Materiały źródłowe

• #1 Cognitive changes after chemo | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/cognitive-changes-after-chemo/?pg=2

  Chemo brain or brain fog is real! I’m thankful my oncologist & nurse brought this to me & my husband’s attention during our education session before starting chemo. It is still frustrating to deal with. I’m seeing a light at the end of the tunnel for treatment for breast cancer (Invasive Lobular Carcinoma) but sounds like it takes quite some time to get back to normal. […] While the causative mechanism is yet unclear, it most probably is related to neuroinflammation. […] Many people have feel it’s as if they’ve suddenly developed Alzheimer’s. They find it difficult to carry-on conversations with spouses family members and friends as they can not find the words, have difficulty following conversations or are forgetful of what they were talking about.

• #1 Chemobrain in Cancer Treatment: Mechanisms and Its Prevention | SpringerLink

  https://link.springer.com/10.1007/978-3-030-80962-1_352-1

  Therapeutic use of chemotherapy has led to a significant increase in the number of cancer survivors worldwide. […] Chemotherapy often causes symptoms of cognitive decline as characterized by the impairment of verbal memory, executive function, visuospatial functioning, and short-term memory. […] Despite the attention focused on chemobrain over the past few decades, the biological understanding regarding the proposed molecular pathogenesis of chemobrain remains fragmentary. Understanding the mechanisms underlying the development of chemobrain would assist the prevention or treatment of the adverse effects of chemotherapy on brain function. […] This review comprehensively compiles the existing candidate mechanisms of chemobrain observed in animal studies with an attempt to gain mechanistic insight into the condition. […] In addition to considering biological pathways, we also summarize promising therapeutic strategies to alleviate symptoms of chemobrain which have already been proven to provide effective neuroprotection in chemobrain models.

• #1 “Chemo Brain” and Alzheimer’s Risk | Cognitive Vitality | Alzheimer’s Drug Discovery Foundation

  https://www.alzdiscovery.org/cognitive-vitality/blog/chemo-brain-and-alzheimers-risk

  Up to 70 percent of cancer patients experience cognitive impairment, including diminished memory, reasoning, and multitasking ability. The condition is commonly called chemo brain or chemo fog, even though chemotherapy is unlikely the sole cause of these cognitive problems. The duration of chemo brain can vary from a few weeks to several years. […] More studies are needed to determine the long-term relationships among cancer, cancer treatments, and cognitive dysfunction. Clinical trials are underway to test whether docosahexaenoic acid (DHA) or nicotine patches may prevent or reduce cognitive dysfunction in patients receiving chemotherapy.

• #1 Plausible Biochemical Mechanisms of Chemotherapy-induced Cognitive Impairment (“Chemobrain”), a Condition That Significantly Impairs the Quality of Life of Many Cancer Survivors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6502692/

  Increasing numbers of cancer patients survive and live longer than five years after therapy, but very often side effects of cancer treatment arise at same time. One of the side effects, chemotherapy-induced cognitive impairment (CICI), also called chemobrain or chemofog by patients, brings enormous challenges to cancer survivors following successful chemotherapeutic treatment. […] The molecular mechanisms of CICI involves very complicated processes, which have been the subject of investigation over the past decades. Many mechanistic candidates have been studied including disruption of the blood-brain barrier (BBB), DNA damage, telomere shortening, oxidative stress and associated inflammatory response, gene polymorphism of neural repair, altered neurotransmission, and hormone changes. […] Oxidative stress is considered as a vital mechanism, since over 50% of FDA-approved anti-cancer drugs can generate reactive oxygen species (ROS) or reactive nitrogen species (RNS), which lead to neuronal death.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20230228/Microglia-may-be-the-culprit-behind-concentration-and-memory-problems-after-chemotherapy.aspx

  Immune cells that keep the brain free of debris but also contribute to inflammation are the likely culprits behind the concentration and memory problems that sometimes follow one type of chemotherapy, a new study in mice suggests. […] Researchers previously showed that female mice given paclitaxel, a drug commonly used to treat breast, ovarian and other cancers, developed memory problems that were linked to inflammation in the brain. […] „That was the peak of the paper: We demonstrated that microglia were necessary for the cognitive impairments we’ve seen with paclitaxel the behavior was reversed,” said senior author Leah Pyter, an investigator in the Institute for Behavioral Medicine Research at The Ohio State University. […] „So we think that when microglia are activated and become pro-inflammatory, that’s what is ultimately affecting neurons to impair memory.”

• #1 Cellular mechanisms and treatments for chemobrain: insight from aging and neurodegenerative diseases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7278555/

  Fourth, the postmitotic brain accounts for ~ 2% of the bodyweight, but consumes ~ 20% of glucosederived energy, resulting in a high production of reactive oxygen species (ROS)a major source of DNA damage. […] In addition, chemotherapeutic drugs may also have offtarget effects independent of their anticancer mechanisms. […] We propose that focusing on the cellular consequences is currently the most feasible approach for the development of treatments and preventions for chemobrain. […] Reduced neurogenesis is a common factor in aging and neurodegenerative diseases. […] Because memory problems are common symptoms of chemobrain, it is not surprising that reduced neurogenesis is the most commonly studied mechanism for chemobrain. […] Supporting these observations, several studies reported that oligodendrocyte precursor cells (OPCs) and nondividing mature oligodendrocytes are especially vulnerable to chemotherapy as compared to neurons and astrocytes.

• #1 Cellular mechanisms and treatments for chemobrain: insight from aging and neurodegenerative diseases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7278555/

  Although several studies focus on diminished cell division, other intrinsic properties of the adult brain likely contribute to its vulnerability to chemotherapy. […] First, chemotherapeutics drugs, especially the DNAtargeting agents, can cause DNA damage in postmitotic neurons, which accelerates senescence and eventual cell death. […] The postmitotic brain also exhibits diminished DNA repair capacity. […] Thus, the accumulation of DNA damage caused by chemotherapy can accelerate neuronal dysfunction and death. […] Second, many chemotherapeutic drugs target the microtubule network critical for segregating chromosomes during mitosis. […] Third, nonneuronal cells, including astrocytes, oligodendrocytes, and microglia, play essential roles in maintaining the health and normal functions of the CNS.

• #1 Cellular mechanisms and treatments for chemobrain: insight from aging and neurodegenerative diseases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7278555/

  The involvement of glial cells, either hypoactivation or hyperactivation, requires more investigation. […] There is a common consensus that chronic neuroinflammation is responsible for maintaining longterm cognitive dysfunctions in aging and neurodegenerative diseases. […] Elevated peripheral cytokines were also observed in cancer survivors receiving various regimens of chemotherapeutic drugs. […] Despite significant advances in our understanding of chemobrain, both at the clinical level and at the cellularmolecular basis, several challenges persist. […] With sufficient knowledge of the consequence of chemotherapy at all levelsmolecular, cellular, and behavioralbetter prevention or treatment options can be developed.

