{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T14:54:06Z","timestamp":1791644046555,"version":"4.3.4"},"reference-count":11,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T00:00:00Z","timestamp":1538697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Patients with gluten ataxia (GA) without enteropathy have lower levels of antigliadin antibodies (AGA) compared to patients with coeliac disease (CD). Magnetic Resonance Spectroscopy (NAA\/Cr area ratio) of the cerebellum improves in patients with GA following a strict gluten-free diet (GFD). This is associated with clinical improvement. We present our experience of the effect of a GFD in patients with ataxia and low levels of AGA antibodies measured by a commercial assay. Methods: Consecutive patients with ataxia and serum AGA levels below the positive cut-off for CD but above a re-defined cut-off in the context of GA underwent MR spectroscopy at baseline and after a GFD. Results: Twenty-one consecutive patients with GA were included. Ten were on a strict GFD with elimination of AGA, 5 were on a GFD but continued to have AGA, and 6 patients did not go on a GFD. The NAA\/Cr area ratio from the cerebellar vermis increased in all patients on a strict GFD, increased in only 1 out of 5 (20%) patients on a GFD with persisting circulating AGA, and decreased in all patients not on a GFD. Conclusion: Patients with ataxia and low titres of AGA benefit from a strict GFD. The results suggest an urgent need to redefine the serological cut-off for circulating AGA in diagnosing GA.<\/jats:p>","DOI":"10.3390\/nu10101444","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T12:16:44Z","timestamp":1538741804000},"page":"1444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia"],"prefix":"10.3390","volume":"10","author":[{"given":"Marios","family":"Hadjivassiliou","sequence":"first","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Gr\u00fcnewald","sequence":"additional","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sanders","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Zis","sequence":"additional","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Croall","sequence":"additional","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Shanmugarajah","sequence":"additional","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8380-8755","authenticated-orcid":false,"given":"Ptolemaios","family":"Sarrigiannis","sequence":"additional","affiliation":[{"name":"Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Trott","sequence":"additional","affiliation":[{"name":"Departments of Dietetics, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Wild","sequence":"additional","affiliation":[{"name":"Departments of Immunology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Hoggard","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,10,5]]},"reference":[{"key":"ref_1","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_2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1038\/ajg.2015.434","article-title":"Neurological dysfunction in Coeliac Disease and Non-Coeliac Gluten Sensitivity","volume":"111","author":"Hadjivassiliou","year":"2016","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e7907","DOI":"10.1136\/bmj.e7907","article-title":"Does gluten sensitivity in the absence of coeliac disease exist?","volume":"345","author":"Aziz","year":"2012","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1038\/nrgastro.2015.107","article-title":"The spectrum of non-coeliac gluten sensitivity","volume":"12","author":"Aziz","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_5","unstructured":"(2018, September 04). Available online: www.phadia.com\/da\/Products\/Phadia-Laboratory-Systems\/Phadia-2500\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1136\/jnnp-2016-314863","article-title":"Causes of progressive cerebellar ataxia: Prospective evaluation of 1500 patients","volume":"88","author":"Hadjivassiliou","year":"2016","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1212\/WNL.0000000000004237","article-title":"Effect of gluten-free diet on MR spectroscopy in gluten ataxia","volume":"89","author":"Hadjivassiliou","year":"2017","journal-title":"Neurology"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hadjivassiliou, M. (2018). Advances in Therapies of Cerebellar Disorders: Immune mediated Ataxias. CNS Neurol. Disord. Drug Targets.","DOI":"10.2174\/1871527317666171221110548"},{"key":"ref_9","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_10","unstructured":"Currie, S., Hadjivassiliou, M., Craven, I.J., Wilkinson, I.D., Griffiths, P.D., and Hoggard, N. Magnetic resonance spectroscopy of the brain. Postgrad. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/mds.23067","article-title":"Neurochemical alterations in spinocerebellar ataxia type 1 and their correlations with clinical status","volume":"25","author":"Oz","year":"2010","journal-title":"Mov. Disord."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/10\/1444\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:24:09Z","timestamp":1760196249000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/10\/1444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,5]]},"references-count":11,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,10]]}},"alternative-id":["nu10101444"],"URL":"https:\/\/doi.org\/10.3390\/nu10101444","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,5]]}}}