Gluten sensitivity and the Central Nervous System

[natasa778]

http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(10)70149-6/fulltext

In their Personal View, Hadjivassiliou and colleagues1 indicate that some cases of gluten sensitivity are associated with white matter lesions in the brain and the spinal cord, and that these lesions are indistinguishable from those seen in patients with multiple sclerosis.

We would like to speculate whether, in a patient with multiple sclerosis and coeliac disease, treatment of one condition could lead to an improvement in the other disorder.

We have described a case report2 of a 29-year-old woman with relapsing-remitting multiple sclerosis. After treatment with interferon beta for 1 year, she had another relapse that was, for the first time, associated with gastrointestinal symptoms (diarrhoea and abdominal pain) and weight loss. The patient was diagnosed with coeliac disease (as proven by duodenal biopsy samples). Interferon beta was stopped and a gluten-free diet was started as a single treatment. She has followed this diet for the past 7 years and has been in good health during that time without any further relapses. Since the first year of being on a gluten-free diet, concentrations of anti-transglutaminase IgA antibodies have returned to normal. In 2004, after 2 years of being on this diet, gastrointestinal endoscopy showed normal duodenal mucosa. In 2009, a clear decrease in spinal and brain lesions was confirmed by use of MRI. The patient is now fully asymptomatic and results from neurological assessments are normal.

Although the favourable response of the neurological and gastrointestinal symptoms to the gluten-free diet of this case strongly indicates coeliac disease as the primary cause of the CNS effects, we believe that this patient presented both diseases. Coeliac disease appeared as an associated condition rather than as the main cause of the neurological disorder. Moreover, coeliac disease is often associated with other autoimmune diseases and its association with optical neuromyelitis or multiple sclerosis has been described.3

The complex causes of autoimmune diseases not only present a challenge to the development and testing of new therapies but also offer the potential to identify subgroups of patients who might benefit from particular approaches. Consuming gliadin for several years, starting in infancy, might not only be the cause of activation of coeliac disease but, in some patients, could also be an additional factor to trigger the beginning of other autoimmune diseases. Continued studies of such diseases are needed to help identify the most appropriate strategies for each disorder.4

 

[xchocoholic]

I had white lesions on my brain that went away too post gf diet. However I still have other neuro symptoms. I ate gluten for 50 years of which 15 1/2 were post ataxia onset. I assume damaging an already damaged area won't heal as easy.

 

[S.A.]

My son had severe sensory processing disorder and autistic-like symptoms, the worst of which cleared up on the gf/cf diet. He never had an MRI to compare white lesions. I think this is an area that deserves more research money.