• #1

  https://www.healio.com/news/hematology-oncology/20200518/chemo-brain-an-imprecise-term-for-a-complex-phenomenon

  The thought was that chemo brain couldn’t be real because many drugs don’t readily get into the brain, so how could that be causing cognitive issues? […] What the research has shown over the past 10 years is that although the drugs may not readily cross the blood-brain barrier, the inflammatory cytokines that our body produces in response to the chemotherapy interleukin-1, interleukin-6, tumor necrosis factor-alpha and others can cross the blood-brain barrier, and we know they can be neurotoxic. […] Certain demographic characteristics place some individuals at higher risk [for] impairment. […] We found older age, male gender, low education, low income levels and most importantly an individual’s cognitive reserve to be important predictors of cognitive outcomes [after] transplant. […] Genetics also could play a role in predicting which patients will be most affected by cognitive symptoms after HSCT.

• #1

  https://sussex.figshare.com/articles/journal_contribution/A_feasibility_study_exploring_the_role_of_pre-operative_assessment_when_examining_the_mechanism_of_chemo-brain_in_breast_cancer_patients/23428580

  Women receiving chemotherapy treatment for breast cancer may experience problems with their memory and attention (cognition), which is distressing and interferes with quality of life. […] Research shows however, that approximately a third of women with breast cancer perform poorly on tests of cognition before commencing chemotherapy. […] We aimed to examine the acceptability and relevance of pre-surgical assessments (bloods, brain imaging, cognitive tests and self-report questionnaires) when investigating the phenomenon of chemo-brain and investigate whether inflammatory markers mediate chemotherapy-induced neuropsychological impairments in women treated for breast cancer. […] Increases in soluble tumour necrosis factor receptor II (sTNFRII), interleukin-6, interleukin-10 and vascular endothelial growth factor occurred post chemotherapy only. […] The preliminary results support the hypothesis that chemotherapy induced fatigue is mediated by a change in peripheral cytokine levels which could explain some symptoms of chemo brain experienced by patients.

• #1 Chemo brain: myth or clinical reality? Literature review and clinical case – Yakhin – Neurology Bulletin

  https://journals.eco-vector.com/1027-4898/article/view/635304

  Cognitive impairment associated with chemotherapy develops through several potential mechanisms including damage to the bloodbrain barrier, increased oxidative stress and inflammation in the brain, and impaired neurogenesis, each leading to neuronal dysfunction. […] Other potential mechanisms have been suggested, including inhibition of hippocampal neurogenesis and direct neuronal damage, as well as activation of secondary glial cells, i.e. microglia and astrocytes, production of proinflammatory cytokines, and defects in myelin-producing cells (oligodendrocyte lineage). […] A model of abnormalities in the brain default mode network as a potential biomarker of chemotherapy-induced damage is of interest. […] Changes in brain activity (signals, cerebral blood flow) in patients with cancer have been observed in all functional networks, including prefrontal, parietal, occipital, temporal, and cerebellar regions.

• #1 Plausible Biochemical Mechanisms of Chemotherapy-induced Cognitive Impairment (“Chemobrain”), a Condition That Significantly Impairs the Quality of Life of Many Cancer Survivors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6502692/

  The candidate mechanisms are shown in Fig. 1. In this current review paper, we summarize recent important candidate mechanisms of CICI mentioned above, especially cytokines and oxidative stress. […] Some commonly used chemotherapeutic agents lead to significantly increased cell death and decreased cell division in multiple areas in brain of mice. […] Dysfunction of the BBB has been recognized in several neurological disorders and many neurodegenerative diseases, including Parkinson disease (PD) and Alzheimer disease (AD), both with associated pro-inflammatory states. […] Fully 50% of FDA-approved anti-cancer drugs are ROS-generating agents, and ROS can compromise the BBB by triggering several pathways, including oxidative stress. […] Oxidative stress and correlated mitochondrial damage often occur in cancer patients or survivors after treatment of chemotherapeutic agents and are considered as one of main candidate mechanisms of CICI.

• #1 Post-chemotherapy cognitive impairment – Wikipedia

  https://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment

  Research has revealed that neural progenitor cells are particularly vulnerable to the cytotoxic effects of chemotherapy agents. […] Due to the critical role the hippocampus plays in memory, it has been the focus of various studies involving post-chemotherapy cognitive impairment. […] This evidence suggests that chemotherapy agent toxicity to cells in the hippocampus may be partially responsible for the memory declines experienced by some patients. […] Deficits in visuo-spatial, visual-motor, and visual memory functions are among the symptoms seen in post-chemotherapy patients. […] While estrogen hormone supplementation may reverse the symptoms of PCCI in women treated for breast cancer, this carries health risks, including possibly promoting the proliferation of estrogen-responsive breast cancer cells.

• #1 Low-doses of cisplatin injure hippocampal synapses: A mechanism for ‘chemo’ brain?

  https://escholarship.org/uc/item/55w7s7qb

  Low-doses of cisplatin injure hippocampal synapses: A mechanism for chemo brain? […] Chemotherapy-related cognitive deficits are a major neurological problem, but the underlying mechanisms are unclear. […] Here we report that exposure to low concentrations of cisplatin (0.1M) causes the loss of dendritic spines and synapses within 30min. […] Longer exposures injured dendritic branches and reduced dendritic complexity. […] At this low concentration, cisplatin did not affect NSC viability nor provoke apoptosis. […] However, higher cisplatin levels (1M) led to the rapid loss of synapses and dendritic disintegration, and neuronal-but not NSC-apoptosis. […] In-vivo treatment with cisplatin at clinically relevant doses also caused a reduction of dendritic branches and decreased spine density in CA1 and CA3 hippocampal neurons.

• #1 Low-doses of cisplatin injure hippocampal synapses: A mechanism for ‘chemo’ brain?

  https://escholarship.org/uc/item/55w7s7qb

  The density of dendritic spines is related to the degree of neuronal connectivity and function, and pathological changes in spine number or structure have significant consequences for brain function. […] Therefore, this synapse and dendritic damage might contribute to the cognitive impairment observed after cisplatin treatment.

• #1 A noninvasive treatment for “chemo brain” – ecancer

  https://ecancer.org/en/news/24368-a-noninvasive-treatment-for-chemo-brain

  Patients undergoing chemotherapy often experience cognitive effects such as memory impairment and difficulty concentrating a condition commonly known as chemo brain. […] MIT researchers have now shown that a noninvasive treatment that stimulates gamma frequency brain waves may hold promise for treating chemo brain. […] Research has shown that these drugs can induce inflammation in the brain, as well as other detrimental effects such as loss of white matter the networks of nerve fibres that help different parts of the brain communicate with each other. […] Chemo brain caught our attention because it is extremely common, and there is quite a lot of research on what the brain is like following chemotherapy treatment, Tsai says. […] I think this is a very fundamental mechanism to improve myelination and to promote the integrity of oligodendrocytes. It seems that its not specific to the agent that induces demyelination, be it chemotherapy or another source of demyelination, Tsai says.

