{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:59:41Z","timestamp":1792299581140,"version":"4.4.0"},"reference-count":130,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Celiac disease (CD) is a common chronic inflammatory disorder occurring in genetically predisposed individuals secondary to gluten ingestion. CD usually presents with gastrointestinal symptoms such as pain, bloating, flatulence, and constipation or diarrhea. However, individuals can present in a nonclassical manner with only extraintestinal symptoms. The neurological manifestations of CD include ataxia, cognitive impairment, epilepsy, headache, and neuropathy. A lifelong gluten-free diet is the current recommended treatment for CD. This review discusses the relevant neurological manifestations associated with CD and the novel therapeutics. Further research is required to get a better understanding of the underlying pathophysiology of the neurological manifestations associated with CD. Clinicians should keep CD in the differential diagnosis in individuals presenting with neurological dysfunction of unknown cause.<\/jats:p>","DOI":"10.3390\/diseases10040111","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T02:52:21Z","timestamp":1668999141000},"page":"111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["A Comprehensive Review of the Neurological Manifestations of Celiac Disease and Its Treatment"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-8576","authenticated-orcid":false,"given":"Dhir","family":"Gala","sequence":"first","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelbie","family":"Scharf","sequence":"additional","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8317-2729","authenticated-orcid":false,"given":"Megan","family":"Kudlak","sequence":"additional","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Green","sequence":"additional","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2258-4372","authenticated-orcid":false,"given":"Faisal","family":"Khowaja","sequence":"additional","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mili","family":"Shah","sequence":"additional","affiliation":[{"name":"American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0058-2421","authenticated-orcid":false,"given":"Vikash","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The Brooklyn Hospital Center, 121 DeKalb Ave, Brooklyn, NY 11201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Ullal","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, American University of the Caribbean School of Medicine, 1 University Drive at Jordan Dr, Cupecoy, Sint Maarten, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MPG.0000000000002497","article-title":"European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020","volume":"70","author":"Husby","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4291\/wjgp.v8.i2.27","article-title":"Celiac disease: From pathophysiology to treatment","volume":"8","author":"Parzanese","year":"2017","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7110","DOI":"10.3748\/wjg.v21.i23.7110","article-title":"Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity","volume":"21","author":"Elli","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_4","first-page":"78","article-title":"Gastrointestinal and non-gastrointestinal presentation in patients with celiac disease","volume":"16","author":"Villanacci","year":"2013","journal-title":"Arch. Iran. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kreutz, J.M., Adriaanse, M.P.M., van der Ploeg, E.M.C., and Vreugdenhil, A.C.E. (2020). Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease. Nutrients, 12.","DOI":"10.3390\/nu12020500"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3389\/fped.2018.00350","article-title":"Celiac Disease: A Review of Current Concepts in Pathogenesis, Prevention, and Novel Therapies","volume":"6","author":"Galipeau","year":"2018","journal-title":"Front. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1542\/peds.2014-1787","article-title":"Age at gluten introduction and risk of celiac disease","volume":"135","author":"Aronsson","year":"2015","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1038\/ajg.2015.287","article-title":"Infections and risk of celiac disease in childhood: A prospective nationwide cohort study","volume":"110","author":"Marild","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1021\/jf062755g","article-title":"Prolamin hydrolysis in wheat sourdoughs with differing proteolytic activities","volume":"55","author":"Loponen","year":"2007","journal-title":"J. Agric. Food Chem."