale. 1997;27:139–53.

  31. Bourreau Y, Roux S, Gomot M, Bonnet-Brilhault F, Barthélémy C. Validation of the repetitive and restricted behaviour scale in autism spectrum disorders. Eur Child Adolesc Psychiatry. 2009;18:675–82.

    Article  Google Scholar 

  32. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E. The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord. 2001;31:5–17.

    Article  CAS  Google Scholar 

  33. Baron-Cohen S, Wheelwright S. The empathy quotient: an investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. J Autism Dev Disord. 2004;34:163–75.

    Article  Google Scholar 

  34. Dupont A-C, Serrière S, Barantin L, Vercouillie J, Tauber C, Gissot V, et al. Study of influence of the glutamatergic concentration of [18F]FPEB binding to metabotropic glutamate receptor subtype 5 with N-acetylcysteine challenge in rats and SRM/PET study in human healthy volunteers. Transl Psychiatry. 2021;11:66.

    Article  CAS  Google Scholar 

  35. Apps MAJ, Lockwood PL, Balsters JH. The role of the midcingulate cortex in monitoring others’ decisions. Front Neurosci. 2013;7:1–7.

  36. Apps MAJ, Rushworth MFS, Chang SWC. The anterior cingulate gyrus and social cognition: tracking the motivation of others. Neuron. 2016;90:692–707.

    Article  CAS  Google Scholar 

  37. Leech R, Sharp DJ. The role of the posterior cingulate cortex in cognition and disease. Brain. 2014;137:12–32.

    Article  Google Scholar 

  38. Wilson M, Andronesi O, Barker PB, Bartha R, Bizzi A, Bolan PJ, et al. Methodological consensus on clinical proton MRS of the brain: review and recommendations. Magn Reson Med. 2019;82:527–50.

    Article  Google Scholar 

  39. Oeltzschner G, Zöllner HJ, Hui SCN, Mikkelsen M, Saleh MG, Tapper S, et al. Osprey: open-source processing, reconstruction & estimation of magnetic resonance spectroscopy data. J Neurosci Methods. 2020;343:108827.

    Article  CAS  Google Scholar 

  40. Gasparovic C, Song T, Devier D, Bockholt HJ, Caprihan A, Mullins PG, et al. Use of tissue water as a concentration reference for proton spectroscopic imaging. Magn Reson Med. 2006;55:1219–26.

    Article  CAS  Google Scholar 

  41. Harris AD, Puts NAJ, Edden RAE. Tissue correction for GABA-edited MRS: considerations of voxel composition, tissue segmentation, and tissue relaxations: tissue correction for GABA-Edited MRS. J Magn Reson Imaging. 2015;42:1431–40.

    Article  Google Scholar 

  42. Gussew A, Erdtel M, Hiepe P, Rzanny R, Reichenbach JR. Absolute quantitation of brain metabolites with respect to heterogeneous tissue compositions in 1H-MR spectroscopic volumes. Magn Reson Mater Phys. 2012;25:321–33.

    Article  CAS  Google Scholar 

  43. Truong V, Duncan NW. Suggestions for improving the visualization of magnetic resonance spectroscopy voxels and spectra. R Soc Open Sci. 2020;7:200600.

    Article  Google Scholar 

  44. Park E, Sullivan JM, Planeta B, Gallezot J-D, Lim K, Lin S-F, et al. Test–retest reproducibility of the metabotropic glutamate receptor 5 ligand [18F]FPEB with bolus plus constant infusion in humans. Eur J Nucl Med Mol Imaging. 2015;42:1530–41.

    Article  CAS  Google Scholar 

  45. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc: Ser B (Methodol). 1995;57:289–300.

    Google Scholar 

  46. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.

  47. Sawilowsky SS. New effect size rules of thumb. J Mod Appl Stat Meth. 2009;8:597–9.

    Article  Google Scholar 

  48. Blasco H, Bessy C, Plantier L, Lefevre A, Piver E, Bernard L, et al. The specific metabolome profiling of patients infected by SARS-COV-2 supports the key role of tryptophan-nicotinamide pathway and cytosine metabolism. Sci Rep. 2020;10:16824.

    Article  CAS  Google Scholar 

  49. Nadler JJ, Moy SS, Dold G, Simmons N, Perez A, Young NB, et al. Automated apparatus for quantitation of social approach behaviors in mice. Genes Brain Behav. 2004;3:303–14.

    Article  CAS  Google Scholar 

  50. Genovese CR, Lazar NA, Nichols T. Thresholding of statistical maps in functional neuroimaging using the false discovery rate. NeuroImage. 2002;15:870–8.