• #1 Chemo brain: myth or clinical reality? Literature review and clinical case – Yakhin – Neurology Bulletin

  https://journals.eco-vector.com/1027-4898/article/view/635304

  In addition to changes in brain activity, neuroimaging methods reveal decreased gray matter density in frontal, parietal, and temporal regions, and diffusion-weighted MRI data suggest decreased white matter integrity affecting the superior longitudinal fasciculus, corpus callosum, great forceps, and corona radiata, as well as altered structural connectivity throughout the brain network. […] One study demonstrated evidence of a dramatic reduction in cortical thickness, along with an acceleration of predicted brain age from before treatment and 1 month after chemotherapy in breast cancer patients compared to controls. […] These results suggest that accelerated aging is one of the underlying mechanisms of chemo brain. […] Notably, cancer survivors diagnosed with chemo brain tend to have a negative correlation of symptoms with time after treatment, suggesting that some recovery does occur. […] Nevertheless, deficits can be detected up to 10 years after treatment, suggesting permanent cognitive deficits in some of the cases.

• #1 Mechanisms and Treatment for Cancer- and Chemotherapy-Related Cognitive Impairment in Survivors of Non-CNS Malignancies

  https://www.cancernetwork.com/view/cog-impairment

  Several clinical studies in breast cancer survivors have shown an association between proinflammatory cytokines and CRCI. […] Chemotherapy may impair metabolic and cellular function of the brain through direct cytotoxic damage to neurons and other cells. […] Recent evidence suggests that chemotherapy-induced damage impedes metabolic function and energy utilization of brain cells, as opposed to causing the death of brain cells. […] Some have suggested that the HPA axis contributes to CRCI, but few studies have directly examined the validity of this statement. […] Several genetic variabilities have been associated with CRCI. Apolipoprotein E (ApoE) plays a role in lipid metabolism and is implicated in Alzheimer’s disease. […] There is limited evidence on the involvement of genetic associations in CRCI, and more research is required.

• #1 Mechanism Underpinning

  https://www.genengnews.com/news/mechanism-underpinning-chemo-brain-identified-points-to-existing-drug-as-potential-therapy/

  The team reported on its findings in Journal of Clinical Investigation, in a paper titled “Sphingosine-1-phosphate receptor 1 activation in the central nervous system drives cisplatin-induced cognitive impairment,” in which they concluded, “Collectively, our results identify the molecular mechanisms engaged by the S1P/S1PR1 axis in CRCI and establish S1PR1 antagonism as an approach to target CRCI with therapeutics that have fast-track clinical application.” […] However, the authors continued, “Our current understanding of the mechanisms underlying CRCI and their impact on cognition is limited, due to the multifactorial origins of CRCI.” […] Through this newly reported research the team found that in the central nervous system, cisplatin increases levels of S1P, which contributes to the development of CRCI through activation of S1PR1 on astrocytes and S1PR1-driven mitochondrial dysfunction and neuroinflammatory processes.

• #1 Fat Molecule in Brain Linked to Chemo Brain – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2022/chemo-brain-prevention-s1p

  A significant number of patients who undergo cisplatin treatment are affected by persistent cognitive impairment. […] The researchers then analyzed areas of the mouse brains that are important for cognition. As in their pain studies, the researchers found that levels of S1P had increased in these areas after cisplatin treatment, which caused other brain changes, including inflammation, that have been linked to cognitive impairment. […] This new study shows the damage cisplatin does and how the S1PR1-targeted drugs can potentially reduce that damage. […] But it’s unclear how well cognitive function assessments in mice mirror the cognitive decline in people that results from the cisplatin chemotherapy. […] We want to look at not only if can we prevent cognitive impairment [in people with cancer], but if we can treat and improve it.

• #1 Mechanism Underpinning

  https://www.genengnews.com/news/mechanism-underpinning-chemo-brain-identified-points-to-existing-drug-as-potential-therapy/

  The studies also revealed that mechanistically, cisplatin-induced S1P formation is mediated by the toll-like receptor 4. […] “We believe this is the first study implicating TLR4 activation as a causal mechanism for CRCI,” they noted. […] “Our studies provide evidence that TLR4 activation in the brain is the linchpin in cisplatin-induced S1P formation, S1P-mediated S1PR1 activation, and cognitive deficits.” […] The findings bridge some gaps in scientists’ understanding about the molecular mechanisms underlying CRCI, and identify a novel target for therapeutic intervention with functional S1PR1 antagonists. […] Importantly, S1PR1 antagonists do not interfere with the efficacy of chemotherapy, as the team, and others, have shown in previous work, and can also block tumor cell growth, inflammation and metastasis. […] They further concluded in their paper, “Building on a compelling preclinical platform, future clinical trials are needed to assess the anticancer effects of S1PR1 antagonists given alone or in combination with chemotherapy.”

• #1 Mind jumble: Understanding chemo brain

  https://medicalxpress.com/news/2020-05-mind-jumble-chemo-brain.html

  There is no cure, though some medications may help minimize symptoms, said Monje, who advises patients to consult with a neurologist familiar with the condition. […] For the past two decades, Monje has studied cancer therapy-related cognitive impairment along with a small community of neuroscientists across the country who are excavating the biology that underlies the disorder. […] Two of the major cancer treatments, radiation and chemotherapy, can lead to cognitive difficulties, though the impacts of cranial radiation tend to be more severe and to progress more rapidly. […] Scientists have recognized the effects of radiation on the brain for decades, but they have only recently begun to appreciate the true impact of chemotherapy on the brain. […] Monje’s latest studies, published in 2018 in Cell and last year in Neuron, have uncovered a cascade of cellular events caused by the common chemotherapy drug methotrexate that can disrupt brain function and cognitive abilities.

• #1 In ‘chemo brain,’ researchers see clues to unravel long Covid’s brain fog

  https://www.statnews.com/2022/01/28/long-covid-brain-fog-chemo-brain/

  Stanford neuro-oncologist Michelle Monje is studying the link between „chemo brain” and long Covid’s brain fog. […] Monje set out to analyze chemo brain and long Covid brain fog, her starting point was neuroinflammation and the cognitive impairment it causes. […] I worried back in the spring of 2020 that we would perhaps see a syndrome very similar to what we see after cancer therapy, that we might start to see a cognitive syndrome characterized by things like impairment in memory, executive function, attention, speed of information processing, multitasking, Monje told STAT. […] She knew the commonly used cancer drug methotrexate directly stimulates certain microglia in the brains white matter that then turn cells called astrocytes neurotoxic. […] Monje set out to understand if a similar physiological process might be at play in long Covid brain fog, and if it might be a potentially reversible one.

• #1 How Your Gut Plays a Role in ‘Chemo Brain’ Symptoms

  https://www.cancercenter.com/community/blog/2022/05/microbiota-and-the-brain

  For cancer patients, chemotherapy treatments may be altering the body’s normal balance of bacteria in ways that produce the forgetfulness known as chemo brain or chemo fog. […] The review suggests that the gut microbiome may influence brain function through short-chain fatty acids (SCFAs), which are produced by beneficial bacteria when fiber is fermented in the colon. […] Human studies have been insufficient to support the connection between the gut microbiome and chemo brain, Dr. Vashi says, adding, It’s too early to say that, but there are some animal studies that suggest that. […] For example, a 2021 study on mice showed chemotherapy may lead to dysbiosis, a disruption and imbalance of gut flora, which was associated with cognitive impairment, anxiety, and mood disorders.

