{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:46:44Z","timestamp":1784544404291,"version":"3.55.0"},"reference-count":82,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"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: Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. Methods: A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). Results: MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. Conclusions: An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.<\/jats:p>","DOI":"10.3390\/nu13051530","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T21:35:39Z","timestamp":1619904939000},"page":"1530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-8807","authenticated-orcid":false,"given":"Francesco","family":"Fisicaro","sequence":"first","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5659-662X","authenticated-orcid":false,"given":"Giuseppe","family":"Lanza","sequence":"additional","affiliation":[{"name":"Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy"},{"name":"Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela Cinzia","family":"D\u2019Agate","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, University Hospital \u201cPoliclinico G. Rodolico-San Marco\u201d, Via Santa Sofia 78, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-3065","authenticated-orcid":false,"given":"Raffaele","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9072-4971","authenticated-orcid":false,"given":"Mariagiovanna","family":"Cantone","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sant\u2019Elia Hospital, ASP Caltanissetta, Via Luigi Russo 6, 93100 Caltanissetta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-6826","authenticated-orcid":false,"given":"Luca","family":"Falzone","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Unit, Instituto Nazionale Tumori-IRCCS \u201cFondazione G. Pascale\u201d, Via Mariano Semmola 53, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pennisi","sequence":"additional","affiliation":[{"name":"Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-6863","authenticated-orcid":false,"given":"Rita","family":"Bella","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Pennisi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/B978-0-7020-4087-0.00041-3","article-title":"Gluten-related neurologic dysfunction","volume":"120","author":"Hadjivassiliou","year":"2014","journal-title":"Handb. Clin. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1136\/bmj.39316.442338.AD","article-title":"Adult coeliac disease","volume":"335","author":"Hopper","year":"2007","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.bpg.2005.02.006","article-title":"Diagnosis of coeliac disease","volume":"19","author":"Green","year":"2005","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1136\/jnnp.72.5.560","article-title":"Gluten sensitivity as a neurological illness","volume":"72","author":"Hadjivassiliou","year":"2002","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_5","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_6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jneuroim.2008.01.008","article-title":"Neurological complications of celiac disease and autoimmune mechanisms: A prospective study","volume":"195","author":"Briani","year":"2008","journal-title":"J. Neuroimmunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1016\/j.cgh.2019.03.014","article-title":"Neurologic deficits in patients with newly diagnosed celiac disease are frequent and linked with autoimmunity to transglutaminase 6","volume":"17","author":"Hadjivassiliou","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1136\/jnnp-2012-303281","article-title":"Should we be \u201cnervous\u201d about coeliac disease? Brain abnormalities in patients with coeliac disease referred for neurological opinion","volume":"83","author":"Currie","year":"2012","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Vinciguerra, L., Lanza, G., Puglisi, V., Fisicaro, F., Pennisi, M., Bella, R., and Cantone, M. (2020). Update on the neurobiology of vascular cognitive impairment: From lab to clinic. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21082977"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cantone, M., Lanza, G., Vinciguerra, L., Puglisi, V., Ricceri, R., Fisicaro, F., Vagli, C., Bella, R., Ferri, R., and Pennisi, G. (2019). Age, Height, And sex on motor evoked potentials: Translational data from a large italian cohort in a clinical environment. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00185"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"351680","DOI":"10.1155\/2013\/351680","article-title":"Preserved Transcallosal inhibition to transcranial magnetic stimulation in nondemented elderly patients with leukoaraiosis","volume":"2013","author":"Lanza","year":"2013","journal-title":"BioMed Res. Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Fisicaro, F., Lanza, G., Cantone, M., Ferri, R., Pennisi, G., Nicoletti, A., Zappia, M., Bella, R., and Pennisi, M. (2020). Clinical and electrophysiological hints to TMS in de novo patients with Parkinson\u2019s disease and progressive supranuclear palsy. J. Pers. Med., 10.","DOI":"10.3390\/jpm10040274"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"13 Fisicaro, F., Lanza, G., Bella, R., and Pennisi, M. (2020). \u201cSelf-neuroenhancement\u201d: The last frontier of noninvasive brain stimulation?. J. Clin. Neurol., 16, 158\u2013159.","DOI":"10.3988\/jcn.2020.16.1.158"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.brs.2008.06.002","article-title":"State of the art: Pharmacologic effects on cortical excitability measures tested by transcranial magnetic stimulation","volume":"1","author":"Paulus","year":"2008","journal-title":"Brain Stimulat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.clinph.2014.08.028","article-title":"TMS