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Cognitive impairment and celiac disease.
William T Hu1, Joseph A Murray, Melanie C Greenaway
1Departments of Neurology, Internal Medicine, Psychology, and Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minn, USA.
Archives of Neurology
|October 13, 2006
Summary
Cognitive impairment may be linked to celiac disease, particularly when accompanied by neurological symptoms like ataxia. Gluten withdrawal showed potential benefits for some patients, warranting further investigation.
Area of Science:
- Neurology
- Gastroenterology
- Immunology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten ingestion.
- Cognitive impairment can manifest with various neurological symptoms.
- The association between celiac disease and neurological dysfunction requires further elucidation.
Purpose of the Study:
- To characterize the clinical, radiological, electrophysiological, and histological profiles of patients with cognitive impairment and celiac disease.
- To explore the temporal relationship between celiac disease and cognitive decline.
- To identify potential diagnostic and therapeutic implications.
Main Methods:
- A case series design was employed at a referral center.
- Patients with biopsy-proven celiac disease and new-onset cognitive impairment were identified from medical records (1970-2005).
- Exclusion criteria included alternative causes for cognitive impairment.
Main Results:
- Thirteen patients (5 women, median age 64) presented with cognitive decline coinciding with celiac disease symptoms.
- Common symptoms included amnesia, confusion, and personality changes; neuropsychological testing suggested frontosubcortical impairment.
- Ataxia and peripheral neuropathy were observed in several patients; gluten withdrawal benefited three individuals.
Conclusions:
- A potential association between progressive cognitive impairment and celiac disease is suggested by the temporal relationship and neurological findings.
- The presence of ataxia and peripheral neuropathy, often linked to celiac disease, supports this association.
- Further research is warranted to confirm this link and explore treatment strategies, including gluten withdrawal.
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