• #1 Pharmacological rescue of cognitive function in a mouse model of chemobrain | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-021-00463-2

  After chemotherapy, many cancer survivors suffer from long-lasting cognitive impairment, colloquially known as chemobrain. However, the trajectories of cognitive changes and the underlying mechanisms remain unclear. […] We establish the InsP3R calcium pathway and impaired neuronal morphology as mechanisms for paclitaxel-induced cognitive impairment. Our findings suggest lithium and PKC inhibitors as candidate agents for preventing chemotherapy-induced cognitive impairment. […] We observed a reduction in dendritic complexity and length in the hippocampus and cortex of mice treated with paclitaxel, which we hypothesize to be the cellular mechanism for the memory deficits observed in these mice. The upregulation of PKC acutely in the hippocampus and the cortex, which persists chronically in the cortex, may provide the underlying molecular mechanism for this observation.

• #1 The Mystery of Chemotherapy Brain: Kynurenines, Tubulin and Biophoton Release | Anticancer Research

  https://ar.iiarjournals.org/content/40/3/1189

  Cytokines have been shown to cause damage to the brain and other tissues in multiple ways. […] Unlike most chemotherapies, cytokines can freely cross the blood brain barrier. […] ROS have also been postulated by many to be causally involved in chemo brain. […] Anthracyclines like doxorubicin have been shown to result in the production of extremely high levels of ROS. […] Both mitochondria in the cytoskeleton and closely-associated microtubules have a much higher refractive index than surrounding tissues, and these systems can act like optical waveguides. […] It is notable that increased biophoton release can alter the orientation of microtubules. […] There is much evidence that microtubules are key to neurocognitive development, and abnormalities of microtubules are linked to deficiencies in cognition and memory.

• #1 UCF Researcher Tackles ‘Chemo Brain’ – College of Medicine

  https://med.ucf.edu/news/ucf-researcher-tackles-chemo-brain/

  Brain fog, difficulty concentrating and forgetfulness are common complaints among many cancer patients who have undergone chemotherapy. […] the connection between cancer treatment and cognitive function has remained unclear until now. […] Dr. Singla theorizes that inflammation induced by exposure to Doxorubicin causes chemo brain and later in life may cause Alzheimers disease and dementia in cancer patients treated with the drug. […] This is caused by various neurochemical alterations, oxidative stress and abnormalities in the brain which is linked to cell death and dysfunction. […] He found that exposure to the treatment caused a tangling of neurons, vacuoles or holes in brain cells and the presence of Hirano bodies proteins usually found in the nerve cells of Alzheimers patients. […] We also observed a significant decrease in brain weight and size, suggesting atrophy or shrinkage in the brain, Dr. Singla added. […] Knowing the mechanisms of how Doxorubicin affects the brain will help researchers to develop therapies to prevent or even reverse chemo brain.

• #1 Doxorubicin-induced elevated oxidative stress and neurochemical alterations in brain and cognitive decline: protection by MESNA and insights into mechanisms… | Oncotarget

  https://www.oncotarget.com/article/25718/text/

  Dox-treatment severely impaired the activity of both PC-PLD and PLD in brain of the mouse model of chemotherapy used in this study. […] The decrease in activity of these two enzymes may, in part, explain the changes in the Cho signal seen on hippocampal H1-MRS. […] These studies form the basis of additional investigations to gain insights into CICI.

• #1 Chemo brain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chemo-brain/symptoms-causes/syc-20351060

  Chemo brain is a widely used term because this condition was first reported in people having chemotherapy treatments. But experts don’t fully know the causes of these concentration and memory changes. There’s likely more than one cause. […] There are many causes of changes in memory and thinking in people with cancer. These chemo brain symptoms can be caused by the cancer, treatment for the cancer, complications of cancer treatment and other things. […] Cancer-related causes may include: The stress of a cancer diagnosis, which can cause worry and distress. These can add to issues with memory and thinking. […] Some people may be more likely to get chemo brain based on genetic makeup. […] Factors that may increase the risk of chemo brain and memory changes in people with cancer include: Brain cancer. […] Some people with chemo brain have thinking and memory changes that affect their ability to work.

• #1 Insights into the mechanism of ‘chemobrain’: deriving a multi-factorial model of pathogenesis – Australian Medical Student Journal

  https://www.amsj.org/archives/4274

  Cognitive outcomes in patients undergoing chemotherapy appear to be affected by treatment characteristics. […] The duration and type of regimen were also implicated as possible treatment factors. […] Individual cognitive characteristics […] Cognitive decline prior to treatment can contribute indirectly to chemobrain by establishing a lower baseline cognitive function. […] Genetic susceptibility […] The apoliprotein E (APOE) and catechol-o-methyltransferase (COMT) genes are involved in neural repair and neurotransmission. […] The fact that cognitive impairment has been shown in diverse types of cancer (breast, CNS, and lymphoma) and even in the presence of the protective blood-brain barrier (BBB), suggests that direct neurotoxicity of chemotherapeutic agents is only partially responsible for chemobrain.

• #1 Insights into the mechanism of ‘chemobrain’: deriving a multi-factorial model of pathogenesis – Australian Medical Student Journal

  https://www.amsj.org/archives/4274

  Cytokine imbalance may also be involved in cognitive decline. […] It is believed that a reduction in hormones such as oestrogen and testosterone is associated with cognitive decline. […] Despite all the research so far, there is still no consensus on how chemobrain develops. […] Chemotherapeutic drugs such as Adriamycin are also known to increase production of reactive oxygen species (ROS) and contribute to reduced anti-oxidant capacity. […] Based on these observations, it is conceivable that oxidative DNA damage and telomere shortening could form the basis of a model of CNS dysfunction to explain chemobrain. […] By extrapolation, other pro-inflammatory cytokines such as IL-6 may play similar roles and different chemotherapeutic agents could induce distinct cytokine profiles with varying CNS effects.

• #1 Post-chemotherapy cognitive impairment – Wikipedia

  https://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment

  Post-chemotherapy cognitive impairment (PCCI) (also known in the scientific community as „CRCIs or Chemotherapy-Related Cognitive Impairments” and in lay terms as chemotherapy-induced cognitive dysfunction or impairment, chemo brain, or chemo fog) describes the cognitive impairment that can result from chemotherapy treatment. […] Although the causes and existence of post-chemotherapy cognitive impairment have been a subject of debate, recent studies have confirmed that post-chemotherapy cognitive impairment is a real, measurable side effect of chemotherapy that appears in some patients. […] PCCI is complex and factors other than the chemotherapeutic agents may impact cognitive functioning. […] The importance of hormones, particularly estrogen, on cognitive function is underscored by the presence of cognitive impairment in breast cancer patients before chemotherapy is begun, the similarity of the cognitive impairments to several menopausal symptoms, the increased rate of PCCI in pre-menopausal women, and the fact that the symptoms can frequently be reversed by taking estrogen.

