Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity

Psychiatr Q. 2012 Mar;83(1):91-102. doi: 10.1007/s11126-011-9186-y.

Abstract

Celiac Disease (CD) is an immune-mediated disease dependent on gluten (a protein present in wheat, rye or barley) that occurs in about 1% of the population and is generally characterized by gastrointestinal complaints. More recently the understanding and knowledge of gluten sensitivity (GS), has emerged as an illness distinct from celiac disease with an estimated prevalence 6 times that of CD. Gluten sensitive people do not have villous atrophy or antibodies that are present in celiac disease, but rather they can test positive for antibodies to gliadin. Both CD and GS may present with a variety of neurologic and psychiatric co-morbidities, however, extraintestinal symptoms may be the prime presentation in those with GS. However, gluten sensitivity remains undertreated and underrecognized as a contributing factor to psychiatric and neurologic manifestations. This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease, and summarizes the potential mechanisms related to this immune reaction.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies / blood
  • Ataxia / complications
  • Ataxia / immunology
  • Celiac Disease / complications
  • Celiac Disease / epidemiology
  • Celiac Disease / immunology
  • Celiac Disease / psychology*
  • Comorbidity
  • Epilepsy / complications
  • Epilepsy / epidemiology
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / psychology*
  • Gliadin / immunology
  • Glutens / adverse effects*
  • Glutens / immunology*
  • Humans
  • Mental Disorders / complications
  • Mental Disorders / epidemiology*
  • Mental Disorders / immunology
  • Mice
  • Prevalence
  • Schizophrenia / complications
  • Schizophrenia / epidemiology
  • Schizophrenia / immunology

Substances

  • Antibodies
  • Glutens
  • Gliadin