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BRAIN FOG AND GLUTEN | Healthy Cocoberry





Original Article

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Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity

  1. I. T. Lichtwark1,
  2. E. D. Newnham2,
  3. S. R. Robinson3,
  4. S. J. Shepherd2,
  5. P. Hosking4,
  6. P. R. Gibson2,4 and
  7. G. W. Yelland3,4,*

Article first published online: 28 MAY 2014

DOI: 10.1111/apt.12809


Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 40, Issue 2, pages 160–170, July 2014

Additional Information(Show All)

How to CiteAuthor InformationPublication HistoryFunding Information

  1. Lichtwark and Newnham are equal first authors.

  2. This article was accepted for publication after full peer-review.



Mild impairments of cognition or ‘Brain fog’ are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated.


This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten-free diet.


Eleven patients (8 females, 3 males), mean age 30 (range 22–39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers.


All patients had excellent adherence to the diet. Marsh scores improved significantly (= 0.001, Friedman’s test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (= 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377–0.735; all < 0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability.


In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten-free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks.