Brain fog and non-coeliac gluten sensitivity: Proof of concept brain MRI pilot study

Iain D Croall, Nigel Hoggard, Imran Aziz, Marios Hadjivassiliou and David S Sanders

PLOS ONE, 2020, vol. 15, issue 8, 1-11

Abstract: Aims: Non-Coeliac Gluten Sensitivity (NCGS) is poorly understood, particularly in terms of its neurological outcomes. We initially conducted a prospective postal survey to investigate its neurological presentation and symptom course. Results from this then motivated a follow-up pilot study utilising brain MRI to characterise potential diagnostic biomarkers for future research. Methods: Patients with NCGS were recruited from a specialist centre and completed a prospective postal questionnaire (N = 125). This summarised symptoms experienced, their severity and their course. Onset time was compared by Chi-squared analysis to data from the same centre concerning coeliac disease patients (N = 224). Five respondents on a strict gluten-free diet who self-reported brain fog then attended a pilot study, completing MR brain imaging/questionnaires before/after a gluten challenge. “Baseline” data were assessed for abnormalities, while symptom severity and cerebral blood flow (CBF) were compared before/after challenge. Results: Survey participants were aged 47 (85% female). Prevalence of neurological symptoms were: headaches (51%), brain fog (48%), balance issues (31%), tingling (19%). Median symptom resolution time was 48 hours, while onset was 90 minutes; onset pattern was not significantly different compared to CD patients (p = 0.322). Extra-intestinal symptoms worsened by 37%(±28) during a typical reaction. Predominantly non-statistical observations from the brain imaging study are discussed. Conclusions: Neurological symptoms in NCGS are common, and onset time is comparable to that in CD. Brain imaging may be a useful future means of investigating physiological injury and responses to gluten in further study.

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0238283

DOI: 10.1371/journal.pone.0238283

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