Weinstock Leonard B, Afrin Lawrence B, Reiersen Angela M, Brook Jill, Blitshteyn Svetlana, Ehrlich Gillian, Schofield Jill R, Kinsella Laurence, Kaufman David, Dempsey Tania, Molderings Gerhard J
Gastroenterology Department, Gastrointestinal Alliance, 11525 Olde Cabin Road, St. Louis, MO, 63141, USA.
AIM Center for Personalized Medicine, Senior Consultant in Hematology/Oncology, Department of Mast Cell Studies, 3010 Westchester Avenue, Suite 404, Armonk, NY, 10577, USA.
Brain Behav Immun Health. 2025 Jun 30;48:101048. doi: 10.1016/j.bbih.2025.101048. eCollection 2025 Oct.
Neuropsychiatric disorders have been observed in mast cell activation syndrome (MCAS). MCAS is a common, yet rarely diagnosed, inflammatory, and immunologic disease characterized by mast cell dysregulation.
Questionnaires from 553 MCAS and 558 control subjects determined the prevalence and odds ratio of neurologic disorders (fatigue, cognitive dysfunction, fainting/near fainting, migraine-like headaches, muscle pain/tenderness/weakness, pain/numbness/tingling in extremities, restless legs syndrome, seizure-like activity, insomnia, sleep attacks, tinnitus, acoustic startle, Tourette's syndrome, resting tremor, and light/sun/pain/odors/scents/noise hypersensitivity) and psychiatric disorders (anxiety, agoraphobia, panic attacks, depression, bipolar depression, mania/hypomania, psychosis/schizophrenia, hallucinations, obsessive compulsive disorder, attention-deficit/hyperactivity disorder, anger management problems, post-traumatic stress disorder, suicidal thoughts, and eating disorders).
Among 19 neurologic disorders, female MCAS patients reported higher rates in all but 1 disorder and male MCAS patients reported higher rates in all but 2 disorders. Among 14 psychiatric disorders, female MCAS patients reported higher rates in all and male MCAS patients reported higher rates in 8 disorders. Many of the disorders with increased prevalences were statistically greater compared to corresponding controls.In self-reported ratings for effects on health status (0 = no benefit, 10 = maximum benefit), mean (SD) response was 6.3 (2.5) for antihistamines, 5.6 (3.2) for low-dose naltrexone, and 5.6 (3.1) for benzodiazepines.
MCAS subjects have significantly elevated odds ratios for many neuropsychiatric disorders and may see improvement of symptoms using MCAS-targeted therapies, suggesting that mast cell dysregulation affects the brain and peripheral nervous systems and contributes to neuropsychiatric symptoms. Certain mast cell mediators, specific genetic predisposition, and life experiences could determine which disorder is apt to develop or worsen.
在肥大细胞活化综合征（MCAS）中已观察到神经精神障碍。MCAS是一种常见但很少被诊断出来的炎症性和免疫性疾病，其特征是肥大细胞调节异常。
对553名MCAS患者和558名对照者进行问卷调查，以确定神经障碍（疲劳、认知功能障碍、昏厥/接近昏厥、偏头痛样头痛、肌肉疼痛/压痛/无力、四肢疼痛/麻木/刺痛、不宁腿综合征、癫痫样活动、失眠、睡眠发作、耳鸣、听觉惊吓、妥瑞氏综合征、静止性震颤以及对光/阳光/疼痛/气味/香味/噪音过敏）和精神障碍（焦虑、广场恐惧症、惊恐发作、抑郁、双相抑郁、躁狂/轻躁狂、精神病/精神分裂症、幻觉、强迫症、注意力缺陷多动障碍、愤怒管理问题、创伤后应激障碍、自杀念头以及饮食失调）的患病率和比值比。
在19种神经障碍中，除1种障碍外，女性MCAS患者报告的发病率在所有障碍中均较高，男性MCAS患者除2种障碍外，报告的发病率在所有障碍中均较高。在14种精神障碍中，女性MCAS患者报告的发病率在所有障碍中均较高，男性MCAS患者在8种障碍中报告的发病率较高。与相应对照组相比，许多患病率增加的障碍在统计学上具有显著差异。在自我报告的对健康状况影响的评分中（0 = 无益处，10 = 最大益处）,抗组胺药的平均（标准差）反应为6.3（2.5），低剂量纳曲酮为5.6（3.2），苯二氮䓬类药物为5.6（3.1）。
MCAS患者患许多神经精神障碍的比值比显著升高，使用针对MCAS的疗法可能会改善症状，这表明肥大细胞调节异常会影响大脑和周围神经系统，并导致神经精神症状。某些肥大细胞介质、特定的遗传易感性和生活经历可能决定易患哪种疾病或使病情恶化。
