Neurocognitive sequelae of cancer treatment

Packer, Roger J.; Mehta, Minesh P.

doi:10.1212/wnl.59.1.8

Cited by 22 publications

(6 citation statements)

References 15 publications

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“…Furthermore, similar results were obtained in brains of rabbits that were inoculated intravenously (IV) with virulent mutants of the Vollum strain [3]. In addition, high rates of meningitis have been reported in humans [7]–[9] and non-human primates ("cardinal's cap"), with occasional local extension of infection into the neuropil [10]. Herein, we report an attempt to test the hypothesis that brain invasion is a toxin-independent phenomenon with similar fatal consequences on rabbits and GP by using of intracerebral/intracranial (IC) inoculation and comparing the outcome to the pattern exhibited following IV inoculation.…”

Section: Introductionsupporting

confidence: 67%

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The Central Nervous System as Target of Bacillus anthracis Toxin Independent Virulence in Rabbits and Guinea Pigs

et al. 2014

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Infection of the central nervous system is considered a complication of Anthrax and was reported in humans and non-human primates. Previously we have reported that Bacillus anthracis possesses a toxin-independent virulent trait that, like the toxins, is regulated by the major virulence regulator, AtxA, in the presence of pXO2. This toxin-independent lethal trait is exhibited in rabbits and Guinea pigs following significant bacteremia and organ dissemination. Various findings, including meningitis seen in humans and primates, suggested that the CNS is a possible target for this AtxA-mediated activity. In order to penetrate into the brain tissue, the bacteria have to overcome the barriers isolating the CNS from the blood stream. Taking a systematic genetic approach, we compared intracranial (IC) inoculation and IV/SC inoculation for the outcome of the infection in rabbits/GP, respectively. The outstanding difference between the two models is exhibited by the encapsulated strain VollumΔpXO1, which is lethal when injected IC, but asymptomatic when inoculated IV/SC. The findings demonstrate that there is an apparent bottleneck in the ability of mutants to penetrate into the brain. Any mutant carrying either pXO1 or pXO2 will kill the host upon IC injection, but only those carrying AtxA either on pXO1 or in the chromosome in the background of pXO2 can penetrate into the brain following peripheral inoculation. The findings were corroborated by histological examination by H&E staining and immunofluorescence of rabbits' brains following IV and IC inoculations. These findings may have major implications on future research both on B. anthracis pathogenicity and on vaccine development.

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Section: Introductionsupporting

confidence: 67%

“…Elucidation of the mechanism by which AtxA mediates brain penetration may be of major importance, as Anthrax meningitis is the main neurological complication of systemic infection, approaching 100% mortality despite intensive antibiotic therapy [9].…”

Section: Discussionmentioning

confidence: 99%

The Central Nervous System as Target of Bacillus anthracis Toxin Independent Virulence in Rabbits and Guinea Pigs

et al. 2014

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“…En relación a la dosis total aplicada, diferentes autores (9,27,44) han señalado que radiaciones iguales o superiores a 60 Gy se asocian a un mayor riesgo de presentar alteraciones neuropsicológicas. Así, la mayor parte de estudios en los que se observan alteraciones en la memoria visual (22,34,35) o en otras funciones neuropsicológicas como por ejemplo atención (25,43) , inteligencia general (26) , fluidez fonológica (35) , así como funciones ejecutivas (43) , las dosis máximas aplicadas a los pacientes fueron superiores a 60 Gy.…”

Section: Datos a Favor De La Existencia De Deterioro Cognitivo Asociaunclassified

Efectos cognitivos de la radioterapia en gliomas de bajo grado

2012

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El aumento en las tasas de supervivencia de los pacientes con gliomas de bajo grado está suscitando un elevado interés en los efectos neurotóxicos asociados a los tratamientos, en especial a la radioterapia. En la actualidad, se señala la presencia de alteraciones principalmente en memoria visual asociada a dicha técnica de tratamiento, aunque existen datos contrarios que postulan que la radioterapia, al igual que otros tratamientos, favorece el control de la enfermedad y preserva el rendimiento neuropsicológico de esta población. No obstante, las limitaciones metodológicas de estos estudios y la dificultad en el seguimiento de estos pacientes podrían estar provocando esta divergencia en los resultados hallados en este campo de investigación. Por ello, se reitera la necesidad de realizar estudios que utilicen las técnicas de tratamiento de radioterapia actuales, que aumentan la seguridad y disminuyen los efectos secundarios neurológicos, así como que apliquen cuestionarios con una adecuada sensibilidad a los efectos neurotóxicos de los tratamientos adyuvantes.Palabras claves: Gliomas bajo grado, radioterapia, rendimiento neuropsicológico. Correspondencia:Ana Sanz Grupo IMO. Calle Velázquez 146. Madrid. 28002. Correo electrónico: asanz@grupoimo.com EFECTOS COGNITIVOS DE LA RADIOTERAPIA EN GLIOMAS DE BAJO GRADO COGNITIVE EFFECTS OF RADIOTHERAPY IN LOW GRADE GLIOMAS AbstractThe increased survival of patients with low grade gliomas generated increased interest in the neurotoxic effects associated with treatment, especially radiotherapy. Currently, the radiotherapy is associated with visual memory failures in this population. On the contrary, some authors postulate that radiotherapy, as well as other treatments, helps control the disease and preserves the neuropsychological performance. However, methodological limitations of these studies and the difficulty in monitoring these patients could be causing this divergence in the results found in this research field. Therefore, we note the need for studies that use radiation therapy treatment techniques current, which increase safety and reduce neurological side effects, and apply appropriate questionnaires with a sensitivity to the neurotoxic effects of adjuvant treatments.

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“…In addition to the increased risk of secondary cancer and death, survivors of childhood CNS malignancies are at risk for morbidity related to injury from the tumor itself and long-term effects of radiation, surgery, and chemotherapy (Butler et al 1994 ;Packer and Mehta 2002 ;Nathan et al 2007) . The CNS tumor survivors have among the highest morbidity rates of all pediatric cancer survivors (Hays et al 1992 ;Foreman et al 1999) .…”

Section: General Late Effectsmentioning

confidence: 99%

Pediatric CNS Tumors

2010

Pediatric Oncology

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Neurocognitive sequelae of cancer treatment

Cited by 22 publications

References 15 publications

The Central Nervous System as Target of Bacillus anthracis Toxin Independent Virulence in Rabbits and Guinea Pigs

The Central Nervous System as Target of Bacillus anthracis Toxin Independent Virulence in Rabbits and Guinea Pigs

Efectos cognitivos de la radioterapia en gliomas de bajo grado

Pediatric CNS Tumors

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