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Stadlmann, V., Harant, H., Korschineck, I., Hermann, M., Forster, F., and Missbichler, A. (2015). Novel avian single-chain fragment variable (scFv) targets dietary gluten and related natural grain prolamins, toxic entities of celiac disease. BMC Biotechnol., 15.","DOI":"10.1186\/s12896-015-0223-z"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.bbadis.2004.06.009","article-title":"Deamidation and cross-linking of gliadin peptides by transglutaminases and the relation to celiac disease","volume":"1690","author":"Skovbjerg","year":"2004","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/s41594-019-0353-4","article-title":"T cell receptor cross-reactivity between gliadin and bacterial peptides in celiac disease","volume":"27","author":"Petersen","year":"2020","journal-title":"Nat. Struct. Mol. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zanoni, G., Navone, R., Lunardi, C., Tridente, G., Bason, C., Sivori, S., Beri, R., Dolcino, M., Valletta, E., and Corrocher, R. (2006). In celiac disease, a subset of autoantibodies against transglutaminase binds toll-like receptor 4 and induces activation of monocytes. PLoS Med., 3.","DOI":"10.1371\/journal.pmed.0030358"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1006\/clin.1995.1025","article-title":"Molecular mimicry as a possible cause of autoimmune reactions in celiac disease? Antibodies to gliadin cross-react with epitopes on enterocytes","volume":"74","author":"Tuckova","year":"1995","journal-title":"Clin. Immunol. Immunopathol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jaut.2018.10.012","article-title":"Molecular mimicry and autoimmunity","volume":"95","author":"Rojas","year":"2018","journal-title":"J. Autoimmun."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1038\/cmi.2017.151","article-title":"Vaccine-induced autoimmunity: The role of molecular mimicry and immune crossreaction","volume":"15","author":"Segal","year":"2018","journal-title":"Cell. Mol. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"355.e9","DOI":"10.1016\/j.amjmed.2005.08.044","article-title":"Trends in the presentation of celiac disease","volume":"119","author":"Rampertab","year":"2006","journal-title":"Am. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/j.amjmed.2017.05.027","article-title":"Delay in Diagnosis of Celiac Disease in Patients Without Gastrointestinal Complaints","volume":"130","author":"Paez","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4321\/S1130-01082013000300006","article-title":"Bone mineral density in adult coeliac disease: An updated review","volume":"105","author":"Lucendo","year":"2013","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"198025","DOI":"10.1155\/2012\/198025","article-title":"Bone mineralization in celiac disease","volume":"2012","author":"Larussa","year":"2012","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jbspin.2017.03.006","article-title":"Occurrence of rheumatic symptoms in celiac disease: A meta-analysis: Comment on the article \u201cOsteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity\u201d by Dos Santos and Liote. Joint Bone Spine 2016, doi:10.1016\/j.jbspin.2016.09.007","volume":"84","author":"Daron","year":"2017","journal-title":"Jt. Bone Spine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1111\/jdv.17183","article-title":"S2k guidelines (consensus statement) for diagnosis and therapy of dermatitis herpetiformis initiated by the European Academy of Dermatology and Venereology (EADV)","volume":"35","author":"Gorog","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_23","first-page":"691","article-title":"The clinical pattern of subclinical\/silent celiac disease: An analysis on 1026 consecutive cases","volume":"94","author":"Bottaro","year":"1999","journal-title":"Am. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/01.mcg.0000212618.12455.a8","article-title":"Diagnosis of celiac disease in clinical practice: Physician\u2019s alertness to the condition essential","volume":"41","author":"Collin","year":"2007","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3389\/fped.2019.00357","article-title":"Changing Pattern of Childhood Celiac Disease Epidemiology: Contributing Factors","volume":"7","author":"Popp","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1111\/apt.14335","article-title":"Declining trend in the incidence of biopsy-verified coeliac disease in the adult population of Finland, 2005\u20132014","volume":"46","author":"Virta","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"41","DOI":"10.4103\/0019-5154.198031","article-title":"Psoriasis and Risk of Celiac Disease: A Systematic Review and Meta-analysis","volume":"62","author":"Ungprasert","year":"2017","journal-title":"Indian J. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1684\/ejd.2013.2158","article-title":"Does urticaria risk increase in patients with celiac disease? A large population-based cohort study","volume":"23","author":"Ludvigsson","year":"2013","journal-title":"Eur. J. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rodrigo, L., Beteta-Gorriti, V., Alvarez, N., Gomez de Castro, C., de Dios, A., Palacios, L., and Santos-Juanes, J. (2018). Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients, 10.","DOI":"10.20944\/preprints201805.0158.v1"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Persechino, F., Galli, G., Persechino, S., Valitutti, F., Zenzeri, L., Mauro, A., Corleto, V.D., Parisi, P., Ziparo, C., and Evangelisti, M. (2021). Skin Manifestations and Coeliac Disease in Paediatric Population. Nutrients, 13.","DOI":"10.3390\/nu13103611"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00004836-199002000-00010","article-title":"Obstetric and gynecological problems in women with untreated celiac sprue","volume":"12","author":"Molteni","year":"1990","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.ajog.2015.09.080","article-title":"Celiac disease and obstetric complications: A systematic review and metaanalysis","volume":"214","author":"Saccone","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Laurikka, P., Nurminen, S., Kivela, L., and Kurppa, K. (2018). Extraintestinal Manifestations of Celiac Disease: Early Detection for Better Long-Term Outcomes. Nutrients, 10.","DOI":"10.3390\/nu10081015"},{"key":"ref_34","first-page":"236","article-title":"Increased rates of pregnancy complications in women with celiac disease","volume":"28","author":"Moleski","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1093\/humupd\/dmu007","article-title":"Celiac disease and reproductive disorders: Meta-analysis of epidemiologic associations and potential pathogenic mechanisms","volume":"20","author":"Tersigni","year":"2014","journal-title":"Hum. Reprod. Update"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.gastro.2005.05.065","article-title":"Celiac disease and risk of adverse fetal outcome: A population-based cohort study","volume":"129","author":"Ludvigsson","year":"2005","journal-title":"Gastroenterology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1002\/ppul.21357","article-title":"Benefit of gluten-free diet in idiopathic pulmonary hemosiderosis in association with celiac disease","volume":"46","author":"Sethi","year":"2011","journal-title":"Pediatr. Pulmonol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1161\/CIRCULATIONAHA.110.965624","article-title":"Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease","volume":"123","author":"Ludvigsson","year":"2011","journal-title":"Circulation"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1093\/eurheartj\/ehr167","article-title":"Increased risk of atrial fibrillation in patients with coeliac disease: A nationwide cohort study","volume":"32","author":"Emilsson","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e001594","DOI":"10.1161\/JAHA.112.001594","article-title":"Risk of idiopathic dilated cardiomyopathy in 29,000 patients with celiac disease","volume":"1","author":"Emilsson","year":"2012","journal-title":"J. Am. Heart Assoc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/aje\/kwr069","article-title":"Increased risk of cataract among 28,000 patients with celiac disease","volume":"174","author":"Mollazadegan","year":"2011","journal-title":"Am. J. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1136\/bjophthalmol-2011-301051","article-title":"Increased risk of uveitis in coeliac disease: A nationwide cohort study","volume":"96","author":"Mollazadegan","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1586\/egh.11.38","article-title":"Clinical and immunological features of celiac disease in patients with Type 1 diabetes mellitus","volume":"5","author":"Volta","year":"2011","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Volta, U., Caio, G., Stanghellini, V., and De Giorgio, R. (2014). The changing clinical profile of celiac disease: A 15-year experience (1998\u20132012) in an Italian referral center. BMC Gastroenterol., 14.","DOI":"10.1186\/s12876-014-0194-x"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1093\/qjmed\/95.2.79","article-title":"Coeliac disease and autoimmune Addison\u2019s disease: A clinical pitfall","volume":"95","author":"Walsh","year":"2002","journal-title":"QJM"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1023\/A:1026650118759","article-title":"Frequency and significance of anti-gliadin and anti-endomysial antibodies in autoimmune hepatitis","volume":"43","author":"Volta","year":"1998","journal-title":"Dig. Dis. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2165\/11593150-000000000-00000","article-title":"Celiac disease in pediatric patients with autoimmune hepatitis: Etiology, diagnosis, and management","volume":"14","author":"Panetta","year":"2012","journal-title":"Paediatr. Drugs"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s12016-019-08756-7","article-title":"The Epidemiology and Clinical Manifestations of Autoimmunity in Selective IgA Deficiency","volume":"58","author":"Odineal","year":"2020","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.1111\/liv.15000","article-title":"High prevalence of celiac disease in autoimmune hepatitis: Systematic review and meta-analysis","volume":"41","author":"Haggard","year":"2021","journal-title":"Liver Int."