• #1 Chemo Brain and Cognitive Dysfunction | Pacific Neuroscience Institute

  https://www.pacificneuroscienceinstitute.org/blog/brain-tumor/chemobrain-cognitive-dysfunction/

  Radiation therapy has been reported to induce cognitive dysfunction through functional and structural effects on the brain. […] Surgery and anesthesia have also been linked to cancer-related cognitive dysfunction, with evidence pointing to inflammatory and immune responses as the mechanism behind the changes. […] Genetic predisposition has also been implicated as certain genes have been found to play a role in the cognitive decline of individuals receiving chemotherapy. […] In addition to causal relationships between treatment-related risk factors and cognitive dysfunction, patient-related risk factors have also been reported to have an effect on cognition and memory. […] A higher risk of cancer-related cognitive dysfunction has been documented in individuals who have baseline cognitive impairment prior to receiving systemic therapy.

• #1 Managing Chemo Brain in Pediatric Survivors of Childhood Cancer – Oncology Nurse Advisor

  https://www.oncologynurseadvisor.com/features/managing-chemo-brain-in-pediatric-survivors-of-childhood-cancer/

  Cancer-associated cognitive impairment, commonly known as chemo brain, is an adverse effect of cancer and its treatment that survivors experience to varying degrees. […] Chemotherapy was thought to be the only cause of chemo brain, but research suggests that several types of cancer treatment, and even the cancer diagnosis itself, can cause these impairments. […] Children with cancer diagnosed at a young age appear to experience more chemo brain complications than any other patient group. […] Chemo brain may not become apparent immediately.

• #1 Chemo Brain and Cognitive Dysfunction | Pacific Neuroscience Institute

  https://www.pacificneuroscienceinstitute.org/blog/brain-tumor/chemobrain-cognitive-dysfunction/

  Likewise, mood disorders (e.g., anxiety and depression) have been associated with subjective and objective measures of cognitive function. […] Finally, endocrine factors, including the use of hormonal therapy and menopausal symptoms, have been linked to higher rates of cancer-related cognitive dysfunction. […] The data are clear, cancer-related cognitive dysfunction is real. They also suggest that cognitive dysfunction observed in a subset of patients receiving treatment for cancer is often mild and reversible. […] Chemo brain, marked by memory issues and brain fog, is often reversible.

• #1

  https://www.healio.com/news/hematology-oncology/20120510/chemo-brain-linked-to-neurobiological-mechanism

  Other factors such as fatigue and secondary medical conditions could negatively influence cognitive function. […] Diagnosing cognitive dysfunction is difficult because the standard neurological tests available are not sensitive enough to detect the cognitive changes. […] There currently are no reliable pharmacologic treatments for cancer therapy-induced cognitive impairment. […] The narcolepsy treatment modafinil (Provigil, Cephalon) appears promising, but there have been no large randomized clinical trials demonstrating its effectiveness, Wagner said. […] Currently, the most exciting research is being conducted on nondrug strategies such as cognitive behavioral therapy, Wagner said. […] There is a neurobiological mechanism that is associated with the complaints patients have.

• #1

  https://www.healio.com/news/hematology-oncology/20120510/chemo-brain-linked-to-neurobiological-mechanism

  The results showed that women with breast cancer who were treated with chemotherapy had significantly reduced function in the prefrontal cortex, the area of the brain responsible for skills such as problem-solving, working memory and multitasking. […] Additionally, the chemotherapy group showed more perseverative errors and reduced processing speed. There was a significant correlation between reduced left caudal lateral prefrontal cortex activation and higher disease severity and increased subjective executive dysfunction in the women treated with chemotherapy. […] This was a study focused on breast cancer, but there is some evidence that other cancers that are treated with chemotherapy may be at risk for similar problems. […] After treatment, the chemotherapy group had significantly worse scores on tests of attention, psychomotor speed and memory. In addition, they had significant decreases of white matter fractional anisotropy a DTI measure that indicates white matter tissue organization in frontal, parietal and occipital white matter tracts after treatment.

• #1 A noninvasive treatment for “chemo brain” | MIT News | Massachusetts Institute of Technology

  https://news.mit.edu/2024/noninvasive-treatment-chemo-brain-0306

  Stimulating gamma brain waves may protect cancer patients from memory impairment and other cognitive effects of chemotherapy. […] MIT researchers have now shown that a noninvasive treatment that stimulates gamma frequency brain waves may hold promise for treating chemo brain. In a study of mice, they found that daily exposure to light and sound with a frequency of 40 hertz protected brain cells from chemotherapy-induced damage. The treatment also helped to prevent memory loss and impairment of other cognitive functions. […] Using single-cell RNA sequencing, the researchers analyzed the gene expression changes that occurred in mice that received the gamma treatment. They found that in those mice, inflammation-linked genes and genes that trigger cell death were suppressed, especially in oligodendrocytes, the cells responsible for producing myelin. […] I think this is a very fundamental mechanism to improve myelination and to promote the integrity of oligodendrocytes. It seems that its not specific to the agent that induces demyelination, be it chemotherapy or another source of demyelination, Tsai says.

• #1 Fat Molecule in Brain Linked to Chemo Brain – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2022/chemo-brain-prevention-s1p

  Also referred to as cancer-related cognitive impairment, chemo brain can be marked by severe memory problems, a lack of mental sharpness, and what is often described as a mental fog. […] The chemotherapy drug cisplatin is commonly linked to chemo brain. In a new study, a research team identified what they believe may be a key biological change responsible for chemo brain in people treated with cisplatin. […] The increased S1P had several biological effects that are thought to trigger chemo brain, including altering mitochondrial activity in brain cells and promoting inflammation. […] The study, led by Daniela Salvemini, Ph.D., and colleagues from the Saint Louis University School of Medicine, also found that treatments that target a brain receptor for S1P and are already approved by the Food and Drug Administration (FDA) to treat multiple sclerosis prevented chemo brain-like symptoms in mice treated with cisplatin.

• #1 Abstract 4782: Cisplatin induces mitochondrial damage and hippocampal neurotoxicity: a potential mechanism for chemotherapy-related cognitive impairment

  https://escholarship.org/uc/item/9gf2d61t

  When administered to rats, cisplatin causes hippocampal neuronal and mitochondrial damage, as well as cognitive deficits, supporting that role of mitochondrial toxicity in the mechanisms of cisplatin-induced CRCI. […] Importantly the data demonstrates that these processes can be potentially mitigated with administration of the clinically available antioxidant, NAC.

• #1 Gamma Frequency Brainwave Stimulation Potential Treatment Approach for “Chemo Brain” | Inside Precision Medicine

  https://www.insideprecisionmedicine.com/topics/oncology/gamma-frequency-brainwave-stimulation-potential-treatment-approach-for-chemo-brain/

  Researchers at the Massachusetts Institute of Technology (MIT) report that the use of a noninvasive treatment that stimulates gamma frequency brainwaves could be an effective treatment against the cognitive side effects of chemotherapy, often referred to as “chemo brain.” […] The research, published Wednesday in the journal Science Translational Medicine, could reduce the memory impairment and difficulty in concentrating that is common among patients receiving chemotherapy. […] In their study, the investigators found that daily exposure to light and sound with a frequency of 40 hertz protected brain cells from chemotherapy-induced damage in mouse models. […] “Chemo brain caught our attention because it is extremely common, and there is quite a lot of research on what the brain is like following chemotherapy treatment,” Tsai adds.

