The effects of systemic mastocytosis (SM) on the skin, bone marrow and gastrointestinal system are relatively well known, but researchers are increasingly recognizing that the rare condition can have a profound influence on the brain, as well.
Brain fog, mood changes and headaches are just some of the ways SM can affect the brain. Here’s a closer look at the connection between SM and the brain to help you better understand your symptoms and how to manage them.
The connection between mastocytosis, inflammation and the brain
SM occurs when the body accumulates too many mast cells, a type of white blood cell that plays a key role in allergic reactions and immune defense. Mast cells are scattered throughout the body, including areas close to the brain and spinal cord.
When mast cells are activated, they release various chemicals called mediators, including histamine, prostaglandins and cytokines, which cause allergic reactions and inflammation. In SM, some of these substances may cross the blood-brain barrier, potentially triggering neuroinflammation.
Brain fog and cognitive symptoms
One of the most commonly reported neurological issues among people with SM is “brain fog.” This is often described as difficulty concentrating, slowed thinking or problems with memory.
Brain fog has been linked to mast cells in the central nervous system. Fatigue and disrupted sleep, which can stem from mast cell mediator release, can further worsen these symptoms.
Learn more about SM signs and symptoms
Mood changes
Mood disorders are also common among people with SM. Studies have found higher rates of depression, anxiety and irritability in those with SM compared to the general population.
While partly a response to living with a chronic, unpredictable illness, these mood shifts also appear to have a biological basis. Histamine and other mast cell mediators are known to alter neurotransmitter activity, including serotonin and dopamine pathways that regulate mood and motivation.
Headaches and neurological pain
Migraines and chronic headaches are also more frequent in people with SM. The release of histamine and prostaglandins can trigger dilation of blood vessels in the brain, potentially leading to migraine development. Additionally, mast cell activity near nerve endings can amplify pain signaling, contributing to neuropathic pain and heightened sensitivity to stimuli such as light, sound or touch.
Managing brain-related symptoms of systemic mastocytosis
Managing the neurological and cognitive symptoms of SM often means making changes to both your medications and lifestyle.
Antihistamines, leukotriene inhibitors and medications targeting mast cell activity can reduce mediator release and, in turn, lessen brain-related effects. Lifestyle strategies, such as regular sleep, stress reduction techniques and exercise, can also help improve symptoms. Finally, working with a comprehensive care team, including neurologists, psychiatrists or psychologists alongside hematologists can help you find ways to improve quality of life.
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