Cognitive Deficit and White Matter Changes in Celiac Disease

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To validate previous reports over the presence and prevalence of brain injury in patients with celiac disease, neuropsychological dysfunction in patients with celiac disease included in the National UK Biobank was carried out, containing experimental medical data from 500,000 adults in the United Kingdom.

Biobank participants with celiac disease (N = 104; mean age 63 years; 65% female) were matched with healthy individuals (N = 198; mean age 63 years; 67% female) for age, sex, level of education, body mass index and diagnosis of hypertension. All participants were otherwise healthy.

Scores were compared from five cognitive tests and multiple choice responses in 6 questions about mental health between groups using the t test and chi-squared analyses. Groupwise analyses of MRI brain data included a study of diffusion tensor imaging metrics (mean diffusivity, fractional anisotropy, radial diffusivity, axial diffusivity), voxelbased morphometry and Mann-Whitney U comparisons of Fazekas grades.

Compared with controlled individuals, participants with celiac disease had significant deficits in reaction time and significantly higher proportions had indications of anxiety, depression, thoughts of self-harm and healthrelated unhappiness. Tract-based spatial statistics analysis showed significantly increased axial diffusivity in widespread locations, demonstrating white matter changes in brains of participants with celiac disease. Voxel-based morphometry and Fazekas grade analyses did not differ significantly between groups.

It was concluded in an analysis of data from the UK Biobank that participants were found with celiac disease to have cognitive deficit, indications of worsened mental health, and white matter changes, based on analyses of brain images. These findings support the concept that celiac disease is associated with neurological and psychological features.

Croall, I., Sanders, D., Hadjivassiliou, M., Hoggard, N. “Cognitive Deficit and White Matter Changes in Persons With Celiac Disease: A Population-Based Study.” Gastroenterology 2020; Vol. 158, pp. 2112-2122.

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