title: Association between migraine and Celiac disease: results from a preliminary case-control and therapeutic study.
abstract: OBJECTIVE
  Subclinical celiac disease (CD) has been associated with various neurological disorders, the most common being neuropathy and cerebellar ataxia. The aims of the present study were to assess the following: 1) the prevalence of CD in patients affected by migraine; 2) whether there are regional cerebral blood flow abnormalities in migraine patients with CD compared to migraine patients without CD; and 3) the effects of a gluten free diet in migraine patients with CD.
  
  
  METHODS
  A total of 90 patients affected by idiopathic migraine were enrolled, and 236 blood donors were used as controls. Serum IgG antitransglutaminase (TgA) and IgA antiendomysial (EmA) were measured. In positive cases, diagnosis was confirmed endoscopically. A gluten free diet was started in the patients diagnosed with CD, who were followed for 6 months. A single photon emission CT brain study was performed before and after a gluten free diet.
  
  
  RESULTS
  Four of 90 (4.4%; 95% CI = 1.2-11.0) migraine patients were found to have CD compared with 0.4% (95% CI = 0.01-2.3) blood donor controls (p < 0.05). During the 6 months of gluten free diet, one of the four patients had no migraine attacks, and the remaining three patients experienced an improvement in frequency, duration, and intensity of migraine. Single photon emission CT studies showed a regional baseline reduction in brain tracer uptake in all four patients. Such reduction in uptake completely resolved at follow-up.
  
  
  CONCLUSIONS
  Our results suggest that a significant proportion of patients with migraine may have CD, and that a gluten free diet may lead to a improvement in the migraine in these patients.
authors.affiliation: Department of Internal Medicine, Catholic University of the Sacred Heart, Gemelli Hospital, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gabrielli
authors.forename: Filippo
authors.initials: F
authors.lastname: Cremonini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fiore
authors.forename: Giovanni
authors.initials: G
authors.lastname: Addolorato
authors.forename: Cristiano
authors.initials: C
authors.lastname: Padalino
authors.forename: Marcello
authors.initials: M
authors.lastname: Candelli
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: De Leo
authors.forename: Luca
authors.initials: L
authors.lastname: Santarelli
authors.forename: Mario
authors.initials: M
authors.lastname: Giacovazzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Paolo
authors.initials: P
authors.lastname: Pola
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005983:Glutens