    Article  Google Scholar 

  51. Kammermeier PJ. Endogenous homer proteins regulate metabotropic glutamate receptor signaling in neurons. J Neurosci. 2008;28:8560–7.

    Article  CAS  Google Scholar 

  52. Verpelli C, Dvoretskova E, Vicidomini C, Rossi F, Chiappalone M, Schoen M, et al. Importance of Shank3 protein in regulating metabotropic glutamate receptor 5 (mGluR5) expression and signaling at synapses. J Biol Chem. 2011;286:34839–50.

    Article  CAS  Google Scholar 

  53. Ford TC, Crewther DP. A comprehensive review of the 1H-MRS metabolite spectrum in autism spectrum disorder. Front Mol Neurosci. 2016;9:1–27.

  54. Bernardi S, Anagnostou E, Shen J, Kolevzon A, Buxbaum JD, Hollander E, et al. In vivo 1H-magnetic resonance spectroscopy study of the attentional networks in autism. Brain Res. 2011;1380:198–205.

    Article  CAS  Google Scholar 

  55. Bejjani A, O’Neill J, Kim JA, Frew AJ, Yee VW, Ly R, et al. Elevated glutamatergic compounds in pregenual anterior cingulate in pediatric autism spectrum disorder demonstrated by 1H MRS and 1H MRSI. PLoS ONE. 2012;7:e38786.

    Article  CAS  Google Scholar 

  56. Joshi G, Biederman J, Wozniak J, Goldin RL, Crowley D, Furtak S, et al. Magnetic resonance spectroscopy study of the glutamatergic system in adolescent males with high-functioning autistic disorder: a pilot study at 4T. Eur Arch Psychiatry Clin Neurosci. 2013;263:379–84.

    Article  Google Scholar 

  57. Ito H, Mori K, Harada M, Hisaoka S, Toda Y, Mori T, et al. A proton magnetic resonance spectroscopic study in autism spectrum disorder using a 3-Tesla clinical magnetic resonance imaging (MRI) system: the anterior cingulate cortex and the left cerebellum. J Child Neurol. 2017;32:731–9.

    Article  Google Scholar 

  58. Naaijen J, Zwiers MP, Forde NJ, Williams SC, Durston S, Brandeis D, et al. Striatal structure and its association with N-Acetylaspartate and glutamate in autism spectrum disorder and obsessive compulsive disorder. Eur Neuropsychopharmacol. 2018;28:118–29.

    Article  CAS  Google Scholar 

  59. Siegel-Ramsay JE, Romaniuk L, Whalley HC, Roberts N, Branigan H, Stanfield AC, et al. Glutamate and functional connectivity—support for the excitatory-inhibitory imbalance hypothesis in autism spectrum disorders. Psychiatry Res: Neuroimaging. 2021;313:111302.

    Article  Google Scholar 

  60. Tebartz van Elst L, Maier S, Fangmeier T, Endres D, Mueller GT, Nickel K, et al. Disturbed cingulate glutamate metabolism in adults with high-functioning autism spectrum disorder: evidence in support of the excitatory/inhibitory imbalance hypothesis. Mol Psychiatry. 2014;19:1314–25.

    Article  CAS  Google Scholar 

  61. Jiménez-Espinoza C, Marcano Serrano F, González-Mora JL. N-acetylaspartyl-glutamate metabolism in the cingulated cortices as a biomarker of the etiology in ASD: a 1H-MRS model. Molecules. 2021;26:675.

    Article  Google Scholar 

  62. Libero LE, Reid MA, White DM, Salibi N, Lahti AC, Kana RK. Biochemistry of the cingulate cortex in autism: an MR spectroscopy study: biochemistry of the cingulate cortex in autism. Autism Res. 2016;9:643–57.

    Article  Google Scholar 

  63. Shinohe A, Hashimoto K, Nakamura K, Tsujii M, Iwata Y, Tsuchiya KJ, et al. Increased serum levels of glutamate in adult patients with autism. Prog Neuro-Psychopharmacol Biol Psychiatry. 2006;30:1472–7.

    Article  CAS  Google Scholar 

  64. Ghanizadeh A. Increased glutamate and homocysteine and decreased glutamine levels in autism: a review and strategies for future studies of amino acids in autism. Dis Markers. 2013;35:281–6.

    Article  Google Scholar 

  65. Zheng H-F, Wang W-Q, Li X-M, Rauw G, Baker GB. Body fluid levels of neuroactive amino acids in autism spectrum disorders: a review of the literature. Amino Acids. 2017;49:57–65.