and drugs revisited 2014","volume":"126","author":"Ziemann","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/bs.apha.2018.12.002","article-title":"The neurophysiology of hyperarousal in restless legs syndrome: Hints for a role of glutamate\/GABA","volume":"84","author":"Lanza","year":"2019","journal-title":"Adv. Pharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1212\/WNL.53.7.1606-a","article-title":"Cerebellar ataxia associated with subclinical celiac disease responding to gluten-free diet","volume":"53","author":"Pellecchia","year":"1999","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1212\/WNL.54.6.1350","article-title":"Cortical myoclonus and cerebellar pathology","volume":"54","author":"Tijssen","year":"2000","journal-title":"Neurology"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Pennisi, G., Lanza, G., Giuffrida, S., Vinciguerra, L., Puglisi, V., Cantone, M., Pennisi, M., D\u2019Agate, C.C., Naso, P., and Aprile, G. (2014). Excitability of the motor cortex in de novo patients with celiac disease. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0102790"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bella, R., Lanza, G., Cantone, M., Giuffrida, S., Puglisi, V., Vinciguerra, L., Pennisi, M., Ricceri, R., D\u2019Agate, C.C., and Malaguarnera, G. (2015). Effect of a gluten-free diet on cortical excitability in adults with celiac disease. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129218"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pennisi, M., Lanza, G., Cantone, M., Ricceri, R., Ferri, R., D\u2019Agate, C.C., Pennisi, G., Di Lazzaro, V., and Bella, R. (2017). Cortical involvement in celiac disease before and after long-term gluten-free diet: A transcranial magnetic stimulation study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177560"},{"key":"ref_22","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_23","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.clinph.2020.10.003","article-title":"Safety and recommendations for TMS Use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert guidelines","volume":"132","author":"Rossi","year":"2021","journal-title":"Clin. Neurophysiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0028-3932(71)90067-4","article-title":"The assessment and analysis of handedness: The Edinburgh inventory","volume":"9","author":"Oldfield","year":"1971","journal-title":"Neuropsychologia"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.clinph.2015.02.001","article-title":"Non-Invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic Principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. committee","volume":"126","author":"Rossini","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1152\/jn.00832.2016","article-title":"Physiological processes influencing motor-evoked potential duration with voluntary contraction","volume":"117","author":"Geevasinga","year":"2017","journal-title":"J. Neurophysiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"108950","DOI":"10.1016\/j.jneumeth.2020.108950","article-title":"TMS-induced silent periods: A review of methods and call for consistency","volume":"346","author":"Hupfeld","year":"2020","journal-title":"J. Neurosci. Methods"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1212\/WNL.42.10.1951","article-title":"Magnetic brain stimulation: The silent period after the motor evoked potential","volume":"42","author":"Cantello","year":"1992","journal-title":"Neurology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/0168-5597(91)90011-L","article-title":"Spinal motor neuron excitability during the silent period after cortical stimulation","volume":"81","author":"Fuhr","year":"1991","journal-title":"Electroencephalogr. Clin. Neurophysiol. Potentials Sect."},{"key":"ref_32","first-page":"264","article-title":"Inhibitory phenomena in individual motor units induced by transcranial magnetic stimulation","volume":"97","author":"Classen","year":"1995","journal-title":"Electroencephalogr. Clin. Neurophysiol. Mot. Control"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/BF00229631","article-title":"Effects of diazepam, baclofen and thiopental on the silent period evoked by transcranial magnetic stimulation in humans","volume":"109","author":"Inghilleri","year":"1996","journal-title":"Exp. Brain Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/BF00230207","article-title":"On the origin of the postexcitatory inhibition seen after transcranial magnetic brain stimulation in awake human subjects","volume":"94","author":"Roick","year":"1993","journal-title":"Exp. Brain Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s002210050878","article-title":"Mechanism of the silent period following transcranial magnetic stimulation. evidence from epidural recordings","volume":"128","author":"Chen","year":"1999","journal-title":"Exp. Brain Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1113\/jphysiol.1993.sp019732","article-title":"Silent period evoked by transcranial stimulation of the human cortex and cervicomedullary junction","volume":"466","author":"Inghilleri","year":"1993","journal-title":"J. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/0304-3940(94)90909-1","article-title":"The Silent Period after Transcranial Magnetic Stimulation Is of Exclusive Cortical Origin: Evidence from Isolated Cortical Ischemic Lesions in Man","volume":"180","author":"Schnitzler","year":"1994","journal-title":"Neurosci. Lett."