• #1 Gamma Frequency Brainwave Stimulation Potential Treatment Approach for “Chemo Brain” | Inside Precision Medicine

  https://www.insideprecisionmedicine.com/topics/oncology/gamma-frequency-brainwave-stimulation-potential-treatment-approach-for-chemo-brain/

  This form of cancer treatment has many known deleterious effects including increased inflammation of the brain and the loss of white matter, the network of nerve fibers that help parts of the brain communicate with each other. […] The gamma therapy also provided other benefits on behavior including better performance on tests that measure memory and executive function. […] The timing of the treatment was an important variable in producing positive results. Gamma therapy that didn’t start until three months after the start of chemotherapy was much less effective, but if started early, the benefits were still seen for up to four months. […] “I think this is a very fundamental mechanism to improve myelination and to promote the integrity of oligodendrocytes. It seems that it’s not specific to the agent that induces demyelination, be it chemotherapy or another source of demyelination,” Tsai says.

• #1 Neurofeedback: Treatment For Chemo Brain | BrainTrainUK

  https://braintrainuk.com/neurofeedback-for/neurofeedback-for-fibromyalgia-syndrome-fms-2-3/

  In this study published in April 2013 and led by a breast cancer survivor who discovered Neurofeedback to help herself, 23 breast cancer survivors who reported Cognitive Impairment following chemotherapy undertook 20 sessions of Neurofeedback, and their cognitive function was measured before and after: Alvarez, J., Meyer, F. L., Granoff, D. L., & Lundy, A. (2013). The Effect of EEG Biofeedback on Reducing Postcancer Cognitive Impairment. Integrative cancer therapies. 21 out of 23 participants saw their symptoms ‘reversed’. “Strongly significant improvements” were seen on all 4 cognitive measures, all 4 psychological measures, fatigue and some sleep measures. The researchers concluded that Neurofeedback “has potential for reducing the negative cognitive and emotional sequelae of cancer treatment as well as improving fatigue and sleep patterns.”

• #1 Chemo Brain for the Multiple Myeloma Patient – HealthTree for Multiple Myeloma

  https://healthtree.org/myeloma/community/articles/chemo-brain

  There are many different factors that may contribute to cognitive changes in the cancer setting, and so I dont think there is going to be a singular mechanism for everyone. There is a need to look at this broadly, to see what factors are playing a role for each person, and to target interventions to that person. […] Learning systems of adaptation and behavior modification may be an effective way for some patients to overcome cancer-related cognitive decline. […] Exercise is a powerful lifestyle component that may have an impact on several mechanisms of cancer-related cognitive impairment. There is emerging evidence that aerobic exercise supports cognitive recovery.

• #1

  https://www.healio.com/news/hematology-oncology/20200518/chemo-brain-an-imprecise-term-for-a-complex-phenomenon

  We identified certain genes that were associated with post-transplant cognitive impairment, Bhatia told Healio. These included the blood-brain barrier genes, meaning that they helped or prevented chemotherapies in going into the brain. […] The strategy here is for patients to identify and adapt to their problem areas. […] There is emerging evidence that aerobic exercise supports cognitive recovery. […] What was interesting is that when participants went through our group rehabilitation program, the improvements in loneliness these patients achieved paralleled improvements in cognitive symptoms. […] Cancer-related cognitive impairment hasnt been taken seriously for a long time. So, I think for a provider to simply say, yes, this is common among people in your shoes, is tremendously therapeutic.

• #1 UK Researchers Seek to Identify Ways to Relieve Post-Chemotherapy Cognitive Impairment | Research

  https://www.research.uky.edu/news/uk-researchers-seek-identify-ways-relieve-post-chemotherapy-cognitive-impairment

  His expertise in B cell biology has led the team into the investigation of the contribution of immune responses to CICI. […] The new award, titled „A redox-mediated mechanism of chemotherapy-induced cognitive impairment, theorizes a novel mechanism of CICI and identifies strategies for its prevention. […] The research is designed to gain an understanding of damage mechanisms and to identify the cells that produce agents during chemotherapy that lead to cognitive impairment.

• #1

  https://www.healio.com/news/hematology-oncology/20120510/chemo-brain-linked-to-neurobiological-mechanism

  For many years, cancer survivors have complained about a mental fogginess after chemotherapy that interferes with multitasking, processing speed, concentration and memory. […] Recent research, however, has shown that these cognitive issues are not imagined. In fact, two studies have demonstrated brain changes in patients who display symptoms of this mental fog, commonly referred to as chemo brain. […] Most of the research into cognitive impairment has focused on patients with breast cancer because they have been the most vocal about this issue. However, there is evidence that these cognitive challenges also plague patients who have been treated for several other types of cancer. […] Some of the most recent studies have shown that there are measurable changes in the brain after cancer treatment.

• #1 Insights into the mechanism of ‘chemobrain’: deriving a multi-factorial model of pathogenesis – Australian Medical Student Journal

  https://www.amsj.org/archives/4274

  Lastly, how do we reconcile the delayed effects of chemobrain? […] A possible multi-factorial model of chemobrain is summarised in Figure 1. […] Chemotherapy related cognitive impairment can be affected by a number of possible determinants such as treatment characteristics, genetic susceptibility, cytokine imbalance, and hormonal factors. […] Mechanisms such as oxidative stress and telomere shortening have been implicated, and studies suggest a mediating role for cytokines. […] In conclusion, chemobrain is a phenomenon which needs to be studied in depth.

• #2

  https://www.healio.com/news/hematology-oncology/20200518/chemo-brain-an-imprecise-term-for-a-complex-phenomenon

  The various cognitive impairments collectively known as chemo brain can cause anxiety, frustration and difficulty with everyday tasks for cancer survivors. […] Despite what the term suggests, chemo brain and its associated mental changes are not necessarily related only to chemotherapy. Other cancer treatments also can have short- or long-term cognitive implications. Additionally, some changes in cognitive function may be associated with the cancer itself. […] Ongoing research has been seeking to identify the mechanisms behind cancer-related cognitive decline, as well as ways to manage them. […] One of the pieces of this puzzle is that some people appear to be more affected than others. So, part of the challenge is in identifying the underlying mechanisms and subgroups of patients who are impacted.

• #2 Post-chemotherapy cognitive impairment – Wikipedia

  https://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment

  Post-chemotherapy cognitive impairment (PCCI) (also known in the scientific community as „CRCIs or Chemotherapy-Related Cognitive Impairments” and in lay terms as chemotherapy-induced cognitive dysfunction or impairment, chemo brain, or chemo fog) describes the cognitive impairment that can result from chemotherapy treatment. […] Although the causes and existence of post-chemotherapy cognitive impairment have been a subject of debate, recent studies have confirmed that post-chemotherapy cognitive impairment is a real, measurable side effect of chemotherapy that appears in some patients. […] PCCI is complex and factors other than the chemotherapeutic agents may impact cognitive functioning. […] The importance of hormones, particularly estrogen, on cognitive function is underscored by the presence of cognitive impairment in breast cancer patients before chemotherapy is begun, the similarity of the cognitive impairments to several menopausal symptoms, the increased rate of PCCI in pre-menopausal women, and the fact that the symptoms can frequently be reversed by taking estrogen.

