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A recent study found frontal cortical brain perfusion (blood flow)
abnormalities are common in celiac disease patients on an unrestricted diet
that includes gluten.  These abnormalties could explain why some behavioral
problems and mental disorders improve on a gluten-free diet.  I've included
this reference to a Neuropsychiatry Reviews article to provide further
background information on the SPECT technique used in this study.

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Neuropsychiatry Reviews 2001 Feb;2(1)

WHY DON'T PSYCHIATRISTS LOOK AT THE BRAIN?
The Case for Greater Use of SPECT Imaging in Neuropsychiatry
By Daniel G. Amen, MD
Medical Director, The Amen Clinics

http://neuropsychiatryreviews.com/feb01/npr_feb01_spect.html

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Dig Liver Dis. 2004 Aug;36(8):513-8.

Frontal cortical perfusion abnormalities related to gluten intake and
associated autoimmune disease in adult coeliac disease: 99mTc-ECD brain
SPECT study.

Usai P, Serra A, Marini B, Mariotti S, Satta L, Boi MF, Spanu A, Loi G,
Piga M.

Department of Nuclear Medicine, University of Cagliari, Cagliari, Italy.
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OBJECTIVE: Since brain perfusion abnormalities have been described by
single-photon emission computed tomography in some autoimmune diseases, the
aim of the present study was to evaluate the incidence of perfusion
abnormalities by brain single-photon emission computed tomography in a
group of coeliac disease patients, and to investigate whether gluten intake
and associated autoimmune diseases may be considered risk factors in
causing cerebral impairment. METHODS: Thirty-four adult coeliac patients
(16 on a gluten-free diet and 18 on a gluten-containing diet, 18 (53%) with
autoimmune diseases) underwent 99mTc-ethyl cysteinate dimer brain single-
photon emission computed tomography and qualitative evaluation of brain
perfusion was performed together with a semiquantitative estimation using
the asymmetry index. Ten subjects on our database, matched for sex, age and
ethnic group, who were proved normal by histology of jejunal mucosa (four
males and six females; median age 39 years, range 27-55 years), were
included as control group. RESULTS: Twenty-four out of 34 patients (71%)
showed brain single-photon emission computed tomography abnormalities
confirmed by abnormal regional asymmetry index (>5%; range 5.8-18.5%).
Topographic comparison of the brain areas showed that the more significant
abnormalities were localised in frontal regions, and were significantly
different from controls only in coeliac disease patients on unrestricted
diet. The prevalence of single-photon emission computed tomography
abnormalities was similar in coeliac disease patients with (74%) and
without (69%) associated autoimmune disease. CONCLUSIONS: Abnormalities of
brain perfusion seem common in coeliac disease. This phenomenon is similar
to that previously described in other autoimmune diseases, but does not
appear to be related to associated autoimmunity and, at least in the
frontal region, may be improved by a gluten-free diet.

PMID: 15334770 [PubMed - in process]

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