Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity

Irene Tatjana Lichtwark, Evan Newnham, Stephen Richard Robinson, Susan Joy Shepherd, Patrick Hosking, Peter Raymond Gibson, Gregory Wayne Yelland

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Mild impairments of cognition or Brain fog are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated. Aim This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet. Methods Eleven patients (8 females, 3 males), mean age 30 (range 22-39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers. Results All patients had excellent adherence to the diet. Marsh scores improved significantly (P = 0.001, Friedman s test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377-0.735; all P <0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability. Conclusions In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks
Original languageEnglish
Pages (from-to)160 - 170
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume40
Issue number2
DOIs
Publication statusPublished - 2014

Cite this

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title = "Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity",
abstract = "Background Mild impairments of cognition or Brain fog are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated. Aim This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet. Methods Eleven patients (8 females, 3 males), mean age 30 (range 22-39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers. Results All patients had excellent adherence to the diet. Marsh scores improved significantly (P = 0.001, Friedman s test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377-0.735; all P <0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability. Conclusions In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks",
author = "Lichtwark, {Irene Tatjana} and Evan Newnham and Robinson, {Stephen Richard} and Shepherd, {Susan Joy} and Patrick Hosking and Gibson, {Peter Raymond} and Yelland, {Gregory Wayne}",
year = "2014",
doi = "10.1111/apt.12809",
language = "English",
volume = "40",
pages = "160 -- 170",
journal = "Alimentary Pharmacology and Therapeutics",
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Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity. / Lichtwark, Irene Tatjana; Newnham, Evan; Robinson, Stephen Richard; Shepherd, Susan Joy; Hosking, Patrick; Gibson, Peter Raymond; Yelland, Gregory Wayne.

In: Alimentary Pharmacology and Therapeutics, Vol. 40, No. 2, 2014, p. 160 - 170.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity

AU - Lichtwark, Irene Tatjana

AU - Newnham, Evan

AU - Robinson, Stephen Richard

AU - Shepherd, Susan Joy

AU - Hosking, Patrick

AU - Gibson, Peter Raymond

AU - Yelland, Gregory Wayne

PY - 2014

Y1 - 2014

N2 - Background Mild impairments of cognition or Brain fog are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated. Aim This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet. Methods Eleven patients (8 females, 3 males), mean age 30 (range 22-39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers. Results All patients had excellent adherence to the diet. Marsh scores improved significantly (P = 0.001, Friedman s test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377-0.735; all P <0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability. Conclusions In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks

AB - Background Mild impairments of cognition or Brain fog are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated. Aim This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet. Methods Eleven patients (8 females, 3 males), mean age 30 (range 22-39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers. Results All patients had excellent adherence to the diet. Marsh scores improved significantly (P = 0.001, Friedman s test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377-0.735; all P <0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability. Conclusions In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks

UR - http://onlinelibrary.wiley.com/doi/10.1111/apt.12809/pdf

U2 - 10.1111/apt.12809

DO - 10.1111/apt.12809

M3 - Article

VL - 40

SP - 160

EP - 170

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 2

ER -