International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
Open Access
Journal Browser
Go
International Journal of Celiac Disease. 2020, 8(4), 129-135
DOI: 10.12691/ijcd-8-4-5
Open AccessArticle

Intellectual and Attentional Characteristics of Children with Celiac Disease after Initiation of a Gluten-Free Diet

Ada Lee1, Sherin Daniel1, Denease Francis1, Catherine Messina2, Jaeah Chung3, Lesley Small-Harary1, Janet E Fischel4 and Anupama Chawla1,

1Division of Pediatric Gastroenterology and Nutrition, Renaissance School of Medicine at Stony Brook University, Stony Brook Children’s Hospital, Stony Brook, NY 11794

2Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY 11794

3Division of Developmental and Behavioral Pediatrics, Ichahn School of Medicine at Mt Sinai, New York, NY 10029

4Division of Developmental and Behavioral Pediatrics, Renaissance School of Medicine at Stony Brook University, Stony Brook Children’s Hospital, Stony Brook, NY 11794

Pub. Date: December 01, 2020

Cite this paper:
Ada Lee, Sherin Daniel, Denease Francis, Catherine Messina, Jaeah Chung, Lesley Small-Harary, Janet E Fischel and Anupama Chawla. Intellectual and Attentional Characteristics of Children with Celiac Disease after Initiation of a Gluten-Free Diet. International Journal of Celiac Disease. 2020; 8(4):129-135. doi: 10.12691/ijcd-8-4-5

Abstract

The association of celiac disease (CD) with various cognitive and behavioral symptoms has been reported, but findings are mixed and inconclusive. This prospective study aimed to evaluate whether elimination of gluten in children with newly diagnosed CD leads to improvement in cognitive and behavioral functioning particularly related to attention after 6 months of a gluten-free diet (GFD). Thirty-three patients completed the study. Parent ratings of child behavior and direct assessment of child intelligence and attentional characteristics were collected. Parent reported scores on the Child Behavior Checklist (CBCL) demonstrated improvement in somatic symptoms and attentional characteristics after 6 months of GFD. Between 6-33% of the patients showed improvement in the 4 different attentional characteristics evaluated by the Conners Continuous Performance Test (CPT3). We conclude that parent ratings support improvement in somatic symptoms and attentional characteristics in celiac patients once on a GFD for 6 months.

Keywords:
Celiac disease ADHD behavior IQ cognitive psychological

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005; 40(1): 1-19.
 
[2]  Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE. The prevalence of celiac disease in the United States. Am J Gastroenterol 2012; 107(10): 1538-44.
 
[3]  Leonard MM, Fogle R, Asch A, Katz A. Screening for Celiac Disease in a Pediatric Primary Care Setting. Clin Pediatr (Phila) 2016; 55(3): 214-8.
 
[4]  Lichtwark IT, Newnham ED, Robinson SR, Shepherd SJ, Hosking P, Gibson PR, Yelland GW.. Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity. Aliment Pharmacol Ther 2014; 40(2): 160-70.
 
[5]  Murray JA. The widening spectrum of celiac disease. Am J ClinNutr 1999; 69(3): 354-65.
 
[6]  Lahat E, Broide E, Leshem M, et al. Prevalence of celiac antibodies in children with neurologic disorders. PediatrNeurol 2000; 22(5): 393-6.
 
[7]  Niederhofer H, Pittschieler K. A preliminary investigation of ADHD symptoms in persons with celiac disease. J AttenDisord 2006; 10(2): 200-4.
 
[8]  Niederhofer H. Association of attention-deficit/hyperactivity disorder and celiac disease: a brief report. Prim Care Companion CNS Disord 2011; 13(3): PCC.
 
[9]  Zelnik N, Pacht A, Obeid R, Lerner A. Range of neurologic disorders in patients with celiac disease. Pediatrics 2004; 113(6): 1672-6.
 
[10]  Terrone G, Parente I, Romano A, Auricchio R, Greco L, Del Giudice E. The Pediatric Symptom Checklist as screening tool for neurological and psychosocial problems in a paediatric cohort of patients with coeliac disease. ActaPaediatr 2013; 102(7): e325-8.
 
[11]  Mazzone L, Reale L, Spina M, Guarnera M, Lionetti E, Martorana S, Mazzone D. Compliant gluten-free children with celiac disease: an evaluation of psychological distress. BMC Pediatr 2011; 11: 46.
 
[12]  Pynnonen PA, Isometsa ET, Aronen ET, Verkasalo MA, Savilahti E, Aalberg VA. Mental disorders in adolescents with celiac disease. Psychosomatics 2004; 45: 32-35.
 
[13]  Coburn SS, Puppa EL, Blanchard S. Psychological Comorbidities in Childhood Celiac Disease: A Systematic Review. J Pediatr Gastroenterol Nutr. 2019; 69(2): e25-e33.
 
[14]  Kaufman AS, Kaufman NL. Kaufman Brief Intelligence Test, second edition. Circle Pines, MN: American Guidance Services; 2004.
 
[15]  Conners KC. Conners Continuous Performance Test 3rd Edition, TM (Conners CPT 3TM) &Conners Continuous Auditory Test of Attention TM. Multi-Health Systems Inc, North Tonawanda, NY, 2014.
 
[16]  Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families; 2001.
 
[17]  17. Vecsei E, Steinwendner S, Kogler H, Innerhofer A, Hammer K, Haas OA, Amann G, Chott A, Vogelsang H, Schoenlechner R, Huf W, Vécsei A. Follow-up of pediatric celiac disease: value of antibodies in predicting mucosal healing, a prospective cohort study. BMC Gastroenterol 2014; 14: 28.
 
[18]  Husby S, Bai JC. Follow-up of Celiac Disease. GastroenterolClin North Am 2019; 48(1): 127-36.
 
[19]  Mardini HE, Westgate P, Grigorian AY. Racial Differences in the Prevalence of Celiac Disease in the US Population: National Health and Nutrition Examination Survey (NHANES) 2009-2012. Digestive diseases and sciences 2015; 60(6): 1738-42.
 
[20]  Choung RS, Unalp-Arida A, Ruhl CE, Brantner TL, Everhart JE, Murray JA. Less Hidden Celiac Disease But Increased Gluten Avoidance Without a Diagnosis in the United States: Findings From the National Health and Nutrition Examination Surveys From 2009 to 2014. Mayo Clinic proceedings 2017; 92(1): 30-38.