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In autism, brain doesn’t ‘prune’ extra synapses

"What's remarkable about the findings," says David Sulzer, "is that hundreds of genes have been linked to autism, but almost all of our human subjects had overactive mTOR and decreased autophagy, and all appear to have a lack of normal synaptic pruning. (Credit: Thiago Periera/Flickr)

Neuroscientists have discovered extra synapses in the brains of children and adolescents with autism. The excess is due to a slowdown in the normal brain “pruning” process during development, they say.

Because synapses are the points where neurons connect and communicate with each other, the excessive synapses may have profound effects on how the brain functions. The study appears online in the journal Neuron.

A drug that restores normal synaptic pruning can improve autistic-like behaviors in mice, the researchers found, even when the drug is given after the behaviors appear.

spines on neurons
Neurons in brains from people with autism do not undergo normal pruning during childhood and adolescence. The images show representative neurons from unaffected brains (top) and brains from autistic patients (bottom); the spines on the neurons indicate the location of synapses. (Credit: Guomei Tang, Mark S. Sonders/CUMC)

“This is an important finding that could lead to a novel and much-needed therapeutic strategy for autism,” says Jeffrey Lieberman, professor and chair of psychiatry at Columbia University Medical Center (CUMC) and director of the New York State Psychiatric Institute, who was not involved in the study.

Although the drug, rapamycin, has side effects that may preclude its use in people with autism, “the fact that we can see changes in behavior suggests that autism may still be treatable after a child is diagnosed, if we can find a better drug,” says the study’s senior investigator, David Sulzer, professor of neurobiology at CUMC.

During normal brain development, a burst of synapse formation occurs in infancy, particularly in the cortex, a region involved in autistic behaviors; pruning eliminates about half of these cortical synapses by late adolescence.

Scientists know that many genes linked to autism affect synapses, and some researchers have hypothesized that people with autism may have more synapses.

Counting spines in the brain

To test this hypothesis, coauthor Guomei Tang, assistant professor of neurology at CUMC, examined brains from children with autism who had died from other causes.


Thirteen brains came from children ages two to nine, and thirteen brains came from children ages 13 to 20. The researchers examined 22 brains from children without autism for comparison.

Tang measured synapse density in a small section of tissue in each brain by counting the number of tiny spines that branch from these cortical neurons; each spine connects with another neuron via a synapse.

By late childhood, she found, spine density had dropped by about half in the control brains, but by only 16 percent in the brains from autism patients.

“It’s the first time that anyone has looked for, and seen, a lack of pruning during development of children with autism,” says Sulzer, “although lower numbers of synapses in some brain areas have been detected in brains from older patients and in mice with autistic-like behaviors.”

Clues to what caused the pruning defect were also found in the patients’ brains—the autistic children’s brain cells were filled with old and damaged parts and were very deficient in a degradation pathway known as “autophagy.” Cells use autophagy (a term from the Greek for self-eating) to degrade their own components.

Drug tests in mice

Using mouse models of autism, the researchers traced the pruning defect to a protein called mTOR. When mTOR is overactive, they found, brain cells lose much of their “self-eating” ability. And without this ability, the brains of the mice were pruned poorly and contained excess synapses.

“While people usually think of learning as requiring formation of new synapses,” Sulzer says, “the removal of inappropriate synapses may be just as important.”

The researchers could restore normal autophagy and synaptic pruning—and reverse autistic-like behaviors in the mice—by administering rapamycin, a drug that inhibits mTOR.

The drug was effective even when administered to the mice after they developed the behaviors, suggesting that such an approach may be used to treat patients even after the disorder has been diagnosed.

Because large amounts of overactive mTOR were also found in almost all of the brains of the autism patients, the same processes may occur in children with autism.

Hundreds of genes

“What’s remarkable about the findings,” says Sulzer, “is that hundreds of genes have been linked to autism, but almost all of our human subjects had overactive mTOR and decreased autophagy, and all appear to have a lack of normal synaptic pruning.

“This says that many, perhaps the majority, of genes may converge onto this mTOR/autophagy pathway, the same way that many tributaries all lead into the Mississippi River. Overactive mTOR and reduced autophagy, by blocking normal synaptic pruning that may underlie learning appropriate behavior, may be a unifying feature of autism.”

Alan Packer, senior scientist at the Simons Foundation, which funded the research, says the study is an important step forward in understanding what’s happening in the brains of people with autism.

“The current view is that autism is heterogeneous, with potentially hundreds of genes that can contribute. That’s a very wide spectrum, so the goal now is to understand how those hundreds of genes cluster together into a smaller number of pathways; that will give us better clues to potential treatments,” he says.

“The mTOR pathway certainly looks like one of these pathways. It is possible that screening for mTOR and autophagic activity will provide a means to diagnose some features of autism, and normalizing these pathways might help to treat synaptic dysfunction and treat the disease.”

Additional funding came from the US Department of Defense, the Parkinson’s Disease Foundation, JPB Foundation, National Institutes of Health, and the American Heart Association. Harvard Brain Bank and Maryland NICHD Brain & Tissue Bank provided brain tissue.

Source: Columbia University