Celiac Disease Associated with Increased Risk of Neurological Problems in Adults
Celiac disease appears to be associated with increased likelihood of developing neurological problems that include migraine, carpal tunnel syndrome, and movement disorders such as unsteadiness and impaired gait, according to a study by a group of European researchers. Moreover, the researchers found more than a third of the adult celiac disease patients they studied reported experiencing depression, personality change, or psychosis. The study results were published in the November 16, 2009, issue of Movement Disorders.
The study involved 72 adults—10 men and 62 women ranging in age from 36 to 66—with biopsy-confirmed celiac disease and adherence to a gluten-free diet. The participants underwent a neurological examination and completed a questionnaire that provided information about their neurological and general medical history.
More than a fourth—28 percent—of the study participants had a history of migraine. “In many cases, there was a decrease of the frequency and intensity of migraine attacks after the introduction of a gluten-free diet,” wrote lead researcher Katrin Burk, M.D., of the University of Marburg in Germany.
The neurological history questionnaire also revealed that more than a third of study participants had a history of psychiatric disorders. “Interestingly, 35 percent of patients with celiac disease report a history of psychiatric disease, including depression, personality change, or even psychosis,” Burk wrote. Twenty percent of participants reported suffering from carpal tunnel syndrome, and 8 percent had episodes of dizziness associated with inner ear or vestibular problems.
The neurological examination found that more than one-quarter of participants had problems with stance and gait and 35 percent had impaired proprioception—the sensory “feedback” loop that continuously monitors the relative positions and movements of body parts. Roughly 13 percent of participants showed impairment of the vestibular-ocular reflex, which coordinates information received from the inner ear with muscles that move the eye in order to keep objects of interest in the center of the field of vision when the head is moving.
“Taken together, we found a high frequency of proprioceptive and vestibular deficits leading to problems of stance and gait. The prevalence of neurological manifestations and celiac disease is striking and must be considered more than accidental. It is true that pathogenic mechanisms linking celiac disease to the nervous system have not yet been identified. Obviously, the patients’ gluten-free diet had resolved intestinal symptoms, but had not prevented the development of neurological deficits,” Burk and colleagues concluded.
Because participants in the study had no signs of nutritional deficiencies due to malabsorption, the link between the observed neurological disorders and celiac disease is likely associated—at least in part—with immune-related inflammatory changes throughout the central and peripheral nervous systems, Burk and colleagues speculated.
