Celiac disease as a model of gut–brain autoimmunity: from gluten exposure to neuropsychiatric manifestations
By
Valentina Pucinischi
Martina Piersanti
Giovanni Di Nardo
Matteo Guarino
Umberto Volta
Roberto De Giorgio
Renata Auricchio
Alessandro Ferretti
Pasquale Parisi
Maurizio Mennini
May 14, 2026
Clinical Scorecard: Celiac Disease: Exploring Gut-Brain Autoimmunity from Gluten Intake to Neuropsychiatric Symptoms
At a Glance
Category Detail
Condition Celiac Disease (CeD) Key Mechanisms Autoimmune responses, blood-brain barrier dysfunction, gut dysbiosis, neuroinflammation, micronutrient deficiencies. Target Population Genetically predisposed individuals, both pediatric and adult populations. Care Setting Multidisciplinary clinical settings.
Key Highlights
Celiac disease is associated with a wide range of neurological and psychiatric manifestations. Neurological symptoms include cerebellar ataxia, peripheral neuropathy, and cognitive dysfunction. Psychiatric manifestations include depression, anxiety, and ADHD. Some patients may experience persistent symptoms despite adherence to a gluten-free diet. Early identification and strict dietary monitoring are crucial for preventing irreversible neurological damage. Guideline-Based Recommendations
Diagnosis
Utilize serological tests for tissue transglutaminase antibodies. Consider intestinal biopsy for definitive diagnosis. Management
Implement a strict gluten-free diet (GFD). Multidisciplinary management approach is recommended. Monitoring & Follow-up
Regular follow-up to assess dietary adherence and symptom resolution. Monitor for potential nutrient deficiencies. Risks
Risk of irreversible neurological damage if not managed appropriately. Potential for persistent neuropsychiatric symptoms despite GFD. Patient & Prescribing Data
Individuals with celiac disease, particularly those with neurological or psychiatric symptoms.
Strict adherence to a gluten-free diet can lead to symptom improvement, but some patients may not fully recover.
Clinical Best Practices
Early diagnosis and intervention are essential. Educate patients about the importance of a gluten-free diet. Monitor for and address any neurological or psychiatric symptoms. Related Resources & Content
