SPECT brain images of most of the few celiac disease patients studied reveal abnormalities that are usually more severe in the frontal areas of the brain. The improvement of these anomalies is observed with a gluten-free diet. The front 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 Sprue patients and in 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 alterations 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 who are 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 an abnormal SPECT scan were reversed on a gluten-free diet. He presented an established diagnosis of schizophrenia, diarrhea, and weight loss. The endomysial antibody was positive and villus atrophy was observed in the intestinal biopsy. The SPECT examination was performed before and after the gluten-free diet. Before GFD, the scan confirmed an abnormal decrease in blood flow to the frontal lobe of the brain. With a GFD, the schizophrenia symptoms resolved, the bowel injury resolved, and the SPECT normalized. More recently, in 2004, Usai et al. reported 34 celiac patients in whom 70% had abnormal SPECT scans. 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 scan. It is a combined nuclear medicine CT scan of the head performed by injecting a radioisotopic material that is absorbed by the brain according to blood flow and metabolism. A scan is produced which is a color-coded three-dimensional representation of brain metabolism or activity. Dr. Daniel Amen is one of the nation’s leading experts in SPECT brain imaging. You can take a free online brain system questionnaire at http://www.amenclinic.com that may be helpful. Their detailed and well-researched recommendations on nutritional interventions for the brain are also worth reviewing. More collaboration with neuroscientists and gastroenterologists is definitely needed to further investigate the association of poor brain function and gluten. SPECT imaging technology seems to be an interesting tool available to us if we can get research funding. We will continue to explore the gut-brain connection further.