Iron deposition and functional connectivity alterations in the right substantia nigra of adult males with autism.

The substantia nigra (SN) is a midbrain nucleus implicated not only in motor control and reward processing but also in higher-order cognitive functions. Iron homeostasis in this region is essential for neurotransmitter synthesis, especially for dopamine, and thus, iron dysregulation may contribute to the symptomatology of autism spectrum disorder (ASD). However, iron deposition and functional circuits of the SN in the autistic brain remain underexplored. This study investigated iron deposition and functional connectivity (FC) of the SN in 53 adult males with ASD and 99 typically developing controls using quantitative susceptibility mapping and resting-state fMRI. Compared to controls, the ASD group exhibited higher magnetic susceptibility in the right SN, suggesting elevated iron deposition. Within the ASD group, higher iron deposition was associated with more severe socio-communicative deficits and reduced sensory-seeking behavior. Seed-based FC analyses further revealed that the ASD group exhibited stronger FC between the right SN and bilateral visual cortices and reduced FC with the right superior frontal gyrus. These results highlight the critical role of the SN in the autistic brain and indicate that altered iron homeostasis in the SN may contribute to disruptions in the dopaminergic system that underlie the core symptoms of ASD.