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Cognitive impairment in celiac disease improves on a gluten-free diet

Cognitive impairment in celiac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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Mild impairments of cognition or ‘Brain fog’ are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated.

Dr Yelland and colleagues from Australia performed a longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet.

The research team tested 11 patients, with a mean age of 30 years, with a battery of cognitive tests at weeks 0, 12 and 52.

Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested.
Cognitive performance improves with adherence to the diet in parallel to mucosal healing
Alimentary Pharmacology & Therapeutics

Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores.

Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers.

The team found that all patients had excellent adherence to the diet.

The researchers observed that Marsh scores improved significantly, and tissue transglutaminase antibody concentrations decreased from a mean of 58 at baseline to 17 U/mL at week 52.

The team found that 4 of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months, and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels.

However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability.

Dr Yelland's team concludes, "In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing."

"Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks."

Aliment Pharmacol Ther 2014: 40(2): 160-170
26 June 2014

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