Chemo brain: myth or clinical reality? Literature review and clinical case

Abstract

The review presents a psychopathological phenomenon new for the Russian psychiatry. It combines various cognitive and psychopathological entities (hallucinations, delusions, consciousness disorders) occurring in cancer patients as a result of chemotherapy. In foreign literature, such entities are generalized under such common terms as chemo brain, chemo fog, and post-chemotherapy cognitive impairment (PCCI). Chemo Brain is a symptom complex developing after treatment with various groups of chemotherapeutic drugs and caused by certain functional and structural brain changes. This article collates the data on etiology, pathogenesis, clinical features and interventions in case of disorders generally known as Chemo Brain. In addition, it discusses chemotherapeutic drugs most often inducing the Chemo Fog phenomenon (Cisplatin, Doxorubicin, Methotrexate, 5-fluorouracil), and a clinical Chemo Brain case with severe cognitive impairment and a confusion episode. A 74-year-old female patient undergoing chemotherapy for sigmoid colon carcinoma and metastases experienced a sharp deterioration of memory, self-care, and mobility after a routine chemotherapy round. The patient had been treated with a cocktail of chemotherapy drugs for 3 years and had several surgeries. With acute memory impairment, she consulted the internal medicine department. The doctors were puzzled with her symptoms. Having received advice of various medical specialists and the corresponding treatment, the patient showed improvement of both cognitive and motor functions. The review emphasizes the need for further clinical research of Chemo Brain drug treatment.