Dr. Joseph Murray of the Mayo Clinic is one of the leading celiac specialists in North America. Yet, despite his considerable knowledge and experience, Murray was surprised by a recent Mayo Clinic case study analysis that considered 13 patients with celiac disease and found a possible link to their cognitive decline.
In the case study analysis, the most common neurological symptoms were amnesia, acalculia (the inability to perform basic calculations), confusion, and personality changes; of the 10 patients with ataxia, 4 also had peripheral neuropathy.
This news release from the Mayo Clinic quotes Murray as follows:
"There has been a fair amount written before about celiac disease and neurological issues like peripheral neuropathy (nerve problems causing numbness or pain) or balance problems, but this degree of brain problem -- the cognitive decline we've found here -- has not been recognized before. I was not expecting there would be so many celiac disease patients with cognitive decline."Murray theorizes that the correlation between cognitive decline and worsening celiac symptoms could be attributed to nutritional deficiency, inflammatory cytokines (chemical messengers of inflammation that could contribute to problems in the brain), and/or an immune attack on the brain.
The median age at the onset of cognitive impairment was 64 years (range, 45-79 years). In 3 of the 13 cases, the cognitive decline reversed or stabilized after the patients committed themselves to a gluten-free diet. Five of the patients received a brain autopsy or biopsy that revealed no Alzheimer's disease or any other well-known cause of dementia.
Dr. Murray does not recommend that people with cognitive decline go on gluten-free diets unless they have received a confirmed diagnosis of celiac disease. The standard diagnosis involves a series of blood tests and, if necessary, an endoscopic biopsy.
Dr. William Hu of the Mayo Clinic suggests that, "For patients who come in with atypical forms of dementia, we need to consider checking for celiac disease, especially if the patients have diarrhea, weight loss or a younger age of onset -- under age 70."
The case study analysis appears in October's Archives of Neurology.