},{"key":"ref_50","first-page":"116","article-title":"Celiac Disease and Elevated Liver Enzymes: A Review","volume":"9","author":"Wu","year":"2021","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1111\/j.1572-0241.2002.06031.x","article-title":"Celiac disease in autoimmune cholestatic liver disorders","volume":"97","author":"Volta","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1136\/gut.40.4.492","article-title":"Down\u2019s syndrome is strongly associated with coeliac disease","volume":"40","author":"Gale","year":"1997","journal-title":"Gut"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"264","DOI":"10.12998\/wjcc.v5.i7.264","article-title":"Screening of celiac disease in Down syndrome\u2014Old and new dilemmas","volume":"5","author":"Pavlovic","year":"2017","journal-title":"World J. Clin. Cases"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1177\/0009922820941247","article-title":"Incidence of Celiac Disease in Down Syndrome: A Longitudinal, Population-Based Birth Cohort Study","volume":"59","author":"Ostermaier","year":"2020","journal-title":"Clin. Pediatr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"5495","DOI":"10.1210\/jc.2002-020855","article-title":"Prevalence and clinical picture of celiac disease in Turner syndrome","volume":"87","author":"Bonamico","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1136\/jmg.38.11.767","article-title":"Coeliac disease in Williams syndrome","volume":"38","author":"Giannotti","year":"2001","journal-title":"J. Med. Genet."},{"key":"ref_57","first-page":"59","article-title":"Neurological manifestations, diagnosis, and treatment of celiac disease: A comprehensive review","volume":"11","author":"Nikpour","year":"2012","journal-title":"Iran. J. Neurol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/07853890.2016.1222450","article-title":"Dermatitis herpetiformis: A cutaneous manifestation of coeliac disease","volume":"49","author":"Collin","year":"2017","journal-title":"Ann. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/j.1365-2036.2006.03206.x","article-title":"Is exocrine pancreatic insufficiency in adult coeliac disease a cause of persisting symptoms?","volume":"25","author":"Leeds","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3109\/00365521.2011.639084","article-title":"Gluten-free diet and autoimmune thyroiditis in patients with celiac disease. A prospective controlled study","volume":"47","author":"Metso","year":"2012","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/j.1365-2036.2005.02361.x","article-title":"Systematic review: The liver in coeliac disease","volume":"21","author":"Duggan","year":"2005","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/apt.12271","article-title":"The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease","volume":"37","author":"Emilsson","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1007\/s00198-008-0624-0","article-title":"Bone in celiac disease","volume":"19","author":"Bianchi","year":"2008","journal-title":"Osteoporos. Int."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"289","DOI":"10.7326\/0003-4819-142-4-200502150-00011","article-title":"Narrative review: Celiac disease: Understanding a complex autoimmune disorder","volume":"142","author":"Alaedini","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1046\/j.0305-1846.2000.00292.x","article-title":"The neurology and neuropathology of coeliac disease","volume":"26","author":"Wills","year":"2000","journal-title":"Neuropathol. Appl. Neurobiol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Mearns, E.S., Taylor, A., Thomas Craig, K.J., Puglielli, S., Leffler, D.A., Sanders, D.S., Lebwohl, B., and Hadjivassiliou, M. (2019). Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review. Nutrients, 11.","DOI":"10.3390\/nu11020380"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2174\/1570159X16666180917105033","article-title":"Immune-mediated Cerebellar Ataxias: Practical Guidelines and Therapeutic Challenges","volume":"17","author":"Mitoma","year":"2019","journal-title":"Curr. Neuropharmacol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1212\/WNL.0000000000004237","article-title":"Effect of gluten-free diet on cerebellar MR spectroscopy in gluten ataxia","volume":"89","author":"Hadjivassiliou","year":"2017","journal-title":"Neurology"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/S0140-6736(98)05342-2","article-title":"Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia","volume":"352","author":"Hadjivassiliou","year":"1998","journal-title":"Lancet"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1159\/000369509","article-title":"Gluten-related disorders: Gluten ataxia","volume":"33","author":"Hadjivassiliou","year":"2015","journal-title":"Dig. