Monday, February 05, 2007

Gluten associated SPECT brain imaging abnormalities in frontal area of brain reverse with gluten free diet

Though reports of functional brain scans or SPECT imaging in celiac disease are limited there are some very interesting findings. The most dramatic is the report in 1997 of a patient with established schizophrenia who was newly diagnosed with celiac disease as confirmed by a positive endomysial antibody blood test and villous atrophy on intestinal biopsy. Before starting a gluten-free diet he had an abnormal SPECT scan showing decreased blood flow to the frontal lobe of the brain. On a gluten-free diet his schizophrenia and celiac disease symptoms resolved and both the intestinal biopsy and brain scan normalized.

More recently in 2004, Usai et al., reported that 70% of 34 celiac disease patients had abnormal SPECT scans showing the most pronounced abnormalities in the frontal areas of the brain that are less severe on a gluten free diet. Disturbances of the frontal area of the brain are associated ADD, anxiety, depression, Bipolar disorder, drug and alcohol addiction, and schizophrenia, all of which have been associated with celiac disease.

SPECT, or single photon emission computerized tomography, is a combined nuclear medicine CAT scan of the head performed by injecting a radioisotope taken up by the brain according to blood flow and metabolism. The scan produced is a color-coded 3-D representation of functional brain activity. Daniel Amen MD, an expert on SPECT brain imaging, provides a free online brain system quiz that can partly predict what part of the brain may be affected ( His very detailed and well-researched nutritional recommendations for brain health are also helpful. After recently corresponding with him I am hopeful that further research into the association of SPECT abnormalities gluten may result from our collaboration as we continue to explore the gut-brain connection.

Schizophrenic symptoms and SPECT abnormalities in a coeliac patient: Regression after a gluten-free diet. De Santis A J Intern Med. 1997; 242(5): 421-3

Frontal cortical perfusion abnormalities related to gluten intake and associated autoimmune disease in adult coeliac disease: 99mTc-ECD brain SPECT study. Usai P et al. Dig Liver Dis. 2004; 36(8): 513-8

Images of Human Behavior: A Brain SPECT Atlas. Daniel G. Amen, MD 2004. Mindworks Press. Newport Beach, CA.

Making a Good Brain Great. Daniel G. Amen, MD
2005. Harmony Books. New York.

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