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2017 ; 11
(ä): 498
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Neurophysiology of the "Celiac Brain": Disentangling Gut-Brain Connections
#MMPMID28928632
Pennisi M
; Bramanti A
; Cantone M
; Pennisi G
; Bella R
; Lanza G
Front Neurosci
2017[]; 11
(ä): 498
PMID28928632
show ga
Celiac disease (CD) can be considered a complex multi-organ disorder with highly
variable extra-intestinal, including neurological, involvement. Cerebellar
ataxia, peripheral neuropathy, seizures, headache, cognitive impairment, and
neuropsychiatric diseases are complications frequently reported. These
manifestations may be present at the onset of the typical disease or become
clinically evident during its course. However, CD subjects with subclinical
neurological involvement have also been described, as well as patients with clear
central and/or peripheral nervous system and intestinal histopathological disease
features in the absence of typical CD manifestations. Based on these
considerations, a sensitive and specific diagnostic method that is able to detect
early disease process, progression, and complications is desirable. In this
context, neurophysiological techniques play a crucial role in the non-invasive
assessment of central nervous system (CNS) excitability and conductivity.
Moreover, some of these tools are known for their valuable role in early
diagnosis and follow-up of several neurological diseases or systemic disorders,
such as CD with nervous system involvement, even at the subclinical level. This
review provides an up-to-date summary of the neurophysiological basis of CD using
electroencephalography (EEG), multimodal evoked potentials, and transcranial
magnetic stimulation (TMS). The evidence examined here seems to converge on an
overall profile of "hyperexcitable celiac brain," which partially recovers after
institution of a gluten-free diet (GFD). The main translational correlate is that
in case of subclinical neurological involvement or overt unexplained symptoms,
neurophysiology could contribute to the diagnosis, assessment, and monitoring of
a potentially underlying CD.