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. 2021 May 1;13(5):1530.
doi: 10.3390/nu13051530.

Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients

Francesco Fisicaro  1 , Giuseppe Lanza  2   3 , Carmela Cinzia D'Agate  4 , Raffaele Ferri  3 , Mariagiovanna Cantone  5 , Luca Falzone  6 , Giovanni Pennisi  2 , Rita Bella  7 , Manuela Pennisi  1
Affiliations

Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients

Francesco Fisicaro et al. Nutrients. .

Abstract

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.

Keywords: cortical excitability; executive dysfunction; gamma-amino-butyric acid; gluten-related pathology; transcallosal inhibition; transcranial magnetic stimulation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Correlation between MoCA score and iSP duration in patients with celiac disease. Legend: MoCA = Montreal Cognitive Assessment; iSP = ipsilateral silent period; continuous line: linear regression lines; dashed lines: limits within which 95% of observations are expected.
See this image and copyright information in PMC

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