HUSSAM ABDULLAH A ASSIRI
DOI: https://doi.org/Background: Emerging evidence suggests a potential association between celiac disease (CeD) and attention-deficit/hyperactivity disorder (ADHD), possibly mediated by shared immunological, nutritional, and gut-brain axis mechanisms. However, findings remain inconsistent. This systematic review evaluates the epidemiological links and biological pathways between CeD and ADHD.
Methods: Following PRISMA guidelines, we conducted a comprehensive search of PubMed, Web of Science, Scopus, and ScienceDirect for studies examining CeD-ADHD associations. Two independent reviewers screened records, extracted data, and assessed study quality using standardized tools.
Results: Five studies met inclusion criteria, revealing conflicting evidence. Some clinical studies reported higher ADHD prevalence in CeD patients (up to 22.2%) and symptom improvement with a gluten-free diet (GFD), while others found no significant association. A Mendelian randomization study found no genetic link. Nutritional deficiencies, immune dysregulation, and gut-brain interactions were proposed as potential shared mechanisms, though heterogeneity in study designs and populations limited conclusive interpretations.
Conclusion: Current evidence does not uniformly support a direct CeD-ADHD link but suggests that ADHD-like symptoms in CeD patients may arise from malabsorption, inflammation, or GFD non-compliance. Further large-scale, longitudinal studies are needed to clarify causality and underlying mechanisms. Clinicians should consider case-finding for CeD in ADHD patients with gastrointestinal symptoms.