• #2 Does chemotherapy have cognitive side effects? Chemo brain

  https://www.medicalnewstoday.com/articles/does-chemotherapy-have-cognitive-side-effects

  Chemo brain is a chemotherapy side effect. It involves cognitive changes such as poor memory and concentration. It may occur during or after treatment. […] The mechanisms underlying chemo brain are still unclear, but experts theorize that it is a combined effect of neuron damage, abnormal repair, and brain remodeling. […] Recent studies have shown that chemotherapy causes toxic effects on cells in the central nervous system (CNS). It induces oxidative stress and cell death, inhibits neuron growth and development, and activates other processes that may be harmful to cells in the brain. These changes alter neuron development and cause problems with learning and memory. […] Chemo brain affects up to 75% of people during treatment. It persists for several months after chemotherapy treatment in 35% of patients. […] While chemotherapy is the key contributor to cognitive impairment, other factors may also contribute.

• #2 Chemotherapy-Mediated Neuronal Aberration

  https://www.mdpi.com/1424-8247/16/8/1165

  Chemotherapy exhibits neurotoxicity by damaging the DNA in neurons by interfering with the DNA repair system and antioxidant machinery. […] The chemotherapy-mediated inflammation contributes to chemobrain in cancer patients. […] Chemotherapy is the fundamental therapeutic strategy for cancer treatment that is often associated with serious neurological and cognitive disorders referred to as chemotherapy-induced cognitive impairment (CICI)/chemo brain/chemo fog. […] Chemotherapeutic agents govern various cognitive functions by regulating pro-inflammatory cytokines in the frontal cortex, hippocampus, and corpus callosum. […] The role of chemotherapeutic drug-mediated inflammation in the cognitive impairment of cancer patients is still under investigation. […] In this review, we discuss the effect of chemotherapeutic agents on physiological as well as molecular aberration of neuronal cells and their impact on brain function.

• #2 Insights into the mechanism of ‘chemobrain’: deriving a multi-factorial model of pathogenesis – Australian Medical Student Journal

  https://www.amsj.org/archives/4274

  Cytokine imbalance may also be involved in cognitive decline. […] It is believed that a reduction in hormones such as oestrogen and testosterone is associated with cognitive decline. […] Despite all the research so far, there is still no consensus on how chemobrain develops. […] Chemotherapeutic drugs such as Adriamycin are also known to increase production of reactive oxygen species (ROS) and contribute to reduced anti-oxidant capacity. […] Based on these observations, it is conceivable that oxidative DNA damage and telomere shortening could form the basis of a model of CNS dysfunction to explain chemobrain. […] By extrapolation, other pro-inflammatory cytokines such as IL-6 may play similar roles and different chemotherapeutic agents could induce distinct cytokine profiles with varying CNS effects.

• #2 Mechanisms and Treatment for Cancer- and Chemotherapy-Related Cognitive Impairment in Survivors of Non-CNS Malignancies

  https://www.cancernetwork.com/view/cog-impairment

  Up to 70% of survivors of adult-onset, noncentral nervous system (CNS) solid tumors report cognitive symptoms, and approximately 30% have impairment on formal neuropsychological testing. The etiology of the impairment is unknown. […] Here, we review the evidence for the putative mechanisms of CRCI by examining clinical and preclinical models, primarily those associated with chemotherapy. […] The role of inflammation is the most extensively studied mechanism in the development of CRCI. It is based on the assumption that malignancy and systemic treatments, such as chemotherapy, induce inflammation in the body, which is then propagated to the brain via well-characterized pathways of immune-to-brain signaling. […] Neuroinflammation then regulates mood, cognitive, and behavioral changes associated with CRCI.

• #2 Post-chemotherapy cognitive impairment – Wikipedia

  https://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment

  Research has revealed that neural progenitor cells are particularly vulnerable to the cytotoxic effects of chemotherapy agents. […] Due to the critical role the hippocampus plays in memory, it has been the focus of various studies involving post-chemotherapy cognitive impairment. […] This evidence suggests that chemotherapy agent toxicity to cells in the hippocampus may be partially responsible for the memory declines experienced by some patients. […] Deficits in visuo-spatial, visual-motor, and visual memory functions are among the symptoms seen in post-chemotherapy patients. […] While estrogen hormone supplementation may reverse the symptoms of PCCI in women treated for breast cancer, this carries health risks, including possibly promoting the proliferation of estrogen-responsive breast cancer cells.

• #2 Fat Molecule in Brain Linked to Chemo Brain – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2022/chemo-brain-prevention-s1p

  Also referred to as cancer-related cognitive impairment, chemo brain can be marked by severe memory problems, a lack of mental sharpness, and what is often described as a mental fog. […] The chemotherapy drug cisplatin is commonly linked to chemo brain. In a new study, a research team identified what they believe may be a key biological change responsible for chemo brain in people treated with cisplatin. […] The increased S1P had several biological effects that are thought to trigger chemo brain, including altering mitochondrial activity in brain cells and promoting inflammation. […] The study, led by Daniela Salvemini, Ph.D., and colleagues from the Saint Louis University School of Medicine, also found that treatments that target a brain receptor for S1P and are already approved by the Food and Drug Administration (FDA) to treat multiple sclerosis prevented chemo brain-like symptoms in mice treated with cisplatin.

• #2 Pharmacological rescue of cognitive function in a mouse model of chemobrain | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-021-00463-2

  After chemotherapy, many cancer survivors suffer from long-lasting cognitive impairment, colloquially known as chemobrain. However, the trajectories of cognitive changes and the underlying mechanisms remain unclear. […] We establish the InsP3R calcium pathway and impaired neuronal morphology as mechanisms for paclitaxel-induced cognitive impairment. Our findings suggest lithium and PKC inhibitors as candidate agents for preventing chemotherapy-induced cognitive impairment. […] We observed a reduction in dendritic complexity and length in the hippocampus and cortex of mice treated with paclitaxel, which we hypothesize to be the cellular mechanism for the memory deficits observed in these mice. The upregulation of PKC acutely in the hippocampus and the cortex, which persists chronically in the cortex, may provide the underlying molecular mechanism for this observation.

• #2 Mechanisms and Treatment for Cancer- and Chemotherapy-Related Cognitive Impairment in Survivors of Non-CNS Malignancies

  https://www.cancernetwork.com/view/cog-impairment

  Several clinical studies in breast cancer survivors have shown an association between proinflammatory cytokines and CRCI. […] Chemotherapy may impair metabolic and cellular function of the brain through direct cytotoxic damage to neurons and other cells. […] Recent evidence suggests that chemotherapy-induced damage impedes metabolic function and energy utilization of brain cells, as opposed to causing the death of brain cells. […] Some have suggested that the HPA axis contributes to CRCI, but few studies have directly examined the validity of this statement. […] Several genetic variabilities have been associated with CRCI. Apolipoprotein E (ApoE) plays a role in lipid metabolism and is implicated in Alzheimer’s disease. […] There is limited evidence on the involvement of genetic associations in CRCI, and more research is required.

