Regional cerebral hypoperfusion in patients with celiac disease.
BACKGROUND
Neurological and psychiatric disorders occur in approximately 10% of patients with celiac disease. Although some of these alterations respond to a gluten-free diet, the etiology of these abnormalities is uncertain. Because of a case report that cerebral hypoperfusion in a celiac patient resolved after a gluten-free diet, we studied brain perfusion changes in untreated celiac patients, treated celiac patients, and healthy controls.


METHODS
A total of 15 untreated celiac patients without conditions affecting brain perfusion were enrolled; none had neurological or psychiatric disorders other than anxiety or depression. We also studied 15 celiac patients who were on a gluten-free diet for almost 1 year, and 24 healthy volunteers of similar sex and age. All subjects underwent cerebral single photon emission computed tomography examination.


RESULTS
Of the 15 untreated celiac patients, 11 (73%) had at least one hypoperfused brain region, compared with only 1 (7%) of the 15 celiac patients on a gluten-free diet and none of the controls (P = 0.01). Cerebral perfusion was significantly lower (P <0.05) in untreated celiac patients, compared with healthy controls, in 7 of 26 brain regions. No significant differences in cerebral perfusion were found between celiac patients on a gluten-free diet and healthy controls.


CONCLUSIONS
There is evidence of regional cerebral blood flow alteration in untreated celiac patients.
Institute of Internal Medicine, Catholic University, Rome, Italy. g.addolorato@rm.unicatt.it
Giovanni
G
Addolorato
Daniela
D
Di Giuda
Giuseppe
G
De Rossi
Venanzio
V
Valenza
Marco
M
Domenicali
Fabio
F
Caputo
Antonio
A
Gasbarrini
Esmeralda
E
Capristo
Giovanni
G
Gasbarrini
D000328:Adult; D001007:Anxiety / Q000150:complications; D002446:Celiac Disease / Q000178:diet therapy / Q000503:physiopathology* / Q000523:psychology; D002560:Cerebrovascular Circulation; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon