Regional cerebral hypoperfusion in patients with celiac disease

Am J Med. 2004 Mar 1;116(5):312-7. doi: 10.1016/j.amjmed.2003.09.037.


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.

Conclusion: There is evidence of regional cerebral blood flow alteration in untreated celiac patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / complications
  • Celiac Disease / diet therapy
  • Celiac Disease / physiopathology*
  • Celiac Disease / psychology
  • Cerebrovascular Circulation*
  • Depression / complications
  • Female
  • Humans
  • Male
  • Tomography, Emission-Computed, Single-Photon