Neurological Sciences

, Volume 34, Issue 12, pp 2199–2204 | Cite as

Silent neurological involvement in biopsy-defined coeliac patients

  • Basar BilgicEmail author
  • Demet Aygun
  • Ali Bilgin Arslan
  • Ali Bayram
  • Filiz Akyuz
  • Serra Sencer
  • Hasmet A. Hanagasi
Original Article


Coeliac disease (CD) is an autoimmune disease of small intestine associated with sensitivity to gluten. The clinical manifestations are often of gastrointestinal nature, although the disease may be present asymptomatically as well. It is a chronic disease and in the absence of overt neurological involvement, extended gluten exposure may give rise to silent or subtle morphological and white-matter changes in central nervous system. The present study investigates such changes using brain volumetry and the assessment of white-matter tissue in CD patients without neurological symptoms. Seventeen CD patients without any neurological involvement were included in the study and went under neurological evaluation and anatomical MRI. Individual gray- and white-matter, and subcortical structure volumes were acquired for using automated volumetric analyses. The observed white-matter hyperintensities (WMH) evaluated using Age-Related White-Matter Changes scale. Findings show a bilateral decrease in cortical gray-matter and caudate nuclei volumes in CD compared to controls. Negative correlations were found between the duration of the disease and the volumes of the affected regions. Cerebellum was seemingly unaffected. In addition, significantly higher proportion of WMH was found in CD patients, specifically in bilateral frontal and occipitoparietal cortices. We observed a significant gray-matter and caudate nucleus atrophy in the CD patients in the absence of marked neurological symptoms. Present findings point out to a need for histopathological investigations potentially focusing on anti-TG2 antibodies, and serial volumetric analyses on the CD-related cortical and subcortical changes.


Coeliac disease Neurological involvement White-matter Cortical atrophy Volumetry 


Conflict of interest



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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Basar Bilgic
    • 1
    Email author
  • Demet Aygun
    • 1
  • Ali Bilgin Arslan
    • 2
  • Ali Bayram
    • 3
  • Filiz Akyuz
    • 4
  • Serra Sencer
    • 5
  • Hasmet A. Hanagasi
    • 1
  1. 1.Department of Neurology, Behavioral Neurology and Movement Disorders UnitIstanbul Faculty of Medicine, Istanbul UniversityIstanbulTurkey
  2. 2.Department of Cognitive, Linguistic and Psychological SciencesBrown UniversityProvidenceUSA
  3. 3.Department of Neuroscience Research CenterIstanbul Neuropsychiatry HospitalIstanbulTurkey
  4. 4.Department of Gastrohepatology, Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey
  5. 5.Department of Radiology, Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey

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