Neurological manifestations in people with coeliac disease
Professor Marios Hadjivassiliou is a Consultant Neurologist whose primary research is in 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.
What was the main issue your research was seeking to address?
To investigate cognitive deficits (ie concentration, attention, memory, etc.) in patients with newly diagnosed coeliac disease as well as patients with coeliac disease for over five years, to establish the influence of strictly maintaining a gluten free diet.
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 establish firstly if such cognitive deficits are present and secondly if sticking to a strict gluten free diet may have an influence on cognitive functioning in the long term. We were pleased to achieve our objectives.
What are the key things that were learnt as a result of this project?
Patients with newly diagnosed coeliac disease have some limited cognitive deficits when compared to healthy people without coeliac disease. Such deficits become worse when patients who have been diagnosed for more than five years do not stick to a strict gluten free diet. Those diagnosed for over five years who do maintain their diet seem to do much better.
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 this case, we believe that the results will motivate people to stick to their diet strictly and also reassure them that deficits may be reversible.
How has the funding from Coeliac UK made a difference?
This work would not have been possible without the funding from Coeliac UK.
What are the next stages for this work?
Firstly, we wish to share these findings with a wider network. We would also consider a study following patients with newly diagnosed coeliac disease 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.
What are the implications for future prevention, treatment or cure?
There is a need to highlight the non gut symptoms of coeliac disease, firstly to aid early diagnosis and secondly to encourage patients to maintain a strict gluten free diet. This is particularly important because neurological recovery may be limited if the diagnosis is made late.
Principle Investigator: Professor Marios Hadjivassiliou, Consultant Neurologist
Institution: Royal Hallamshire Hospital, Sheffield
Granted Awarded: £22.3k