Autism Studies and Related Medical Conditions, January 2009 - TACA

174. Headache and CNS white matter abnormalities associated with gluten sensitivity.
Neurology 2001 13;56(3):385-8
"The authors describe 10 patients with gluten sensitivity and abnormal MRI. All
experienced episodic headache, six had unsteadiness, and four had gait ataxia. MRI
abnormalities varied from confluent areas of high signal throughout the white matter to
foci of high signal scattered in both hemispheres. Symptomatic response to gluten-free
diet was seen in nine patients."
175. De Santis A et al. Schizophrenic symptoms and SPECT abnormalities in a coeliac
patient: regression after a gluten-free diet. J Intern Med. 1997 Nov;242(5):421-3.
PMID: 9408073
"A 33-year-old patient, with pre-existing diagnosis of 'schizophrenic' disorder, came to
our observation for severe diarrhoea and weight loss. Use of single photon emission
computed tomography, (99mTc)HMPAO SPECT, demonstrated hypoperfusion of the left
frontal brain area, without evidence of structural cerebral abnormalities. Jejunal biopsy
showed villous atrophy. Antiendomysial antibodies were present. A gluten-free diet was
started, resulting in a disappearence of psychiatric symptoms, and normalization of
histological duodenal findings and of (99mTc)HMPAO SPECT pattern. This is the first
case in which, in an undiagnosed and untreated coeliac patient with psychiatric
manifestations, the (99mTc)HMPAO SPECT demonstrated a dysfunction of frontal cortex
disappearing after a gluten-free diet.
176. Usai P et al. Frontal cortical perfusion abnormalities related to gluten intake and
associated autoimmune disease in adult coeliac disease: 99mTc-ECD brain SPECT
study. Dig Liver Dis. 2004 Aug;36(8):513-8. PMID: 15334770
OBJECTIVE: Since brain perfusion abnormalities have been described by single-photon
emission computed tomography in some autoimmune diseases, the aim of the present
study was to evaluate the incidence of perfusion abnormalities by brain single-photon
emission computed tomography in a group of coeliac disease patients, and to
investigate whether gluten intake and associated autoimmune diseases may be
considered risk factors in causing cerebral impairment. METHODS: Thirty-four adult
coeliac patients (16 on a gluten-free diet and 18 on a gluten-containing diet, 18 (53%)
with autoimmune diseases) underwent 99mTc-ethyl cysteinate dimer brain singlephoton
emission computed tomography and qualitative evaluation of brain perfusion
was performed together with a semiquantitative estimation using the asymmetry index.
Ten subjects on our database, matched for sex, age and ethnic group, who were
proved normal by histology of jejunal mucosa (four males and six females; median age
39 years, range 27-55 years), were included as control group. RESULTS: Twenty-four
out of 34 patients (71%) showed brain single-photon emission computed tomography
abnormalities confirmed by abnormal regional asymmetry index (>5%; range 5.8-
18.5%). Topographic comparison of the brain areas showed that the more significant
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