SPECT brain images of most of the few celiac disease patients studied reveal abnormalities that are usually most severe in the frontal areas of the brain. Improvement of these abnormalities is seen with a gluten-free diet. The frontal area of the brain is important in brain function that controls attention, impulse control, organization, and problem solving. Problems in this area of the brain result in a short attention span, disorganization, procrastination, short-term memory problems, anxiety, and depression.
Not surprisingly, these are common symptoms reported by patients with Sprue and non-celiac gluten sensitivity that improve with a GFD. ADD, schizophrenia, alcohol and drug addiction problems, and depression, all associated with gluten in some studies, are also associated with functional abnormalities in the frontal area of the brain seen on SPECT scans. Although reports of SPECT imaging in celiac disease are limited, there have been some very interesting findings that make sense to those of us familiar with the effect of gluten on the brain.
The most dramatic report I have come across comes from a 1997 report of a newly diagnosed celiac disease patient with established schizophrenia whose symptoms and abnormal SPECT scan were reversed on a gluten-free diet. He presented with an established diagnosis of schizophrenia, diarrhea, and weight loss. Endomysial antibody was positive, and villous atrophy was observed on intestinal biopsy. SPECT scanning was performed before and after the gluten-free diet. Prior to GFD, the scan confirmed an abnormal decrease in blood flow to the frontal lobe of the brain. With a FGD, the schizophrenia symptoms resolved, the intestinal lesion resolved, and the SPECT scan became normal. More recently, in 2004, Usai et al. reported 34 celiac patients in whom 70% had abnormal SPECT scans. Once again, the abnormalities were most pronounced in the frontal areas of the brain and were less severe on a gluten-free diet.
SPECT is a single photon emission computed tomography. It is a nuclear medicine combined CT scan of the head performed by injecting a radioisotope material that is absorbed by the brain according to blood flow and metabolism. A scan is produced that is a color-coded, three-dimensional representation of metabolism or brain activity. Daniel Amen MD is one of the nation’s leading experts in SPECT brain imaging. He can take a free online brain system quiz at http://www.amenclinic.com which may be helpful. His detailed and well-researched recommendations for nutritional interventions for the brain are also worth reviewing. More collaboration with neuroscientists and gastroenterologists is definitely needed to further investigate the association between poor brain function and gluten. SPECT imaging technology seems to be an exciting tool available to us if we can fund the research. We will continue to explore the gut-brain connection further.