Jump to content
  • Join Our Community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Jefferson Adams
    Jefferson Adams

    Gluten-Free Diet Helps Treat Neurological Manifestations of Gluten Sensitivity and Celiac Disease

      A recent study shows that a strict gluten-free diet is effective in treating neurological manifestations of gluten-related disorders.

    Caption: Beta lobe neurons. Image: CC--NICHD

    Celiac.com 04/30/2019 - Doctors recognize that patients with gluten sensitivity, whether or not they have enteropathy, or even gastrointestinal symptoms, can suffer from a range of debilitating neurological manifestations.

    Researchers Panagiotis Zis and Marios Hadjivassiliou of the Academic Department of Neurosciences, Sheffield Teaching hospitals NHS Trust and University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK, recently published an overview of current literature in an effort to assess the available treatment options for the neurological manifestations of gluten-related disorders, specifically, serologically confirmed gluten sensitivity and celiac disease.

    For patients with gluten sensitivity, ataxia is the most common neurological manifestation, followed by peripheral neuropathy. Other conditions linked to gluten sensitivity and celiac disease and discussed in the review include:

    • epilepsy
    • headache
    • encephalopathy
    • movement disorders
    • cognitive impairment
    • muscle disorders

    The team found that a strict gluten-free diet is effective in treating neurological manifestations of gluten-related disorders. Rarely, patients need additional immunosuppressive treatment, usually mycophenolate.

    There have been cases where gluten ingestion triggered schizophrenic episodes in an undiagnosed patient. Meanwhile, a number of studies have shown that a gluten-free diet seems to help improve symptoms of psychological, neurological and inflammatory conditions, including schizophrenia, neuropathy, and diabetes.

    Stay tuned for more news about gluten and related health issues.

    Read more in Current Treatment Options in Neurology


    User Feedback

    Recommended Comments

    There are no comments to display.



    Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Celiac.com 06/01/2015 - Earlier research on celiac disease and neuropathy has been hampered by the use of inpatient data, low study power, and lack of information on neuropathic characteristics.
    A team of researchers recently set out to accurately assess both relative and absolute risk of developing neuropathy in a nationwide population-based sample of patients with biopsy-verified celiac disease. The research team included Sujata P. Thawani, MD, MPH; Thomas H. Brannagan III, MD; Benjamin Lebwohl, MD, MS; Peter H. R. Green, MD; and Jonas F. Ludvigsson, MD, PhD.
    They are variously affiliated with the Peripheral Neuropathy Center at the Neurological Institute of Columbia University College of Physicians and Surgeons, the Celiac Disease Center in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York, New York, with the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden, and with the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.
    For their study, the team collected data on small-intestinal biopsies conducted at Sweden’s 28 pathology departments from 1969 to 2008. They compared the risk of neuropathy in a total of 28 ,232 celiac disease patients, all with villous atrophy, Marsh 3, against results from 139, 473 age- and sex-matched non-celiac control subjects.
    They used Cox proportional hazards regression to estimate hazard ratios (HRs), and 95% confidence intervals (CIs), for neuropathy as defined by relevant International Classification of Diseases codes in the Swedish National Patient Register; including both inpatient and outpatient data.
    They found that patients with biopsy-verified celiac disease faced a 2.5 times higher risk of developing neuropathy (95% CI, 2.1-3.0; P < .001). Celiac patients also had an increased risk of developing chronic inflammatory demyelinating neuropathy (2.8; 1.6-5.1; P = .001), autonomic neuropathy (4.2; 1.4-12.3; P = .009), and mononeuritis multiplex (7.6; 1.8-32.4; P = .006).
    However, the team found no association between celiac disease and acute inflammatory demyelinating polyneuropathy (0.8; 0.3-2.1; P = .68).
    The team found a significantly increased risk of neuropathy in patients with celiac disease, and they are recommending that doctors screen patients with neuropathy for celiac disease.
    Source:
    JAMA Neurol. Published online May 11, 2015. doi:10.1001/jamaneurol.2015.0475

    Jefferson Adams
    Gluten Triggers 1 in 4 Cases of Sporadic Ataxia
    Celiac.com 01/16/2017 - Cerebellar ataxias can be caused by a wide range of disease processes, either genetic or acquired. Establishing a clear diagnosis requires a methodical approach with expert clinical evaluation and investigation.
    A team of researchers recently published a description of the causes of ataxia in 1500 patients with cerebellar ataxia.  The research team included M Hadjivassiliou, J Martindale, P Shanmugarajah, R A Grünewald, P G Sarrigiannis, N Beauchamp, K Garrard, R Warburton, D S Sanders, D Friend, S Duty, J Taylor, and N Hoggard.
    They are variously affiliated with the Academic Department of Neurosciences, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK; Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK; the Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK; and the Department of Neuroradiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
    All patients in the study were referred to the Sheffield Ataxia Centre, UK, and underwent extensive examination, including, where appropriate genetic testing using next-generation sequencing (NGS).
    The team followed-up patients on a 6-month basis for reassessment and further investigations, as needed.
    The team assessed a total of 1500 patients over 20 years. Twenty per cent of those patients had a family history of ataxia, with the remaining having sporadic ataxia.
    The most common cause of sporadic ataxia was gluten ataxia at 25%. They found a genetic cause in 156, or 13% of sporadic cases, with alcohol excess causing 12% and a cerebellar variant of multiple system atrophy causing 11% of sporadic cases.
    Using NGS, they obtained positive results in 32% of 146 patients tested. The most common ataxia they found was EA2. A total of 57% of all familial ataxias were supported by genetic diagnosis. The most common genetic ataxias were Friedreich's ataxia (22%), SCA6 (14%), EA2 (13%), SPG7 (10%) and mitochondrial disease (10%).
    The diagnostic yield following attendance at the Sheffield Ataxia Centre was 63%. Immune-mediated ataxias are common. Advances in genetic testing have significantly improved the diagnostic yield of patients suspected of having a genetic ataxia.
    Making a diagnosis of the cause of ataxia is essential due to potential therapeutic interventions for immune and some genetic ataxias.
    Gluten is a culprit is 25% of sporadic ataxia cases, and clinicians should keep this in mind when diagnosing patients, as many of these cases can be reversed with a gluten-free diet.
    Source:
    J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2016-314863

    Jefferson Adams
    Can a Gluten-Free Diet Help Ataxia Patients?
    Celiac.com 08/10/2017 - Gluten ataxia is defined as sporadic ataxia with positive antigliadin antibodies without an alternative cause. Gluten ataxia patients often receive MRS at baseline and again after a period on a gluten-free diet.
    A research team recently set out to evaluate the effect of gluten free diet on magnetic resonance spectroscopy (MRS) of the cerebellum in patients with gluten ataxia.
    The research team included M Hadjivassiliou, RA Grünewald, DS Sanders, P Shanmugarajah, N Hoggard. They are with the Academic Departments of Neurosciences (M.H., R.A.G., P.S.), Gastroenterology (D.S.S.), and Neuroradiology (N.H.), Sheffield Teaching Hospitals NHS Trust, UK.
    The team included 117 consecutive patients with gluten ataxia in their report. Sixty-three followed a strict a gluten-free diet with elimination of antigliadin antibodies, 35 ate a gluten-free diet, but still tested positive for antigliadin antibodies, while 19 patients were not following a gluten-free diet.
    The N-acetylaspartate (NAA)/creatine (Cr) area ratio from the cerebellar vermis increased in 62 out of 63 (98%) patients on strict a gluten-free diet, in 9 of 35 (26%) patients on a gluten-free diet, but positive antibodies, and in only 1 of 19 (5%) patients not on a gluten-free diet. The NAA/Cr ratio decreased in all 14 ataxia control patients (cerebellar variant of multisystem atrophy), while the researchers saw no differences in the MRS results between patients with celiac disease and those without.
    Better NAA/Cr ratios seen on follow-up scans supports previous findings that gluten ataxia patients see clinical improvement a gluten-free diet
    Such improvements can occur regardless of existing enteropathy, so patients with positive serology and negative duodenal biopsy should still maintain a strict a gluten-free diet.
    Source:
    Neurology. 2017 Jul 19. pii: 10.1212/WNL.0000000000004237.doi: 10.1212/WNL.0000000000004237.

