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Glutaminolysis provides metabolic intermediates for synthetic pathways of macromolecules and provides ammonia and aspartate for synthesis of purines and pyrimidines, which are necessary for the formation of DNA and RNA [5, 6]

When psychiatric symptoms do occur, they often manifest as temper tantrums, aggression, agitation, and rarely psychosis

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Metabolites with VIP values greater than 1 and p-values less than 0.05 were identified as having significant statistical significance, showing a notable association with the observed metabolic changes

The increased apoptosis was related to the activation of p53 and p21, the decrease of the Bcl-2/Bax ratio, and the increase of caspase-3 and phosphorylated c-Jun N-terminal kinase (p-JNK) activity