Cognitive deficits as long‐term side‐effects of adjuvant therapy in breast cancer patients: ‘subjective’ complaints and ‘objective’ neuropsychological test results

Weis, Joachim; Poppelreuter, Martin; Bartsch, Hans Helge

doi:10.1002/pon.1472

Cited by 81 publications

(68 citation statements)

References 24 publications

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“…However, this finding does fit with studies in cancer patients, which have found gray matter reductions in patients undergoing treatment as well as long-term survivors up to 20 years post-treatment (McDonald et al, 2010, 2013; Koppelmans et al, 2012b). Additionally, in the present study an increased percentage of CA+ was observed in the SMC group compared to other groups, suggesting that while cancer may delay age of AD onset, CA+ individuals may have increased cognitive concerns, consistent with the cancer and cognition literature (Ahles and Saykin, 2007; Mehnert et al, 2007; Weis et al, 2009; Mandelblatt et al, 2013; McDonald et al, 2013). Interestingly, the frontal pattern of lower CA+ GMD occurs in regions similar to those reported in neuroimaging studies of breast cancer and chemotherapy-associated gray matter changes (McDonald et al, 2010, 2013).…”

Section: Discussionsupporting

confidence: 88%

Association of cancer history with Alzheimer's disease onset and structural brain changes

et al. 2014

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Epidemiological studies show a reciprocal inverse association between cancer and Alzheimer's disease (AD). The common mechanistic theory for this effect posits that cells have an innate tendency toward apoptotic or survival pathways, translating to increased risk for either neurodegeneration or cancer. However, it has been shown that cancer patients experience cognitive dysfunction pre- and post-treatment as well as alterations in cerebral gray matter density (GMD) on MRI. To further investigate these issues, we analyzed the association between cancer history (CA±) and age of AD onset, and the relationship between GMD and CA± status across diagnostic groups in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort study. Data was analyzed from 1609 participants with information on baseline cancer history and AD diagnosis, age of AD onset, and baseline MRI scans. Participants were CA+ (N = 503) and CA− (N = 1106) diagnosed with AD, mild cognitive impairment (MCI), significant memory concerns (SMC), and cognitively normal older adults. As in previous studies, CA+ was inversely associated with AD at baseline (P = 0.025); interestingly, this effect appears to be driven by non-melanoma skin cancer (NMSC), the largest cancer category in this study (P = 0.001). CA+ was also associated with later age of AD onset (P < 0.001), independent of apolipoprotein E (APOE) ε4 allele status, and individuals with two prior cancers had later mean age of AD onset than those with one or no prior cancer (P < 0.001), suggesting an additive effect. Voxel-based morphometric analysis of GMD showed CA+ had lower GMD in the right superior frontal gyrus compared to CA− across diagnostic groups (Pcrit < 0.001, uncorrected); this cluster of lower GMD appeared to be driven by history of invasive cancer types, rather than skin cancer. Thus, while cancer history is associated with a measurable delay in AD onset independent of APOE ε4, the underlying mechanism does not appear to be cancer-related preservation of GMD.

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Section: Discussionsupporting

confidence: 88%

Association of cancer history with Alzheimer's disease onset and structural brain changes

et al. 2014

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“…These results appear surprising given the numerous studies reporting subjectively assessed cognitive impairment associated with insomnia in the general population (Broman et al, 1992;Edinger, Means, Carney, & Krystal, 2008;Orff et al, 2007;Vignola et al, 2000). However, this may be explained by a ceiling effect given that many women with breast cancer at that stage already assess their cognitive function as poor because of the systemic treatments they received (Hurria et al, 2006;Shilling & Jenkins, 2007;Weis et al, 2009). Hence, a possible additive effect of insomnia would not be detectable by the participant.…”

Section: Discussionmentioning

confidence: 82%

Is Insomnia Associated With Cognitive Impairments in Breast Cancer Patients?

Caplette-Gingras

Savard

et al. 2013

Behavioral Sleep Medicine

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Insomnia and cognitive impairment are both highly prevalent in breast cancer patients. This study, conducted among women treated for non-metastatic breast cancer, aimed at assessing the relationship between insomnia and cognitive functioning, measured objectively and subjectively, and evaluating the moderating role of age, educational level and intellectual potential. Sixty-three women completed a neuropsychological battery, self-report scales of cognitive functioning, 2 weeks of a daily sleep diary, and a demographic and medical questionnaire. Significant differences between women with insomnia and good sleepers were found on verbal episodic memory and executive functioning, assessed objectively, and some aspects of subjective cognitive functioning. Moreover, older age and a higher education were associated with more severe cognitive impairments related to insomnia.

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“…La plupart des plaintes subjectives du chemofog sont probablement liées à des équivalents dépressifs ou de doutes/estime de soi [180]. Des répercussions cognitives des chimiothérapies adjuvantes peuvent néanmoins être révélées par divers tests psychotechniques dans un « sous-groupe » qui n'est d'ailleurs pas nécessairement celui qui s'en plaint le plus !…”

Section: La Grande Diversité Des Préoccupations Est Spécifi Que Au Jeunclassified

Prise en charge du cancer du sein infiltrant de la femme âgée de 40 ans ou moins

Chauvet¹,

Debled²,

Decanter³

et al. 2011

Oncologie

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Cognitive deficits as long‐term side‐effects of adjuvant therapy in breast cancer patients: ‘subjective’ complaints and ‘objective’ neuropsychological test results

Abstract: The identification of verbal-semantic memory as a specific problem area has important implications on the planning of future studies with regard to both the examination of underlying pathophysiological mechanisms and the specific effects of these deficits on patients' self-appraisal.

Cited by 81 publications

References 24 publications

Association of cancer history with Alzheimer's disease onset and structural brain changes

Association of cancer history with Alzheimer's disease onset and structural brain changes

Is Insomnia Associated With Cognitive Impairments in Breast Cancer Patients?

Prise en charge du cancer du sein infiltrant de la femme âgée de 40 ans ou moins

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