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1093\/brain\/awg050","article-title":"Gluten ataxia in perspective: Epidemiology, genetic susceptibility and clinical characteristics","volume":"126","author":"Hadjivassiliou","year":"2003","journal-title":"Brain"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00726-011-1091-z","article-title":"Transglutaminase 6: A protein associated with central nervous system development and motor function","volume":"44","author":"Thomas","year":"2013","journal-title":"Amino Acids"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1053\/j.gastro.2007.04.070","article-title":"Sera of patients with celiac disease and neurologic disorders evoke a mitochondrial-dependent apoptosis in vitro","volume":"133","author":"Cervio","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"423","DOI":"10.2174\/1871527317666171221110548","article-title":"Advances in Therapies of Cerebellar Disorders: Immune-mediated Ataxias","volume":"18","author":"Hadjivassiliou","year":"2019","journal-title":"CNS Neurol. Disord. Drug Targets"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1136\/jnnp.74.9.1221","article-title":"Dietary treatment of gluten ataxia","volume":"74","author":"Hadjivassiliou","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1136\/bmj.2.6132.250","article-title":"Increased prevalence of epilepsy in coeliac disease","volume":"2","author":"Chapman","year":"1978","journal-title":"Br. Med. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1212\/WNL.0b013e3182544728","article-title":"Increased risk of epilepsy in biopsy-verified celiac disease: A population-based cohort study","volume":"78","author":"Ludvigsson","year":"2012","journal-title":"Neurology"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"913","DOI":"10.3109\/00207454.2014.983227","article-title":"Cryptogenic focal epilepsy and \u201chidden\u201d celiac disease in adulthood: A causal or accidental link?","volume":"125","author":"Casciato","year":"2015","journal-title":"Int. J. Neurosci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1469-8749.2012.04369.x","article-title":"Coeliac disease, epilepsy, and cerebral calcifications: Association with TG6 autoantibodies","volume":"55","author":"Johnson","year":"2013","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_80","first-page":"1498","article-title":"Bilateral occipital calcification associated with celiac disease, folate deficiency, and epilepsy","volume":"16","author":"Lea","year":"1995","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/j.1526-4610.2012.02260.x","article-title":"Prevalence of migraine in patients with celiac disease and inflammatory bowel disease","volume":"53","author":"Dimitrova","year":"2013","journal-title":"Headache"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Zis, P., Julian, T., and Hadjivassiliou, M. (2018). Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis. Nutrients, 10.","DOI":"10.3390\/nu10101445"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Fanaeian, M.M., Alibeik, N., Ganji, A., Fakheri, H., Ekhlasi, G., and Shahbazkhani, B. (2021). Prevalence of migraine in adults with celiac disease: A case control cross-sectional study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0259502"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"294","DOI":"10.11607\/ofph.2079","article-title":"Headache in Patients with Celiac Disease and Its Response to the Gluten-Free Diet","volume":"33","author":"Ameghino","year":"2019","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1080\/00365520119754","article-title":"Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: A longitudinal study","volume":"36","author":"Addolorato","year":"2001","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1046\/j.1468-2982.2001.00196.x","article-title":"Migraine and function of the immune system: A meta-analysis of clinical literature published between 1966 and 1999","volume":"21","author":"Kemper","year":"2001","journal-title":"Cephalalgia"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Hadjivassiliou, M., Croall, I.D., Grunewald, R.A., Trott, N., Sanders, D.S., and Hoggard, N. (2021). Neurological Evaluation of Patients with Newly Diagnosed Coeliac Disease Presenting to Gastroenterologists: A 7-Year Follow-Up Study. Nutrients, 13.","DOI":"10.3390\/nu13061846"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S1474-4422(09)70290-X","article-title":"Gluten sensitivity: From gut to brain","volume":"9","author":"Hadjivassiliou","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/CND.0b013e31821c55a1","article-title":"Peripheral neuropathic symptoms in celiac disease and inflammatory bowel disease","volume":"13","author":"Shen","year":"2012","journal-title":"J. Clin. Neuromuscul. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"3147","DOI":"10.1007\/s10620-010-1142-4","article-title":"Celiac disease: Similar presentations in the elderly and young adults","volume":"55","author":"Mukherjee","year":"2010","journal-title":"Dig. Dis. Sci."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1001\/jamaneurol.2015.0475","article-title":"Risk of Neuropathy Among 28,232 Patients With Biopsy-Verified Celiac Disease","volume":"72","author":"Thawani","year":"2015","journal-title":"JAMA Neurol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/MPG.0000000000001420","article-title":"Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet","volume":"65","author":"Jericho","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s13760-017-0870-z","article-title":"Cognitive impairment in celiac disease and non-celiac gluten sensitivity: Review of literature on the main cognitive impairments, the imaging and the effect of gluten free diet","volume":"118","author":"Makhlouf","year":"2018","journal-title":"Acta Neurol. Belg."