ABSTRACT
Autism spectrum disorder (ASD) is typically described as a disorder of childhood; however, challenges in
socioemotional behavior and cognition persist across the lifespan. Nearly 6 million adults in the United States
currently live with ASD, with prevalence more than doubling in the last 10 years. Recent studies suggest that
adults with ASD are twice as likely to develop dementia, and have an increased prevalence of age-related
physical and psychiatric conditions. While brain and behavioral differences are well researched in children with
ASD, a major gap in knowledge exists for the adult brain. The brains of individuals with ASD undergo an
atypical developmental trajectory, marked by initial excess in volume, neuron density, and connectivity in
childhood that is followed by a progressive reduction in cell number, myelin thickness, and synapses into
adulthood. We propose that early neuronal excess and local over-connectivity, in concert with systemic
neuroimmune dysregulation, may render the ASD brain vulnerable to age-related pathological and pro-
inflammatory processes beginning in early adulthood that may ultimately lead to cellular dysfunction and later
cognitive decline. Here we aim to determine the cell types affected as individuals with ASD age through
adulthood and identify neuroinflammatory markers specific to those cells. We will utilize a unique sample of
clinically and genetically characterized human postmortem adult brains, examining regions implicated in the
socioemotional and neurobiological impairments of ASD and aging. We hypothesize that aberrant immune
activation of pro-inflammatory processes contribute to the altered trajectory of brain development, as well as
deleterious neuropathogenic protein aggregations associated with cognitive decline. We will utilize unbiased
transcriptomic methods to determine which genes may be differentially expressed in specific cell groups, and
assays to determine which proteins, including cytokines, may be disproportionately affected with age in ASD
(Aim 1). Informed by these results, we will carry out a systematic examination of the expression of high-priority
markers in specific cell types with preserved spatial information in brain tissue sections (Aim 2). Finally, we will
examine the effects of neuroinflammation and aging in ASD on the synaptic connections between neurons
(Aim 3). These critical, discovery-driven studies will serve as an essential first step to characterize cellular and
molecular processes associated with brain aging in ASD, and provide a fundamental platform upon which
mechanistic studies and animal models can be built. This project will define the neuropathological features
associated with brain aging in ASD and correlate these variables with extensive clinical and genetic information
for each subject, in support of precision medicine. Ultimately, we aim to shift the mindset of autism research
toward the view of adulthood not as an endpoint, but as part of a trajectory of brain development across the
lifespan, with the goal of promoting healthy aging in the rapidly growing population of adults living with ASD.