Original Contribution

The American Journal of Gastroenterology (2003) 98, 625–629; doi:10.1111/j.1572-0241.2003.07300.x

Association Between Migraine and Celiac Disease: Results From a Preliminary Case-Control and Therapeutic Study

Maurizio Gabrielli MD1, Filippo Cremonini MD1, Giuseppe Fiore MD2,3, Giovanni Addolorato MD2,3, Cristiano Padalino MD2,3, Marcello Candelli MD2,3, Maria Elena De Leo MD2,3, Luca Santarelli MD2,3, Mario Giacovazzo MD2,3, Giovanni Gasbarrini MD2,3, Paolo Pola MD2,3 and Antonio Gasbarrini MD1

  1. 1Department of Internal Medicine, Catholic University of the Sacred Heart, Gemelli Hospital, Rome, Italy
  2. 2Department of Pathology, Catholic University of the Sacred Heart, Gemelli Hospital, Rome; Italy
  3. 3Department of Internal Medicine, La Sapienza University, Rome, Italy

Correspondence: Antonio Gasbarrini, MD, Department of Internal Medicine, Catholic University of the Sacred Heart, Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy.

Received 14 March 2002; Accepted 16 July 2002.

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Abstract

OBJECTIVES:

 

Subclinical celiac disease (CD) has been associated with various neurological disorders, the most common being neuropathy and cerebellar ataxia. The aims of the present study were to assess the following: 1) the prevalence of CD in patients affected by migraine; 2) whether there are regional cerebral blood flow abnormalities in migraine patients with CD compared to migraine patients without CD; and 3) the effects of a gluten free diet in migraine patients with CD.

METHODS:

 

A total of 90 patients affected by idiopathic migraine were enrolled, and 236 blood donors were used as controls. Serum IgG antitransglutaminase (TgA) and IgA antiendomysial (EmA) were measured. In positive cases, diagnosis was confirmed endoscopically. A gluten free diet was started in the patients diagnosed with CD, who were followed for 6 months. A single photon emission CT brain study was performed before and after a gluten free diet.

RESULTS:

 

Four of 90 (4.4%; 95% CI = 1.2–11.0) migraine patients were found to have CD compared with 0.4% (95% CI = 0.01–2.3) blood donor controls (p < 0.05). During the 6 months of gluten free diet, one of the four patients had no migraine attacks, and the remaining three patients experienced an improvement in frequency, duration, and intensity of migraine. Single photon emission CT studies showed a regional baseline reduction in brain tracer uptake in all four patients. Such reduction in uptake completely resolved at follow-up.

CONCLUSIONS:

 

Our results suggest that a significant proportion of patients with migraine may have CD, and that a gluten free diet may lead to a improvement in the migraine in these patients.