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    Does Gluten Play a Role in Some Alcohol-related Brain Damage?


    Jefferson Adams


    • Is there a link between gluten and cerebellar degeneration?


    Image Caption: Photo: CC--Tech.Co

    Celiac.com 12/01/2016 - Alcohol-related cerebellar degeneration is one of the most common forms of acquired cerebellar ataxia. Researchers still do not understand the exactly how alcohol damages the cerebellum. Very little study has been done on auto-reactive immune mediated mechanisms as a possible contributor.


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    Recently, a team of researchers set out to investigate the potential role of alcohol-induced immune mediated cerebellar degeneration. The research team included Priya D. Shanmugarajah, Nigel Hoggard, Stuart Currie, Daniel P. Aeschlimann, Pascale C. Aeschlimann, Dermot C. Gleeson, Mohammed Karajeh, Nicola Woodroofe, Richard A. Grünewald and Marios Hadjivassiliou. They are variously associated with the National Blood Service Sheffield, UK; Department of Immunology, Northern General Hospital, Sheffield, UK and Academic Unit of Radiology, University of Sheffield, UK.

    For their study, the team recruited patients with ataxia and a history of heavy alcohol use from the Ataxia and Hepatology tertiary clinics at Sheffield Teaching Hospitals NHS Trust. The team determined the pattern of cerebellar involvement both on clinical (SARA score) and imaging (MRI volumetry and MR spectroscopy) parameters. They also evaluated HLA genotyping, serological markers for gluten-related disorders and serological reactivity on rat cerebellar tissue using indirect immunohistochemistry.

    In all, the team studied thirty-eight patients with ataxia, which negatively impacted the gait in 97% of patients, and stance and heel-shin slide in 89% of patients. The team used MRI volumetric and spectroscopy techniques to show significant structural, volumetric and functional deficiencies of the cerebellum with particular involvement of the cerebellar vermis.

    They found circulating anti-gliadin antibodies in 34% of patients, compared with 12% of healthy controls. They found antibodies to transglutaminase 6 (TG6) in 39% of patients, but only in 4% of healthy control subjects. Using immunohistochemistry, they found Purkinje cell and/or granular layer reactivity in 71% of patient sera.

    Alcohol induced tissue injury to the CNS leading to cerebellar degeneration may also involve immune mediated mechanisms, including sensitization to gluten. The team is calling for role of gluten in ataxia to be studied further, to determine the exact mechanism, and the extent of gluten's impact on ataxia patients.

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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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