Children with autism spectrum disorder and comorbid sleep disorder exhibit impaired perivascular neuroclearance linked to systemic iron deficiency.
In a study of 230 children with ASD (114 with sleep disorder, 116 without) and 110 typically developing controls, those with ASD and sleep disorder showed significantly reduced ALPS indices and elevated free water fraction, indicating impaired neuroclearance. Serum iron was markedly lower in this group, and mediation analysis supported a pathway from iron deficiency to cerebral edema to impaired neuroclearance.
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Children with autism spectrum disorder and comorbid sleep disorder exhibit impaired perivascular neuroclearance linked to systemic iron deficiency. The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Children with autism spectrum disorder and comorbid sleep disorder exhibit impaired perivascular neuroclearance linked to systemic iron deficiency.
This conclusion is most relevant to: Children with autism spectrum disorder (aged not specified) with and without sleep disorder, and typically developing controls.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency. (Journal of affective disorders, 2026) —
How It Works
The proposed biological pathway:
- ▸Systemic iron deficiency
- ▸Increased cerebral edema (elevated free water fraction)
- ▸Impaired perivascular neuroclearance (reduced ALPS index)
- ▸Sleep disruption in ASD
Who Might Benefit
Evidence fit by population:
- ▸Children with autism spectrum disorder (aged not specified) with and without sleep disorder, and typically developing controls
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Observational design cannot establish causality
- ▸Single-center study with potential selection bias
- ▸No direct measurement of sleep architecture (e.g., polysomnography)
Frequently Asked Questions
What is the DKI-ALPS index?▼
It is a diffusion kurtosis imaging measure along the perivascular space used to quantify neuroclearance function.
How was sleep disorder defined in this study?▼
The abstract does not specify diagnostic criteria; children were classified as ASD-SD (with sleep disorder) or ASD-nSD (without) based on clinical assessment.
What is the proposed mechanism linking iron deficiency to neuroclearance dysfunction?▼
The study suggests a pathway: iron deficiency leads to cerebral edema (increased free water fraction), which in turn impairs perivascular neuroclearance.
Could iron supplementation improve sleep in children with ASD?▼
The authors suggest targeted interventions integrating iron supplementation and sleep optimization, but this study does not test supplementation directly.
References
- 1.Yin BY, Deng YY, Chen X, Zhao JY, Ni YX, Zhong SS, Zou FY, Shen LS, Luo XW, Zhou X, Zhang JL, Zhou WY, Deng HZ, Guo RM. “Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency..” Journal of affective disorders, 2026. PMID: 42208817 DOI: 10.1016/j.jad.2026.122035