    Jefferson Adams
    Gluten-Free Diet Likely Improves Neuropathic Pain in Patients with Gluten Neuropathy
    Celiac.com 09/12/2018 - Many people with celiac disease develop peripheral neuropathy, also known as gluten neuropathy. A team of researchers recently set out to determine rates of neuropathic pain in patients with seemingly idiopathic peripheral neuropathy and gluten sensitivity, and to make note of any contributing factors. They included patients with positive antigliadin, endomysial, and/or transglutaminase antibodies, with or without enteropathy.
    The research team included P Zis, PG Sarrigiannis, DG Rao, and M Hadjivassiliou. They are affiliated with the Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, UK.
    They invited all consecutive patients with gluten neuropathy attending a specialist gluten/neurology clinic to participate in the study. They used the DN4 questionnaire and the visual analog scale to assess pain levels. They used the Overall Neuropathy Limitations Scale to assess the severity of neuropathy, along with the Mental Health Index (MHI-5) to assess patients' general mental health status.
    A total of 33 out of 60 patients with gluten neuropathy showed neuropathic pain. The team found no significant differences between the painful, and the non-painful groups in terms of age, gender, neuropathy severity and neuropathy type. 
    Over half of patients with painless gluten neuropathy followed a strict gluten-free diet, compared with just 21.2% of those with painful neuropathy. Patients with painful gluten neuropathy also showed significantly worse MHI-5 scores. 
    After adjusting for age, gender and MHI-5 scores, multivariate analysis showed that, strict gluten-free diet lowered the odds of peripheral neuropathic pain by nearly 90%.
    Most patients with gluten neuropathy commonly have neuropathic pain, which is associated with poorer mental health status. 
    A strict gluten-free diet might substantially reduce rates of peripheral neuropathic pain in patients with gluten neuropathy.
    Read more at: J Neurol. 2018 Jul 21. doi: 10.1007/s00415-018-8978-5.PMID: 30032386

    Jefferson Adams
    Gluten Ataxia Patients with Low Titre Antigliadin Antibodies Benefit from Gluten-Free Diet
    Celiac.com 11/28/2018 - Patients with gluten ataxia without enteropathy have lower levels of antigliadin antibodies (AGA) compared to patients with celiac disease. Magnetic Resonance Spectroscopy (NAA/Cr area ratio) of the cerebellum improves in patients with gluten ataxia following a strict gluten-free diet, and is associated with an improvement in symptoms. 
    A team of researchers recently set out to present their experience of the effect of a gluten-free diet in patients with ataxia and low levels of AGA antibodies measured by a commercial assay. The research team included Marios Hadjivassiliou, Richard A Grünewald, David S Sanders, Panagiotis Zis, Iain Croall, Priya D Shanmugarajah, Ptolemaios G Sarrigiannis, Nick Trott, Graeme Wild, and Nigel Hoggard. They are variously affiliated with the Academic Departments of Neurosciences and Neuroradiology; the Departments of Gastroenterology, the Departments of Dietetics; the Departments of Immunology, Sheffield Teaching Hospitals NHS Trust, in Sheffield, UK.
    The team conducted MR spectroscopy on 21 consecutive patients with ataxia and serum AGA levels below the positive cut-off for celiac disease, but above a re-defined cut-off in the context of gluten ataxia, at baseline and after a gluten-free diet.  Of the 21 included patients with gluten ataxia, the team found that ten were on a strict gluten-free diet with elimination of AGA, 5 were on a gluten-free diet, but continued to have AGA, while 6 patients did not follow a gluten-free diet. 
    The NAA/Cr area ratio from the cerebellar vermis increased in all patients on a strict gluten-free diet, increased in only 1 out of 5  patients on a gluten-free diet with persisting circulating AGA, and decreased in all patients who did not follow a gluten-free diet. 
    From these results, the team concludes that patients with ataxia and low levels of AGA benefit from a strict gluten-free diet. The results suggest an urgent need to redefine the serological cut-off for circulating AGA in the diagnosis of gluten ataxia.
    Read more in Nutrients 2018, 10(10), 1444; doi:10.3390/nu10101444

×
×
  • Create New...