    Article  CAS  Google Scholar 

  66. Lussu M, Noto A, Masili A, Rinaldi AC, Dessì A, De Angelis M, et al. The urinary 1 H-NMR metabolomics profile of an italian autistic children population and their unaffected siblings: metabolomics profile of autistic children. Autism Res. 2017;10:1058–66.

    Article  Google Scholar 

  67. Zaki MM, Abdel-Al H, Al-Sawi M. Assessment of plasma amino acid profile in autism using cation-exchange chromatography with postcolumn derivatization by ninhydrin. Turk J Med Sci. 2017;47:260–67.

  68. Al-Otaish H, Al-Ayadhi L, Bjørklund G, Chirumbolo S, Urbina MA, El-Ansary A. Relationship between absolute and relative ratios of glutamate, glutamine and GABA and severity of autism spectrum disorder. Metab Brain Dis. 2018;33:843–54.

    Article  CAS  Google Scholar 

  69. Bitar T, Mavel S, Emond P, Nadal-Desbarats L, Lefèvre A, Mattar H, et al. Identification of metabolic pathway disturbances using multimodal metabolomics in autistic disorders in a Middle Eastern population. J Pharm Biomed Anal. 2018;152:57–65.

    Article  CAS  Google Scholar 

  70. Khalifa D, Shahin O, Salem D, Raafat O. Serum glutamate was elevated in children aged 3-10 years with autism spectrum disorders when they were compared with controls. Acta Paediatr. 2019;108:295–9.

    Article  CAS  Google Scholar 

  71. Rangel-Huerta OD, Gomez-Fernández A, de la Torre-Aguilar MJ, Gil A, Perez-Navero JL, Flores-Rojas K, et al. Metabolic profiling in children with autism spectrum disorder with and without mental regression: preliminary results from a cross-sectional case–control study. Metabolomics. 2019;15:99.

    Article  CAS  Google Scholar 

  72. Gevi F, Belardo A, Zolla L. A metabolomics approach to investigate urine levels of neurotransmitters and related metabolites in autistic children. Biochim Biophys Acta Mol Basis Dis. 2020;1866:165859.

    Article  CAS  Google Scholar 

  73. Yu X, Qian-Qian L, Cong Y, Xiao-Bing Z, Hong-Zhu D. Reduction of essential amino acid levels and sex-specific alterations in serum amino acid concentration profiles in children with autism spectrum disorder. Psychiatry Res. 2021;297:113675.

    Article  CAS  Google Scholar 

  74. Chaleckis R, Murakami I, Takada J, Kondoh H, Yanagida M. Individual variability in human blood metabolites identifies age-related differences. Proc Natl Acad Sci USA. 2016;113:4252–9.

    Article  CAS  Google Scholar 

  75. Hawkins RA. The blood-brain barrier and glutamate. Am J Clin Nutr. 2009;90:867S–874S.

    Article  CAS  Google Scholar 

  76. Gade S, Hjørnevik T, Park JH, Shen B, Gu M, Tseng J, et al. The first awake simultaneous PET-MR study of an adult with fragile X syndrome: a case report. In Review; 2021.

  77. Tartaglione AM, Schiavi S, Calamandrei G, Trezza V. Prenatal valproate in rodents as a tool to understand the neural underpinnings of social dysfunctions in autism spectrum disorder. Neuropharmacology. 2019;159:107477.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The clinical study was supported by the French National Agency for Research (“Investissements d’Avenir” no. ANR-11-LABX-0018-01), IRON. This study was funded in part by the “Région centre Val de Loire APR-IA 2014-850”. We thank the staffs at the CERRP, iBrain, CIC 1415, PST-ASB core facility and the staff of the child psychiatry unit and the nuclear medicine department of the university hospital of Tours. We also thank the PRIMEX core facility from the Angers University for the MR-experiments to build the MRI template for male rats at early-adolescence. We thank Jacques Dupont for its technical assistance on preclinical behavioral experiments. We extend our deep gratitude to the participants of this study.

Author information

Authors and Affiliations

Authors

Contributions

Conceptualization: FBB, FL, LG, MJSR, PE, and SC; Data acquisition: AL, CB, CR, EHD, FBB, JV, LB, LG, MJSR, SC, SR, and VG; Data analysis: ACD, CT, LB, LG, LN, FB, FBB, MG, MJSR, NA, PE, and SM; Manuscript writing: FB, FBB, LG, MJSR, NA, and PE.

Corresponding author

Correspondence to Frédérique Bonnet-Brilhault.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Galineau, L., Arlicot, N., Dupont, AC. et al. Glutamatergic synapse in autism: a complex story for a complex disorder. Mol Psychiatry 28, 801–809 (2023). https://doi.org/10.1038/s41380-022-01860-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41380-022-01860-9

This article is cited by

Search

Quick links