What is the extent of neurological dysfunction in patients with gluten-related disorders? A magnetic resonance imaging-based study.

The extent of any structural or functional brain abnormality in patients with CD is yet to be fully characterised but may be potentially evaluated through the analysis of magnetic resonance (MR) imaging. Current evidence suggests a propensity for cerebellar disease in these patients as evident by gluten ataxia: an idiopathic sporadic ataxia with positive gluten related antibodies.
Recently, excessive alcohol consumption has been shown to mediate an IgA immune response against transglutaminase 2 thus, raising the possibility of alcohol not just having a direct toxic effect on the cerebellum but also inducing an immune response that may cause cerebellar damage via different pathways. The prevalence of gluten-related serological markers in patients with alcohol-related ataxia is still to be evaluated.
This work had the following aims:
(1) To establish the prevalence of neurological deficit in patients with newly diagnosed coeliac disease (CD),
(2) To compare the clinicoradiological features and evaluate the use of MR imaging as a potential biomarker of this group with two other groups: (a) patients with established CD that had been referred for neurological opinion and (b) patients presenting with a neurological complaint that lead to the diagnosis of CD,
(3) To investigate the prevalence of gluten-related serological markers in patients with alcohol-related ataxia and compare the pattern of brain involvement on MR imaging between patients with alcohol and gluten ataxia.
The following chapters will try to address these questions.