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/(SICI)1097-4598(199809)21:9<1209::AID-MUS15>3.0.CO;2-M","article-title":"Continuous intrathecal baclofen infusions induced a marked increase of the transcranially evoked silent period in a patient with generalized dystonia","volume":"21","author":"Siebner","year":"1998","journal-title":"Muscle Nerve"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/j.1469-7793.1999.0591t.x","article-title":"Differential effects on motorcortical inhibition induced by blockade of GABA uptake in humans","volume":"517","author":"Werhahn","year":"1999","journal-title":"J. Physiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1212\/WNL.41.11.1795","article-title":"Effects of transcranial magnetic stimulation on ipsilateral muscles","volume":"41","author":"Wassermann","year":"1991","journal-title":"Neurology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1113\/jphysiol.1992.sp019243","article-title":"Interhemispheric inhibition of the human motor cortex","volume":"453","author":"Ferbert","year":"1992","journal-title":"J. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1093\/brain\/118.2.429","article-title":"Inhibitory and excitatory interhemispheric transfers between motor cortical areas in normal humans and patients with abnormalities of the corpus callosum","volume":"118","author":"Meyer","year":"1995","journal-title":"Brain"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Faro, A., Giordano, D., Kavasidis, I., Pino, C., Spampinato, C., Cantone, M.G., Lanza, G., and Pennisi, M. (2010, January 27\u201330). An Interactive tool for customizing clinical transacranial magnetic stimulation (TMS) experiments. Proceedings of the XII Mediterranean Conference on Medical and Biological Engineering and Computing 2010, Chalkidiki, Greece.","DOI":"10.1007\/978-3-642-13039-7_50"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1002\/ejsp.2420020412","article-title":"Dealing with a common problem in social science: A simplified rank-biserial coefficient of correlation based on the U statistic","volume":"2","author":"Wendt","year":"1972","journal-title":"Eur. J. Soc. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/S0753-3322(01)80003-2","article-title":"Histopathology of celiac disease","volume":"54","author":"Oberhuber","year":"2000","journal-title":"Biomed. Pharmacother."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s00702-011-0738-y","article-title":"Intra- and Inter-cortical motor excitability in Alzheimer\u2019s disease","volume":"119","author":"Hoeppner","year":"2012","journal-title":"J. Neural Transm."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.pscychresns.2012.04.008","article-title":"Structural and functional cortical disconnection in Alzheimer\u2019s disease: A combined study using diffusion tensor imaging and transcranial magnetic stimulation","volume":"212","author":"Wegrzyn","year":"2013","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.neucli.2011.03.002","article-title":"The relationship between motor cortex excitability and severity of alzheimer\u2019s disease: A transcranial magnetic stimulation study","volume":"41","author":"Khedr","year":"2011","journal-title":"Neurophysiol. Clin. Neurophysiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jns.2006.08.008","article-title":"Ipsilateral silent period: A marker of callosal conduction abnormality in early relapsing-remitting multiple sclerosis?","volume":"250","author":"Jung","year":"2006","journal-title":"J. Neurol. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/B978-0-444-53497-2.00046-2","article-title":"Superficial brain stimulation in multiple sclerosis","volume":"116","author":"Schlaeger","year":"2013","journal-title":"Handb. Clin. Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Llufriu, S., Blanco, Y., Martinez-Heras, E., Casanova-Molla, J., Gabilondo, I., Sepulveda, M., Falcon, C., Berenguer, J., Bargallo, N., and Villoslada, P. (2012). Influence of corpus callosum damage on cognition and physical disability in multiple sclerosis: A multimodal study. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0037167"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/j.1468-1331.2006.01302.x","article-title":"Transcranial magnetic stimulation shows impaired transcallosal inhibition in marchiafava-bignami syndrome","volume":"13","author":"Nardone","year":"2006","journal-title":"Eur. J. Neurol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/apt.12867","article-title":"Editorial: \u201cbrain fog\u201d and coeliac disease\u2014Evidence for its existence: Authors\u2019 reply","volume":"40","author":"Lichtwark","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/jgh.13706","article-title":"Gluten-Induced cognitive impairment (\u201cbrain fog\u201d) in coeliac disease","volume":"32","author":"Yelland","year":"2017","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/01.mcg.0000247995.12087.7b","article-title":"Celiac disease diagnosed in the elderly","volume":"42","author":"Lurie","year":"2008","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_56","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_57","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_58","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.dld.2012.03.008","article-title":"Cognitive performance is impaired in coeliac patients on gluten free diet: A case-control study in patients older than 65 years of age","volume":"44","author":"Casella","year":"2012","journal-title":"Dig. Liver Dis."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Croall, I.D., Tooth, C., Venneri, A., Poyser, C., Sanders, D.S., Hoggard, N., and Hadjivassiliou, M. (2020). Cognitive impairment in coeliac disease with respect to disease duration and gluten-free diet adherence: A pilot study. Nutrients, 12.","DOI":"10.3390\/nu12072028"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1053\/j.gastro.2020.02.028","article-title":"Cognitive deficit and white matter changes in persons with celiac disease: A population-based study","volume":"158","author":"Croall","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"498","DOI":"10.3389\/fnins.2017.00498","article-title":"Neurophysiology of the \u201cceliac brain\u201d: Disentangling gut-brain connections","volume":"11","author":"Pennisi","year":"2017","journal-title":"Front. Neurosci."