Cognitive effects of mast cell disease

Many mast cell patients have cognitive issues, particularly “brain fog,” short term memory difficulties and decreased auditory processing.  There has been only one study on the prevalence of these symptoms in the community.

Cognitive impairment, specifically problems with memory or attention, was reported by 38% of patients in the study.  Of those who reported concerns, 86% were found to truly have some level of cognitive impairment.  59% of those had moderate impairment.  Severe impairment was rare, found in only three patients. 

All three patients were young women (ages 20, 24 and 34) who had histories of menstrual disorders.  It was thought that perhaps this is an effect of GnRH.  Brain mast cells are known to store and secrete gonadotropin-releasing hormone (GnRH), which has been linked to negative effects on cognition and visual memory in young women. 

Age, education, stage of disease and treatments received had no effect on level of impairment.  Immediate auditory memory and attention impairment was frequent, even in young patients. Delayed auditory and visual memory affected 32% and was almost always found in patients who had immediate auditory or working memory disturbances. 

Importantly, the prevalence of cognitive impairment in mast cell patients was found to have a similar frequency to that in MS, another mast cell mediated disease. 

Mast cells are present in the diencephalon region of the brain, particularly in the hypothalamus, areas associated with emotion and cognition.  They have been linked to anxious-depressive type symptoms in several diseases, including autism, MS and Alzheimer’s, as well as to anxiety behaviors in mice. 

However, cognitive effects were not found to be associated with depression or anxiety.  The hypothesis for this is that only specific mediators released by mast cells cause depressive symptoms, while a broad range of mediators impair cognitive processes.