Fisicaro Francesco, Lanza Giuseppe, D'Agate Carmela Cinzia, Pennisi Manuela, Cantone Mariagiovanna, Pennisi Giovanni, Hadjivassiliou Marios, Bella Rita
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
Front Hum Neurosci. 2022 Sep 6;16:931727. doi: 10.3389/fnhum.2022.931727. eCollection 2022.
Sonographic mesenteric pattern in celiac disease (CD) suggests a hyperdynamic circulation. Despite the well-known CD-related neurological involvement, no study has systematically explored the cerebral hemodynamics to transcranial Doppler sonography.
Montreal Cognitive Assessment (MoCA) and 17-item Hamilton Depression Rating Scale (HDRS) were assessed in 15 newly diagnosed subjects with CD and 15 age-, sex-, and education-matched healthy controls. Cerebral blood flow (CBF) velocities and indices of resistivity (RI) and pulsatility (PI) from the middle cerebral artery (MCA), bilaterally, and the basilar artery (BA) were recorded. We also assessed cerebral vasomotor reactivity (CVR) through the breath-holding test (BHT).
Worse scores of MoCA and HDRS were found in patients compared to controls. Although patients showed higher values of CBF velocity from MCA bilaterally compared to controls, both at rest and after BHT, no comparison reached a statistical significance, whereas after BHT both RI and PI from BA were significantly higher in patients. A significant negative correlation between both indices from BA and MoCA score were also noted.
These treatment-naïve CD patients may show some subtle CVR changes in posterior circulation, thus possibly expanding the spectrum of pathomechanisms underlying neuroceliac disease and in particular gluten ataxia. Subclinical identification of cerebrovascular pathology in CD may help adequate prevention and early management of neurological involvement.
乳糜泻（CD）的超声肠系膜模式提示循环血流动力学亢进。尽管CD相关的神经受累已广为人知，但尚无研究系统地通过经颅多普勒超声探讨脑血流动力学。
对15例新诊断的CD患者和15例年龄、性别及教育程度相匹配的健康对照者进行蒙特利尔认知评估（MoCA）和17项汉密尔顿抑郁量表（HDRS）评估。记录双侧大脑中动脉（MCA）和基底动脉（BA）的脑血流（CBF）速度、阻力指数（RI）和搏动指数（PI）。我们还通过屏气试验（BHT）评估脑血管舒缩反应性（CVR）。
与对照组相比，患者的MoCA和HDRS评分更低。尽管患者在静息和BHT后双侧MCA的CBF速度值均高于对照组，但均未达到统计学显著性差异，而在BHT后，患者BA的RI和PI均显著更高。还发现BA的两个指数与MoCA评分之间存在显著负相关。
这些未经治疗的CD患者可能在后循环中表现出一些细微的CVR变化，从而可能扩大神经乳糜泻尤其是麸质共济失调潜在病理机制的范围。CD患者脑血管病变的亚临床识别可能有助于对神经受累进行充分预防和早期管理。
