Association between migraine and Celiac disease: results from a preliminary case-control and therapeutic study.
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.
Gabrielli
Maurizio
M
Department of Internal Medicine, Catholic University of the Sacred Heart, Gemelli Hospital, Rome, Italy.
Cremonini
Filippo
F
Fiore
Giuseppe
G
Addolorato
Giovanni
G
Padalino
Cristiano
C
Candelli
Marcello
M
De Leo
Maria Elena
ME
Santarelli
Luca
L
Giacovazzo
Mario
M
Gasbarrini
Antonio
A
Pola
Paolo
P
Gasbarrini
Antonio
A
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
D005983:Glutens