Opening up the Window into “Chemobrain”: A Neuroimaging Review

Abstract

As more chemotherapy-treated cancer patients are reaching survivorship, side-effects such as cognitive impairment warrant research attention. The advent of neuroimaging has helped uncover a neural basis for these deficits. This paper offers a review of neuroimaging investigations in chemotherapy-treated adult cancer patients, discussing the benefits and limitations of each technique and study design. Additionally, despite the assumption given by the chemobrain label that chemotherapy is the only causative agent of these deficits, other factors will be considered. Suggestions are made on how to more comprehensively study these cognitive changes using imaging techniques, thereby promoting generalizability of the results to clinical applications. Continued investigations may yield better long-term quality of life outcomes by supporting patients' self-reports, and revealing brain regions being affected by chemotherapy.

The chemo brain: Severe cognitive decline following chemotherapy of breast cancer

“…Therefore, it could be asked, if progressive brain atrophy might be a constituent of the chemobrain syndrome in this case. Our observations support the notion that the use of more aggressive and combined treatment modalities in cancer therapy may cause delayed neuropsychiatric complications, such as cognitive decline, progressive myelin disruption, and brain atrophy [12,13,5,8].…”

Default mode network as a potential biomarker of chemotherapy-related brain injury

“…Chemotherapy is often associated with persistent cognitive decline affecting an estimated 78% of patients with non-CNS cancer (Wefel and Schagen, 2012). Neuroimaging studies provide insight regarding the effects of chemotherapy on cognition by demonstrating subtle but diffuse brain injury [see reviews by: (de Ruiter and Schagen, 2013;Kaiser, et al, 2014;Koppelmans, et al, 2013;McDonald and Saykin, 2013;Pomykala, et al, 2013a;Scherling and Smith, 2013;Simo, et al, 2013)].…”

Brain network alterations and vulnerability to simulated neurodegeneration in breast cancer

“…Although most cancer diagnoses originate outside the central nervous system (CNS), cognitive decline affects an estimated 19-78% of these patients (Wefel and Schagen, 2012). Neuroimaging studies suggest that this cognitive impairment stems from subtle but diffuse brain injury (Chao, et al, 2012; D'Agata, et al, 2013; Hsieh, et al, 2014; Koppelmans, et al, 2014) [see reviews by: (de Ruiter and Schagen, 2013; McDonald and Saykin, 2013; Scherling and Smith, 2013)].…”