Background & Aims

There is debate over the presence and prevalence of brain injury in patients with celiac disease. To validate previous reports, we investigated the prevalence of neuropsychological dysfunction in persons with celiac disease included in the National UK Biobank, which contains experimental medical data from 500,000 adults in the United Kingdom.

Methods

Biobank participants with celiac disease (n = 104; mean age, 63 years; 65% female) were matched with healthy individuals (controls, n = 198; mean age, 63 years; 67% female) for age, sex, level of education, body mass index, and diagnosis of hypertension. All participants were otherwise healthy. We compared scores from 5 cognitive tests and multiple choice responses to 6 questions about mental health between groups using the t test and chi-squared analyses. Groupwise analyses of magnetic resonance imaging brain data included a study of diffusion tensor imaging metrics (mean diffusivity, fractional anisotropy, radial diffusivity, axial diffusivity), voxel-based morphometry, and Mann-Whitney U comparisons of Fazekas grades.

Results

Compared with control individuals, participants with celiac disease had significant deficits in reaction time (P = .004), and significantly higher proportions had indications of anxiety (P = .025), depression (P = .015), thoughts of self-harm (P = .025), and health-related unhappiness (P = .010). Tract-based spatial statistics analysis showed significantly increased axial diffusivity in widespread locations, demonstrating white matter changes in the brains of participants with celiac disease. Voxel-based morphometry and Fazekas grade analyses did not differ significantly between groups.

Conclusions

In an analysis of data from the UK Biobank, we found participants with celiac disease to have cognitive deficit, indications of worsened mental health, and white matter changes, based on analyses of brain images. These findings support the concept that celiac disease is associated with neurologic and psychological features.

中文翻译：

---

乳糜泻患者的认知缺陷和白色物质变化：一项基于人群的研究。

背景与目标

对于腹腔疾病患者脑损伤的存在和流行存在争议。为了验证以前的报告，我们调查了英国国家生物库中包含的腹腔疾病患者神经心理功能障碍的患病率，该库包含来自英国500,000名成年人的实验医学数据。

方法

患有腹腔疾病的生物库参与者（n = 104；平均年龄； 63岁； 65％女性）与健康个体（对照组，n = 198；平均年龄：63岁； 67％女性）相匹配，以了解年龄，性别，受教育程度，体重指数和高血压的诊断。所有参与者均健康。我们使用t检验和卡方分析比较了5组认知测试和多项选择答案与6个关于心理健康的问题之间的得分。磁共振成像脑数据的分组分析包括对扩散张量成像指标（平均扩散率，分数各向异性，径向扩散率，轴向扩散率），基于体素的形态学以及Fazekas级Mann-Whitney U比较的研究。

结果

与对照组相比，患有腹腔疾病的参与者的反应时间明显不足（P  = .004），并且明显更高的比例有焦虑（P  = .025），抑郁（P  = .015）和自我伤害的迹象。（P  = .025）和与健康相关的不快乐（P  = .010）。基于行迹的空间统计分析表明，在广泛的位置，轴向扩散性显着增加，表明患有腹腔疾病的参与者大脑中的白质发生了变化。各组之间基于体素的形态学和Fazekas等级分析无显着差异。

结论

在对UK Biobank的数据进行的分析中，我们根据对大脑图像的分析，发现患有乳糜泻的参与者患有认知缺陷，精神健康恶化的迹象以及白质变化。这些发现支持了乳糜泻与神经和心理特征有关的概念。