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1001\/archneur.63.10.1440","article-title":"Cognitive impairment and celiac disease","volume":"63","author":"Hu","year":"2006","journal-title":"Arch. Neurol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/MCG.0000000000001018","article-title":"A Prospective Study on Cognitive Impairment in Middle-aged Adults With Newly Diagnosed Celiac Disease","volume":"53","author":"Longarini","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1212\/WNL.41.3.372","article-title":"Celiac disease, brain atrophy, and dementia","volume":"41","author":"Collin","year":"1991","journal-title":"Neurology"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Caio, G., Volta, U., Sapone, A., Leffler, D.A., De Giorgio, R., Catassi, C., and Fasano, A. (2019). Celiac disease: A comprehensive current review. BMC Med., 17.","DOI":"10.1186\/s12916-019-1380-z"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s00394-016-1238-5","article-title":"Celiac disease: Understanding the gluten-free diet","volume":"56","author":"Bascunan","year":"2017","journal-title":"Eur. J. Nutr."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3390\/diseases3030136","article-title":"The Gluten-Free Diet in the 3rd Millennium: Rules, Risks and Opportunities","volume":"3","author":"Welstead","year":"2015","journal-title":"Diseases"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1365-277X.2006.00659.x","article-title":"The impact of a gluten-free diet on adults with coeliac disease: Results of a national survey","volume":"19","author":"Zarkadas","year":"2006","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Osorio, C.E., Mej\u00edas, J.H., and Rustgi, S. (2019). Gluten Detection Methods and Their Critical Role in Assuring Safe Diets for Celiac Patients. Nutrients, 11.","DOI":"10.3390\/nu11122920"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"e0007","DOI":"10.5041\/RMMJ.10360","article-title":"Gluten in Celiac Disease-More or Less?","volume":"10","author":"Cohen","year":"2019","journal-title":"Rambam Maimonides Med. J."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1080\/17460441.2019.1642321","article-title":"Challenges to drug discovery for celiac disease and approaches to overcome them","volume":"14","author":"Vaquero","year":"2019","journal-title":"Expert Opin. Drug Discov."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3945\/an.116.013292","article-title":"Pediatric Celiac Disease: Follow-Up in the Spotlight","volume":"8","author":"Valitutti","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"101782","DOI":"10.1016\/j.clinre.2021.101782","article-title":"Larazotide acetate for treatment of celiac disease: A systematic review and meta-analysis of randomized controlled trials","volume":"46","author":"Hoilat","year":"2021","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1053\/j.gastro.2014.02.031","article-title":"Glutenase ALV003 attenuates gluten-induced mucosal injury in patients with celiac disease","volume":"146","author":"Lahdeaho","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1056\/NEJMoa2032441","article-title":"A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease","volume":"385","author":"Schuppan","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ebiom.2017.11.018","article-title":"Epitope-Specific Immunotherapy Targeting CD4-Positive T Cells in Celiac Disease: Safety, Pharmacokinetics, and Effects on Intestinal Histology and Plasma Cytokines with Escalating Dose Regimens of Nexvax2 in a Randomized, Double-Blind, Placebo-Controlled Phase 1 Study","volume":"26","author":"Daveson","year":"2017","journal-title":"EBioMedicine"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/1756283X15616576","article-title":"The potential utility of tight junction regulation in celiac disease: Focus on larazotide acetate","volume":"9","author":"Khaleghi","year":"2016","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"G983","DOI":"10.1152\/ajpgi.00386.2020","article-title":"Larazotide acetate: A pharmacological peptide approach to tight junction regulation","volume":"320","author":"Slifer","year":"2021","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1111\/j.1365-2036.2007.03413.x","article-title":"The safety, tolerance, pharmacokinetic and pharmacodynamic effects of single doses of AT-1001 in coeliac disease subjects: A proof of concept study","volume":"26","author":"Paterson","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1038\/ajg.2012.211","article-title":"A randomized, double-blind study of larazotide acetate to prevent the activation of celiac disease during gluten