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Lanza, G., Bella, R., Cantone, M., Pennisi, G., Ferri, R., and Pennisi, M. (2018). Cognitive impairment and celiac disease: Is transcranial magnetic stimulation a trait d\u2019union between gut and brain?. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19082243"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.pneurobio.2007.07.010","article-title":"Clinical neurophysiology of aging brain: From normal aging to neurodegeneration","volume":"83","author":"Rossini","year":"2007","journal-title":"Prog. Neurobiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/j.clinph.2014.07.036","article-title":"Neurophysiological features of motor cortex excitability and plasticity in subcortical ischemic vascular dementia: A TMS mapping study","volume":"126","author":"Guerra","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.clinph.2014.09.001","article-title":"Motor cortex plasticity in subcortical ischemic vascular dementia: What can TMS say?","volume":"126","author":"Pennisi","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Obrenovich, M.E.M. (2018). Leaky gut, Leaky brain?. Microorganisms, 6.","DOI":"10.3390\/microorganisms6040107"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Slim, M., Rico-Villademoros, F., and Calandre, E.P. (2018). Psychiatric comorbidity in children and adults with gluten-related disorders: A narrative review. Nutrients, 10.","DOI":"10.3390\/nu10070875"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1017\/S002966511800277X","article-title":"Identifying and Improving adherence to the gluten-free diet in people with coeliac disease","volume":"78","author":"Muhammad","year":"2019","journal-title":"Proc. Nutr. Soc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jpsychores.2012.11.007","article-title":"Coeliac Disease, diet adherence and depressive symptoms","volume":"74","author":"Giltay","year":"2013","journal-title":"J. Psychosom. Res."},{"key":"ref_70","first-page":"405","article-title":"Transcranial brain stimulation in schizophrenia: Targeting cortical excitability, connectivity and plasticity","volume":"20","author":"Hasan","year":"2013","journal-title":"Curr. Med. Chem."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1016\/j.clinph.2004.03.006","article-title":"TMS and drugs","volume":"115","author":"Ziemann","year":"2004","journal-title":"Clin. Neurophysiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1212\/WNL.49.3.881","article-title":"Effects of phenytoin on cortical excitability in humans","volume":"49","author":"Chen","year":"1997","journal-title":"Neurology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1002\/ana.410400306","article-title":"Effects of antiepileptic drugs on motor cortex excitability in humans: A transcranial magnetic stimulation study","volume":"40","author":"Ziemann","year":"1996","journal-title":"Ann. Neurol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1007\/BF01294721","article-title":"The Glutamate antagonist riluzole suppresses intracortical facilitation","volume":"104","author":"Liepert","year":"1997","journal-title":"J. Neural Transm."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1212\/WNL.51.5.1320","article-title":"Dextromethorphan decreases the excitability of the human motor cortex","volume":"51","author":"Ziemann","year":"1998","journal-title":"Neurology"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S0924-980X(97)00050-7","article-title":"Changes in human motor cortex excitability induced by dopaminergic and anti-dopaminergic drugs","volume":"105","author":"Ziemann","year":"1997","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/0304-3940(93)90464-V","article-title":"Spinal and supraspinal mechanisms contribute to the silent period in the contracting soleus muscle after transcranial magnetic stimulation of human motor cortex","volume":"156","author":"Ziemann","year":"1993","journal-title":"Neurosci. Lett."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1001\/archpsyc.59.4.347","article-title":"Evidence for Impaired cortical inhibition in schizophrenia using transcranial magnetic stimulation","volume":"59","author":"Daskalakis","year":"2002","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.neucli.2020.02.005","article-title":"Global cortical hypoexcitability of the dominant hemisphere in major depressive disorder: A transcranial magnetic stimulation study","volume":"50","author":"Khedr","year":"2020","journal-title":"Neurophysiol. Clin."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1503\/jpn.120003","article-title":"Inhibition of the cortex using transcranial magnetic stimulation in psychiatric populations: Current and future directions","volume":"37","author":"Radhu","year":"2012","journal-title":"J. Psychiatry Neurosci. JPN"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1002\/mus.20727","article-title":"Celiac Disease presenting with motor neuropathy: Effect of gluten free-diet","volume":"35","author":"Rigamonti","year":"2007","journal-title":"Muscle Nerve"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/S0140-6736(10)61163-4","article-title":"Tired legs\u2014A gut diagnosis","volume":"376","author":"Pilato","year":"2010","journal-title":"Lancet Lond. Engl."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:56:30Z","timestamp":1760162190000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,1]]},"references-count":82,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["nu13051530"],"URL":"https:\/\/doi.org\/10.3390\/nu13051530","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,1]]}}}