Cognitive function after chemotherapy in adults with solid tumours

Vardy, Janette; Tannock, Ian F.

doi:10.1016/j.critrevonc.2007.06.001

Cited by 191 publications

(148 citation statements)

References 205 publications

(291 reference statements)

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“…The exact nature and extent of impairments reported are difficult to quantify, and often, patient complaints are more frequent and more severe than what is detected in the clinic (20)(21)(22). However, it is clear that the effects on mood, memory, concentration, and executive functions reported (2-4, 23, 24 and reviewed in ref.…”

Section: Introductionmentioning

confidence: 97%

Impaired Cognitive Function and Hippocampal Neurogenesis following Cancer Chemotherapy

Christie

Acharya

Parihar

et al. 2012

Clinical Cancer Research

255

204

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Purpose: A substantial proportion of breast cancer survivors report significant, long-lasting impairments in cognitive function, often referred to as "chemobrain." Advances in detection and treatment mean that many more patients are surviving long-term following diagnosis of invasive breast cancer. Thus, it is important to define the types, extent, and persistence of cognitive impairments following treatment with cytotoxic cancer drugs.Experimental Design: We examined the effects of chronic treatment with two agents commonly used in patients with breast cancer, cyclophosphamide and doxorubicin (Adriamycin). Athymic nude rats were given 50 mg/kg cyclophosphamide, 2 mg/kg doxorubicin, or saline injections once per week for 4 weeks. A novel place recognition task and contextual and cued fear conditioning were used to characterize learning and memory ability. Immunofluorescence staining for immature and mature neurons and activated microglia was used to assess changes in neurogenesis and neuroinflammation.Results: Cyclophosphamide-and doxorubicin-treated rats showed significantly impaired performance on the novel place recognition task and the contextual fear conditioning task compared with untreated controls, suggesting disrupted hippocampal-based memory function. Chemotherapy-treated animals showed a significant decline in neurogenesis [80%-90% drop in bromodeoxyuridine (BrdUrd)-labeled cells expressing NeuN]. Activated microglia (ED1-positive) were found after cyclophosphamide but not doxorubicin treatment.Conclusions: Our results show that chronic treatment with either of two commonly used chemotherapeutic agents impairs cognitive ability and suggest that strategies to prevent or repair disrupted hippocampal neurogenesis may be effective in ameliorating this serious side effect in cancer survivors.

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Section: Introductionmentioning

confidence: 97%

Impaired Cognitive Function and Hippocampal Neurogenesis following Cancer Chemotherapy

Christie

Acharya

Parihar

et al. 2012

Clinical Cancer Research

255

204

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“…Evidence from previous research suggests that cancertreatment-related cognitive dysfunction only occurs in a subgroup of women, with reports generally ranging between 15 and 50% (Vardy & Tannock, 2007 ). These declines in cognitive performance are subtle, with the most commonly affected domains being verbal memory, language, visual memory/ spatial ability and executive functioning (for meta-analyses, see Faletti, Sanfi lippo, Maruff, Weih, & Phillips, 2005 ;Jansen, Miaskowski, Dodd, Dowling, & Kramer, 2005 ;Stewart, Bielajew, Collins, Parkinson, & Tomiak, 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Predictors of Cognitive Decline After Chemotherapy in Breast Cancer Patients

Vearncombe

Rolfe

Wright

et al. 2009

J Int Neuropsychol Soc

120

100

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The objective of this study is to identify whether decline in cognitive functioning after chemotherapy in women with breast cancer is associated with health/disease, treatment, and psychological variables. Neuropsychological performance, health/disease, and treatment-related information of 136 women with breast cancer (age M = 49.38; SD = 7.92; range = 25.25-67.92) was assessed pre-chemotherapy and 1-month post-chemotherapy. The Reliable Change Index corrected for practice (RCIp) identifi ed women whose performance signifi cantly declined, while Pearson correlations assessed the relationship between cognitive change and predictor variables. A total of 16.9% of women showed signifi cant decline post-chemotherapy, with affected domains including verbal learning and memory, abstract reasoning, and motor coordination. Decline in hemoglobin levels and increased anxiety over the course of chemotherapy was found to signifi cantly predict impairment in multiple cognitive measures. Change in specifi c cognitive measures was signifi cantly associated with baseline fatigue, depression, and functional well-being ( r = 0.23 to 0.33; p = .01 to < .001). Although the effects are small, there is evidence that psychological and health factors may increase vulnerability to cognitive dysfunction after chemotherapy for breast cancer. Signifi cant associations reported in this study may be useful in the identifi cation and treatment of at-risk individuals. ( JINS , 2009, 15, 951-962.)

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“…Up to 70% of patients with cancer report that these cognitive difficulties persist well beyond the duration of treatment [115][116][117]. Studies that have measured cognitive function using standardized neuropsychological assessments have found mild to moderate effects of chemotherapy on cognitive performance in 15%-50% of the survivors after treatment [118,119]. Longitudinal studies have shown that, in a subset of survivors, cognitive difficulties can persist for between 1 and 2 years following the completion of chemotherapy [120,121].…”

Section: The Role Of Ros In Chemobrainmentioning

confidence: 99%

Oxidative Stress and Neurodegenerative Disorders

Qureshi¹,

Parvez²

2007

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Living cells continually generate reactive oxygen species (ROS) through the respiratory chain during energetic metabolism. ROS at low or moderate concentration can play important physiological roles. However, an excessive amount of ROS under oxidative stress would be extremely deleterious. The central nervous system (CNS) is particularly vulnerable to oxidative stress due to its high oxygen consumption, weakly antioxidative systems and the terminal-differentiation characteristic of neurons. Thus, oxidative stress elicits various neurodegenerative diseases. In addition, chemotherapy could result in severe side effects on the CNS and peripheral nervous system (PNS) of cancer patients, and a growing body of evidence demonstrates the involvement of ROS in drug-induced neurotoxicities as well. Therefore, development of antioxidants as neuroprotective drugs is a potentially beneficial strategy for clinical therapy. In this review, we summarize the source, balance maintenance and physiologic functions of ROS, oxidative stress and its toxic mechanisms underlying a number of neurodegenerative diseases, and the possible involvement of ROS in chemotherapy-induced toxicity to the CNS and PNS. We ultimately assess the value for antioxidants as neuroprotective drugs and provide our comments on the unmet needs.

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Cognitive function after chemotherapy in adults with solid tumours

Cited by 191 publications

References 205 publications

Impaired Cognitive Function and Hippocampal Neurogenesis following Cancer Chemotherapy

Impaired Cognitive Function and Hippocampal Neurogenesis following Cancer Chemotherapy

Predictors of Cognitive Decline After Chemotherapy in Breast Cancer Patients

Oxidative Stress and Neurodegenerative Disorders

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