challenge","volume":"107","author":"Leffler","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1053\/j.gastro.2015.02.008","article-title":"Larazotide acetate for persistent symptoms of celiac disease despite a gluten-free diet: A randomized controlled trial","volume":"148","author":"Leffler","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/apt.12147","article-title":"Larazotide acetate in patients with coeliac disease undergoing a gluten challenge: A randomised placebo-controlled study","volume":"37","author":"Kelly","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/00042737-200106000-00023","article-title":"Analysis and clinical effects of gluten in coeliac disease","volume":"13","author":"Stern","year":"2001","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Wei, G., Helmerhorst, E.J., Darwish, G., Blumenkranz, G., and Schuppan, D. (2020). Gluten Degrading Enzymes for Treatment of Celiac Disease. Nutrients, 12.","DOI":"10.3390\/nu12072095"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/B978-0-12-416039-2.00013-6","article-title":"Oral enzyme therapy for celiac sprue","volume":"502","author":"Bethune","year":"2012","journal-title":"Methods Enzymol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1053\/j.gastro.2007.05.028","article-title":"Combination enzyme therapy for gastric digestion of dietary gluten in patients with celiac sprue","volume":"133","author":"Gass","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1053\/j.gastro.2016.11.004","article-title":"No Difference Between Latiglutenase and Placebo in Reducing Villous Atrophy or Improving Symptoms in Patients With Symptomatic Celiac Disease","volume":"152","author":"Murray","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1007\/s10620-017-4687-7","article-title":"Latiglutenase Improves Symptoms in Seropositive Celiac Disease Patients While on a Gluten-Free Diet","volume":"62","author":"Syage","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"13106","DOI":"10.1021\/jacs.5b08325","article-title":"Engineering of Kuma030: A Gliadin Peptidase That Rapidly Degrades Immunogenic Gliadin Peptides in Gastric Conditions","volume":"137","author":"Wolf","year":"2015","journal-title":"J. Am. Chem. Soc."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/1521-4141(200105)31:5<1317::AID-IMMU1317>3.0.CO;2-I","article-title":"T cells from celiac disease lesions recognize gliadin epitopes deamidated in situ by endogenous tissue transglutaminase","volume":"31","author":"Molberg","year":"2001","journal-title":"Eur. J. Immunol."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.ejphar.2007.10.059","article-title":"Transglutaminase inhibitor cystamine alleviates the abnormality in liver from NZB\/W F1 mice","volume":"579","author":"Hsu","year":"2008","journal-title":"Eur. J. Pharmacol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"BSR20180691","DOI":"10.1042\/BSR20180691","article-title":"Cystamine and cysteamine as inhibitors of transglutaminase activity in vivo","volume":"38","author":"Jeitner","year":"2018","journal-title":"Biosci. Rep."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"25402","DOI":"10.1074\/jbc.M109.097162","article-title":"Redox regulation of transglutaminase 2 activity","volume":"285","author":"Stamnaes","year":"2010","journal-title":"J. Biol. Chem."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00726-011-1188-4","article-title":"Recent advances in the development of tissue transglutaminase (TG2) inhibitors","volume":"44","author":"Badarau","year":"2013","journal-title":"Amino Acids"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3389\/fmed.2018.00187","article-title":"Vaccine Immunotherapy for Celiac Disease","volume":"5","author":"Lenti","year":"2018","journal-title":"Front. Med."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/bip.21352","article-title":"Interaction of alpha-gliadin with polyanions: Design considerations for sequestrants used in supportive treatment of celiac disease","volume":"93","author":"Liang","year":"2010","journal-title":"Biopolymers"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1007\/s13311-020-00941-3","article-title":"Update on the Treatment of Ataxia: Medication and Emerging Therapies","volume":"17","author":"Perlman","year":"2020","journal-title":"Neurotherapeutics"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/10717544.2017.1413446","article-title":"The efficacy and safety of riluzole for neurodegenerative movement disorders: A systematic review with meta-analysis","volume":"25","author":"Liu","year":"2018","journal-title":"Drug Deliv."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/10\/4\/111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:30Z","timestamp":1760145750000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/10\/4\/111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,21]]},"references-count":130,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["diseases10040111"],"URL":"https:\/\/doi.org\/10.3390\/diseases10040111","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,21]]}}}