Folic acid supplementation and ASD risk

Hot off the press folks:

Published this week in the Journal of the American Medical Association (JAMA), this paper is worth sharing as it suggests a link between maternal folic acid deficiency and risk for developing ASD: Surén P, Roth C, Bresnahan M, et al. Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children. JAMA. 2013;309(6):570-577. doi:10.1001/jama.2012.155925.

This isn’t the first study to suggest that folic acid or folate may play a role in ASDs.  Folate is a water-soluble B vitamin that acts as a coenzyme or cosubstrate in numerous biochemical reactions and genetic expression.  It is essential for health and reduces risk of birth defects.  However, folic acid must be converted to an active form before it is used by the body (see figure below).  Folinic acid is an active form of folate that is currently under investigation in several clinical trials to improve oxidative stress markers, behavior, and language in individuals with ASD.

One of these studies is being conducted at the Arkansas Children’s Hospital under the direction of Drs. Richard Frye (primary investigator) and S. Jill James (sub-investigator).  Both investigators have published numerous peer-reviewed papers that can be found by searching PubMed.  This study (NCT01602016) was designed to evaluate the effect of folinic acid supplementation on language improvement and behaviors in 130 children with ASD ages 3 to 14 years.  The study involves 3 phases:

  1. A baseline or screening phase to evaluate language impairment and eligibility.
  2. A 12-week, randomized, placebo-controlled, double-blind treatment period with folinic acid or placebo.
  3. A 12-week open-label extension period to provide folinic acid to all participants who complete the double-blind treatment phase.

Notably, this study is being conducted at the Arkansas Children’s Hospital, which is one of the participating centers in the Autism Treatment Network (ATN). What is the ATN? The ATN is a network of hospitals, physicians, researchers, and families at 17 locations across the United States and Canada. The ATN’s goal is to provide comprehensive, high-quality care by teams of healthcare professionals who understand ASDs and are experts at treating ASD-associated medical conditions such as sleep disturbances and gastrointestinal problems.  An ATN hospital would be my first choice in seeking medical care for my son.

Back to folate, my son seems to have benefited from folate supplementation.  He currently takes an active form of folate called L-methylfolate or Deplin®.  I expect more data from researchers in the future to support (or not) the use of folate as an intervention for at least a subset of children with ASDs.

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About EstherAsplund

Freelance regulatory writer, runner, mother. "Life is not about what I produce, it is who I become." - Fr. Keller
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