• #2

  https://www.healio.com/news/hematology-oncology/20120510/chemo-brain-linked-to-neurobiological-mechanism

  The results showed that women with breast cancer who were treated with chemotherapy had significantly reduced function in the prefrontal cortex, the area of the brain responsible for skills such as problem-solving, working memory and multitasking. […] Additionally, the chemotherapy group showed more perseverative errors and reduced processing speed. There was a significant correlation between reduced left caudal lateral prefrontal cortex activation and higher disease severity and increased subjective executive dysfunction in the women treated with chemotherapy. […] This was a study focused on breast cancer, but there is some evidence that other cancers that are treated with chemotherapy may be at risk for similar problems. […] After treatment, the chemotherapy group had significantly worse scores on tests of attention, psychomotor speed and memory. In addition, they had significant decreases of white matter fractional anisotropy a DTI measure that indicates white matter tissue organization in frontal, parietal and occipital white matter tracts after treatment.

• #2 Chemo brain: myth or clinical reality? Literature review and clinical case – Yakhin – Neurology Bulletin

  https://journals.eco-vector.com/1027-4898/article/view/635304

  Cognitive impairment associated with chemotherapy develops through several potential mechanisms including damage to the bloodbrain barrier, increased oxidative stress and inflammation in the brain, and impaired neurogenesis, each leading to neuronal dysfunction. […] Other potential mechanisms have been suggested, including inhibition of hippocampal neurogenesis and direct neuronal damage, as well as activation of secondary glial cells, i.e. microglia and astrocytes, production of proinflammatory cytokines, and defects in myelin-producing cells (oligodendrocyte lineage). […] A model of abnormalities in the brain default mode network as a potential biomarker of chemotherapy-induced damage is of interest. […] Changes in brain activity (signals, cerebral blood flow) in patients with cancer have been observed in all functional networks, including prefrontal, parietal, occipital, temporal, and cerebellar regions.

• #2

  https://www.healio.com/news/hematology-oncology/20120510/chemo-brain-linked-to-neurobiological-mechanism

  Other factors such as fatigue and secondary medical conditions could negatively influence cognitive function. […] Diagnosing cognitive dysfunction is difficult because the standard neurological tests available are not sensitive enough to detect the cognitive changes. […] There currently are no reliable pharmacologic treatments for cancer therapy-induced cognitive impairment. […] The narcolepsy treatment modafinil (Provigil, Cephalon) appears promising, but there have been no large randomized clinical trials demonstrating its effectiveness, Wagner said. […] Currently, the most exciting research is being conducted on nondrug strategies such as cognitive behavioral therapy, Wagner said. […] There is a neurobiological mechanism that is associated with the complaints patients have.

• #2 Mechanism Underpinning

  https://www.genengnews.com/news/mechanism-underpinning-chemo-brain-identified-points-to-existing-drug-as-potential-therapy/

  The studies also revealed that mechanistically, cisplatin-induced S1P formation is mediated by the toll-like receptor 4. […] “We believe this is the first study implicating TLR4 activation as a causal mechanism for CRCI,” they noted. […] “Our studies provide evidence that TLR4 activation in the brain is the linchpin in cisplatin-induced S1P formation, S1P-mediated S1PR1 activation, and cognitive deficits.” […] The findings bridge some gaps in scientists’ understanding about the molecular mechanisms underlying CRCI, and identify a novel target for therapeutic intervention with functional S1PR1 antagonists. […] Importantly, S1PR1 antagonists do not interfere with the efficacy of chemotherapy, as the team, and others, have shown in previous work, and can also block tumor cell growth, inflammation and metastasis. […] They further concluded in their paper, “Building on a compelling preclinical platform, future clinical trials are needed to assess the anticancer effects of S1PR1 antagonists given alone or in combination with chemotherapy.”

• #2 A noninvasive treatment for “chemo brain” – ecancer

  https://ecancer.org/en/news/24368-a-noninvasive-treatment-for-chemo-brain

  Patients undergoing chemotherapy often experience cognitive effects such as memory impairment and difficulty concentrating a condition commonly known as chemo brain. […] MIT researchers have now shown that a noninvasive treatment that stimulates gamma frequency brain waves may hold promise for treating chemo brain. […] Research has shown that these drugs can induce inflammation in the brain, as well as other detrimental effects such as loss of white matter the networks of nerve fibres that help different parts of the brain communicate with each other. […] Chemo brain caught our attention because it is extremely common, and there is quite a lot of research on what the brain is like following chemotherapy treatment, Tsai says. […] I think this is a very fundamental mechanism to improve myelination and to promote the integrity of oligodendrocytes. It seems that its not specific to the agent that induces demyelination, be it chemotherapy or another source of demyelination, Tsai says.

• #2

  https://www.healio.com/news/hematology-oncology/20200518/chemo-brain-an-imprecise-term-for-a-complex-phenomenon

  We identified certain genes that were associated with post-transplant cognitive impairment, Bhatia told Healio. These included the blood-brain barrier genes, meaning that they helped or prevented chemotherapies in going into the brain. […] The strategy here is for patients to identify and adapt to their problem areas. […] There is emerging evidence that aerobic exercise supports cognitive recovery. […] What was interesting is that when participants went through our group rehabilitation program, the improvements in loneliness these patients achieved paralleled improvements in cognitive symptoms. […] Cancer-related cognitive impairment hasnt been taken seriously for a long time. So, I think for a provider to simply say, yes, this is common among people in your shoes, is tremendously therapeutic.

• #2 How to Heal Chemo Brain After Childhood Cancer | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/how-to-heal-chemo-brain-after-childhood-cancer/

  Chronic stress harms the brain, so its important to learn how to calm stress at any age. […] Cancer treatment can mess with gut health. A 2019 study in BMC Cancer shows that chemotherapy adversely impacts the gut microbiota and can lead to gut dysbiosis, an imbalance in gut bacteria. It is also associated with an increased likelihood of leaky gut, which occurs when the lining of the intestines becomes excessively porous. Leaky gut is associated with an increased risk for mood disorders, anxiety disorders, and ADD/ADHD. […] A 2019 study found that cancer survivors reported improved quality of life after neurofeedback therapy. And an exciting 2022 pilot study from UCLA researchers shows that neurofeedback may be beneficial in improving the chemotherapy-induced cognitive deficitschemo brainfacing many cancer survivors.

• #2 Can Understanding Long COVID-19 Teach Us About Chemo Brain? | Cancer Today

  https://www.cancertodaymag.org/fall-2022/can-understanding-long-covid-19-teach-us-about-chemo-brain/

  And just as we anticipated, when we looked at the microglial reactivity, there was the exact same pattern of white matter-specific microglial reactivity that we saw in the methotrexate mouse model and in people who had been previously exposed to chemotherapy. […] Right now, chemo brain research is informing COVID fog research more. […] I think there is just such intense interest in COVID fog that it will advance therapy for chemo brain. […] Its helpful to acknowledge that theres a neurobiological basis for these persistent cognitive symptoms. Its real, it should be accommodated, and theres potential to fix it.

Zobacz więcej