Introduction
Coeliac disease (CD) and gluten ataxia (GA) are two autoimmune, gluten sensitivity disorders. CD is a disease affecting the gut, so after diagnosis, patients are advised to follow a gluten free diet (GFD). Refractory coeliac disease (RCD) is a rare condition, which is non- responsive to GFD. Gluten Ataxia (GA) is a condition affecting the brain, and an unusual form of this presents in combination with myoclonic symptoms and refractory CD. From a pathophysiological point, typical GA is linked with pronounced cerebellar atrophy. This is the 1st study to investigate for a specific pattern of cerebellar degeneration in patients with GA and myoclonus.
Patients- Methods
15 CD patients with myoclonus were matched with 15 healthy controls from a pre-existing clinical and volunteer T1-weighted MRI database of The Sheffield Ataxia Centre. Magnetic Spectroscopy (MRS) data were also available only for the patient group. 11 regional, grey matter cerebellar volumes were calculated using the “SUIT” toolbox, which were compared between groups by independent t-test.
Results
The mean age for patient group was 63.3 years and for the healthy individuals 61.3. All statistical tests were negative. Yet, the only cerebellar region close to significance was Crus I (p= 0.064). Also, only 60% of patients had abnormal MRS values.
Discussion
The goal was to detect if GA and myoclonus patients experience cerebellar atrophy, alike typical GA ones. Due to the absence of statistical importance our a- priori hypothesis was rejected, thus we assumed that GA with myoclonus possibly involves more a cerebral, rather than a cerebellar pathway. Indeed, more patients need to be recruited for further research.