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Meta-Analysis
. 2018 Oct 6;10(10):1445.
doi: 10.3390/nu10101445.

Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

Panagiotis Zis  1 , Thomas Julian  2 , Marios Hadjivassiliou  3
Affiliations
Meta-Analysis

Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

Panagiotis Zis et al. Nutrients. .

Abstract

Objective: The aim of this systematic review was to explore the relationship between coeliac disease (CD) and headache. The objectives were to establish the prevalence of each entity amongst the other, to explore the role of gluten free diet (GFD), and to describe the imaging findings in those affected by headaches associated with CD.

Methodology: A systematic computer-based literature search was conducted on the PubMed database. Information regarding study type, population size, the age group included, prevalence of CD amongst those with headache and vice versa, imaging results, the nature of headache, and response to GFD.

Results: In total, 40 articles published between 1987 and 2017 qualified for inclusion in this review. The mean pooled prevalence of headache amongst those with CD was 26% (95% CI 19.5⁻33.9%) in adult populations and 18.3% (95% CI 10.4⁻30.2%) in paediatric populations. The headaches are most often migraine-like. In children with idiopathic headache, the prevalence of CD is 2.4% (95% CI 1.5⁻3.7%), whereas data for adult populations is presently unavailable. Brain imaging can be normal, although, cerebral calcifications on CT, white matter abnormalities on MRI and deranged regional cerebral blood flow on SPECT can be present. GFD appears to be an effective management for headache in the context of CD, leading to total resolution of headaches in up to 75% of patients.

Conclusions: There is an increased prevalence of CD amongst idiopathic headache and vice versa. Therefore, patients with headache of unknown origin should be screened for CD, as such patients may symptomatically benefit from a GFD.

Keywords: coeliac disease; gluten free diet; gluten sensitivity; headache; migraine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) chart.
Figure 2
Figure 2
Pooled mean prevalence of headache in adults with coeliac disease.
Figure 3
Figure 3
Meta-analysis results as illustrated in the forest plot regarding the odds of having headache in adults with coeliac disease compared to controls.
Figure 4
Figure 4
Pooled mean prevalence of headache in children with coeliac disease.
Figure 5
Figure 5
Pooled mean prevalence of coeliac disease in children with idiopathic headache.
Figure 6
Figure 6
Pooled mean prevalence of serologically confirmed gluten sensitivity in children with idiopathic migraine.
Figure 7
Figure 7
Meta-analysis results as illustrated in the forest plot regarding the odds of having migraine in children with coeliac disease compared to controls.
See this image and copyright information in PMC

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