The brain and coeliac disease

Project Title: Neurological manifestations in people with coeliac disease 

Professor Marios Hadjivassiliou is a Consultant Neurologist whose primary research focuses on the neurological manifestations of gluten related diseases. As well as being a founding member of the Sheffield Institute of Gluten Related Diseases (SIGReD), he is Director of the Sheffield Ataxia Centre and a member of our Health Advisory Council (HAC).

What was the main issue your research was seeking to address?

This research aimed to investigate cognitive deficits (i.e. concentration, attention, memory, etc.) in patients with newly diagnosed coeliac disease compared to patients who have been diagnosed with coeliac disease for more than five years, to establish if a strict gluten free diet can improve neurological issues.

What were you hoping to find out through this research?

Previous reports have suggested that people with coeliac disease may have cognitive deficits. Based on these and our own experience of patients with neurological symptoms we aimed to first establish if cognitive deficits are present in people with coeliac disease and secondly if sticking to a strict gluten free diet can improve cognitive deficits and influence cognitive functioning in the long term.

What are the key things that were learnt as a result of this project?

The study found that patients with newly diagnosed coeliac disease have some limited cognitive deficits when compared to healthy people without coeliac disease. Such cognitive deficits can become worse when patients who have been diagnosed with coeliac disease for more than five years do not stick to a strict gluten free diet. Patients who have been diagnosed for more than five years and who follow a strict gluten free diet seem to have better cognitive function.

How will this project benefit patients?

Patients with coeliac disease often experience neurological symptoms. By establishing the presence of cognitive deficits and demonstrating that a gluten free diet may be beneficial in improving cognitive function, we believe that the results will motivate people to maintain a strict gluten free diet strictly and also reassure people that any cognitive deficits they are experiencing may be reversible.

What are the next stages for this work?

Firstly, these findings must be shared with a wider network. A further study would look to follow patients newly diagnosed with coeliac disease from diagnosis and over a longer period of time. Additionally, we would also like to cognitively evaluate people who are diagnosed with coeliac disease having been referred first to a neurologist as opposed to a gastroenterologist. We deliberately excluded such patients from this study. It is possible that the scale of the problem is much bigger than what we have found.

There is a need to highlight the symptoms of coeliac disease beyond the gut to both aid early diagnosis and to encourage patients to maintain a strict gluten free diet for life. This is particularly important because neurological recovery may be limited if the diagnosis is made late or the diet is not followed adequately.