RESEARCH - Link seen between cognitive impairment and celiac disease

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Link seen between cognitive impairment and celiac disease

10/18/2006

By: Reuters Health

NEW YORK (Reuters Health), Oct 18 - In some cases, cognitive impairment may

follow onset or worsening of celiac disease, findings published in the

October issue of the Archives of Neurology suggest.

Dr. A. phs and colleagues from the Mayo Clinic College of Medicine

studied 13 patients who had an onset of cognitive decline within two years

of symptomatic onset of adult celiac disease, or a severe exacerbation.

Patients were identified from the Mayo Clinic medical records from January

1, 1970, to December 31, 2005.

The median age at the onset of cognitive impairment was 64 years. This

coincided with symptom onset or exacerbation of gastrointestinal complaints

in five subjects. The most common presenting features were amnesia,

acalculia, confusion, and personality changes.

" Surprisingly, three patients were initially diagnosed as having possible

Creutzfeldt-Jakob disease, " the team notes, " because of a rapidly

progressive course. "

Nine patients completed the Short Test of Mental Status. The average score

was 28 (of a total of 38), which indicates moderate impairment.

A total of 10 patients had ataxia. Of these, four also had peripheral

neuropathy.

Nonspecific hyperintensities were observed on magnetic resonance imaging of

the head, and nonspecific diffuse slowing was seen on

electroencephalography.

Six subjects had nutritional deficiencies in folate, vitamin B12, vitamin E,

or a combination thereof, but supplementation did not improve neurological

symptoms in these patients. With gluten withdrawal, cognition improved or

stabilized in three patients.

" The mechanism of cognitive impairment remains elusive in celiac disease, "

Dr. phs and colleagues note. " Patients with celiac disease and ataxia

but no cognitive complaints did poorer on neuropsychological testing than

age- and sex-matched control subjects, suggestive of a chronic

neuropathological process, " they point out. " Autoimmunity involving the

central nervous system is another possible mechanism. "

Last Updated: 2006-10-18 11:13:05 -0400 (Reuters Health)

Arch Neurol 2006;63:1440-1446.

http://www.auntminnie.com/index.asp?Sec=sup & Sub=mri & Pag=dis & ItemId=72818 & wf=1323

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org