title: The progression of coeliac disease: its neurological and psychiatric implications.
abstract: The aim of the paper is to show the various neurological and psychiatric symptoms in coeliac disease (CD). CD is a T cell-mediated, tissue-specific autoimmune disease which affects genetically susceptible individuals after dietary exposure to proline- and glutamine-rich proteins contained in certain cereal grains. Genetics, environmental factors and different immune systems, together with the presence of auto-antigens, are taken into account when identifying the pathogenesis of CD. CD pathogenesis is related to immune dysregulation, which involves the gastrointestinal system, and the extra-intestinal systems such as the nervous system, whose neurological symptoms are evidenced in CD patients. A gluten-free diet (GFD) could avoid cerebellar ataxia, epilepsy, neuropathies, migraine and mild cognitive impairment. Furthermore, untreated CD patients have more symptoms and psychiatric co-morbidities than those treated with a GFD. Common psychiatric symptoms in untreated CD adult patients include depression, apathy, anxiety, and irritability and schizophrenia is also common in untreated CD. Several studies show improvement in psychiatric symptoms after the start of a GFD. The present review discusses the state of the art regarding neurological and psychiatric complications in CD and highlights the evidence supporting a role for GFD in reducing neurological and psychiatric complications.
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Campagna
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Mirko
authors.initials: M
authors.lastname: Pesce
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Tatangelo
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Rizzuto
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: La Fratta
authors.affiliation: Medicine and Health Science School,Università "G. d'Annunzio",Via dei Vestini,31,66100 Chieti CH,Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Grilli
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000503:physiopathology*; D060825:Cognitive Dysfunction; D055050:Diet, Gluten-Free; D018450:Disease Progression; D002523:Edible Grain / Q000737:chemistry; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease; D005973:Glutamine; D006801:Humans; D007154:Immune System Diseases; D007109:Immunity; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D010940:Plant Proteins / Q000737:chemistry; D011392:Proline
chemical_list: D010940:Plant Proteins; D005973:Glutamine; D011392:Proline
keywords:  CD coeliac disease;  CNS central nervous system;  EEG electroencephalogram;  GFD gluten-free diet;  HLA human leucocyte antigen;  IEC intestinal epithelial cell;  IEL intra-epithelial lymphocyte;  IFN interferon;  NK natural killer;  QOL quality of life;  SBD sleep breathing disorders;  SCZ schizophrenia;  tTG transglutaminase; Coeliac disease; Cognitive impairment; Gluten-free diet; Neurological complications; Psychiatric disorders