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Oliveros A, Poleschuk M, Cole PD, Boison D, Jang MH. Chemobrain: An accelerated aging process linking adenosine A 2A receptor signaling in cancer survivors. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 170:267-305. [PMID: 37741694 PMCID: PMC10947554 DOI: 10.1016/bs.irn.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Chemotherapy has a significant positive impact in cancer treatment outcomes, reducing recurrence and mortality. However, many cancer surviving children and adults suffer from aberrant chemotherapy neurotoxic effects on learning, memory, attention, executive functioning, and processing speed. This chemotherapy-induced cognitive impairment (CICI) is referred to as "chemobrain" or "chemofog". While the underlying mechanisms mediating CICI are still unclear, there is strong evidence that chemotherapy accelerates the biological aging process, manifesting as effects which include telomere shortening, epigenetic dysregulation, oxidative stress, mitochondrial defects, impaired neurogenesis, and neuroinflammation, all of which are known to contribute to increased anxiety and neurocognitive decline. Despite the increased prevalence of CICI, there exists a lack of mechanistic understanding by which chemotherapy detrimentally affects cognition in cancer survivors. Moreover, there are no approved therapeutic interventions for this condition. To address this gap in knowledge, this review attempts to identify how adenosine signaling, particularly through the adenosine A2A receptor, can be an essential tool to attenuate accelerated aging phenotypes. Importantly, the adenosine A2A receptor uniquely stands at the crossroads of cancer treatment and improved cognition, given that it is widely known to control tumor induced immunosuppression in the tumor microenvironment, while also posited to be an essential regulator of cognition in neurodegenerative disease. Consequently, we propose that the adenosine A2A receptor may provide a multifaceted therapeutic strategy to enhance anticancer activity, while combating chemotherapy induced cognitive deficits, both which are essential to provide novel therapeutic interventions against accelerated aging in cancer survivors.
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Affiliation(s)
- Alfredo Oliveros
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Michael Poleschuk
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Peter D Cole
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Detlev Boison
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, United States.
| | - Mi-Hyeon Jang
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, United States.
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2
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Rashid MA, Oliveros A, Kim YS, Jang MH. Nicotinamide Mononucleotide Prevents Cisplatin-Induced Mitochondrial Defects in Cortical Neurons Derived from Human Induced Pluripotent Stem Cells. Brain Plast 2022; 8:143-152. [PMID: 36721392 PMCID: PMC9837732 DOI: 10.3233/bpl-220143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Chemotherapy-induced cognitive impairment (CICI) is a neurotoxic side effect of chemotherapy that has yet to have an effective treatment. Objective Using cisplatin, a platinum-based chemotherapy together with excitatory cortical neurons derived from human induced pluripotent cells (iPSCs) to model of CICI, our recent study demonstrated that dysregulation of brain NAD+ metabolism contributes to cisplatin-induced impairments in neurogenesis and cognitive function, which was prevented by administration of the NAD+ precursor, nicotinamide mononucleotide (NMN). However, it remains unclear how cisplatin causes neurogenic dysfunction and the mechanism by which NMN prevents cisplatin-induced cognitive impairment. Given that mitochondrial dysfunction is thought to play a prominent role in age-related neurodegenerative disease and chemotherapy-induced neurotoxicity, we sought to explore if NMN prevents chemotherapy-related neurotoxicity by attenuating cisplatin-induced mitochondrial damage. Results We demonstrate that cisplatin induces neuronal DNA damage, increases generation of mitochondrial reactive oxygen species (ROS) and decreases ATP production, all of which are indicative of oxidative DNA damage and mitochondrial functional defects. Ultrastructural analysis revealed that cisplatin caused loss of cristae membrane integrity and matrix swelling in human cortical neurons. Notably, pretreatment with NMN prevents cisplatin-induced defects in mitochondria of human cortical neurons. Conclusion Our results suggest that increased mitochondrial oxidative stress and functional defects play key roles in cisplatin-induced neurotoxicity. Thus, NMN may be an effective therapeutic strategy to prevent cisplatin-induced deleterious effects on mitochondria, making this organelle a key factor in amelioration of cisplatin-induced cognitive impairments.
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Affiliation(s)
- Mohammad Abdur Rashid
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alfredo Oliveros
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Yu Shin Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mi-Hyeon Jang
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
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3
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Guran E, Hu J, Wefel JS, Chung C, Cata JP. Perioperative considerations in patients with chemotherapy-induced cognitive impairment: a narrative review. Br J Anaesth 2022; 129:909-922. [PMID: 36270848 DOI: 10.1016/j.bja.2022.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/01/2022] [Accepted: 08/23/2022] [Indexed: 11/02/2022] Open
Abstract
Patients with cancer may suffer from a decline in their cognitive function after various cancer therapies, including surgery, radiation, and chemotherapy, and in some cases, this decline in cognitive function persists even years after completion of treatment. Chemobrain or chemotherapy-induced cognitive impairment, a well-established clinical syndrome, has become an increasing concern as the number of successfully treated cancer patients has increased significantly. Chemotherapy-induced cognitive impairment can originate from direct neurotoxicity, neuroinflammation, and oxidative stress, resulting in alterations in grey matter volume, white matter integrity, and brain connectivity. Surgery has been associated with exacerbating the inflammatory response associated with chemotherapy and predisposes patients to develop postoperative cognitive dysfunction. As the proportion of patients living longer after these therapies increases, the magnitude of impact and growing concern of post-treatment cognitive dysfunction in these patients has also come to the fore. We review the clinical presentation, potential mechanisms, predisposing factors, diagnostic methods, neuropsychological testing, and imaging findings of chemotherapy-induced cognitive impairment and its intersection with postoperative cognitive dysfunction.
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Affiliation(s)
- Ekin Guran
- Department of Anaesthesiology and Reanimation, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, Turkey; Anaesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - Jian Hu
- Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey S Wefel
- Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Caroline Chung
- Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Juan P Cata
- Anaesthesiology and Surgical Oncology Research Group, Houston, TX, USA; Department of Anaesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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4
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Aslanzadeh F, Braun S, Brechbiel J, Willis K, Parker K, Lanoye A, Loughan A. Re-examining popular screening measures in neuro-oncology: MMSE and RBANS. Support Care Cancer 2022; 30:8041-8049. [PMID: 35771290 DOI: 10.1007/s00520-022-07213-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The Mini-Mental Status Examination (MMSE) is routinely used in neuro-oncology clinics to rule out cognitive impairment. However, the MMSE is known to have poor sensitivity to mild cognitive impairment, raising concern regarding its continued use. More comprehensive cognitive screeners are available, such as the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and may be better able to assess for cognitive dysfunction. METHODS This retrospective cross-sectional study compared the relative rates of impairment using the MMSE-2 and RBANS in a sample of neuro-oncology patients (N = 81). A preliminary analysis of the sensitivity and specificity of the MMSE-2 to the level of cognitive impairment identified on the RBANS was conducted; in addition, we examined whether an adjustment of the MMSE-2 cut-off score improved consensus with a positive screening on the RBANS. RESULTS The MMSE-2 failed to identify over half of the patients with cognitive dysfunction that were identified on the RBANS. Further analysis showed limited sensitivity of the MMSE-2 to the level of impairment detected on the RBANS, and an adjustment of the cut-off score did not improve the sensitivity or specificity of the MMSE-2. CONCLUSIONS These results provide caution for neuro-oncology clinics using the MMSE. If providers continue to rely on the MMSE to screen for cognitive impairment alone, they may fail to identify individuals with mild cognitive impairments.
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Affiliation(s)
- Farah Aslanzadeh
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah Braun
- Division of Neuro-Oncology, Department of Neurology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Julia Brechbiel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelcie Willis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kyra Parker
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Autumn Lanoye
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.,Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Ashlee Loughan
- Division of Neuro-Oncology, Department of Neurology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA. .,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
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Abraham EH, Khan B, Ling E, Bernstein LJ. The Development and Evaluation of a Patient Educational Resource for Cancer-Related Cognitive Dysfunction. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:111-119. [PMID: 32557399 DOI: 10.1007/s13187-020-01793-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cancer patients and survivors frequently experience cognitive deficits, including problems with attention and memory. These symptoms, referred to as cancer-related cognitive dysfunction (CRCD), are associated with distress. Learning about CRCD and self-management strategies may improve functioning and quality of life in cancer survivors. This study describes the development and evaluation of a CRCD resource for cancer patients. An educational booklet was developed in accordance with multiple evidence-based guidelines for cancer patient education. Cancer patients on chemotherapy (N = 113; 34% men; median age 55, range 19-85) reviewed the booklet and self-reported CRCD knowledge before and after reading the booklet. They also gave ratings on general impressions of the booklet. Seventy-five percent of participants reported that the resource increased their self-reported CRCD knowledge. A Wilcoxon signed-rank test demonstrated that exposure to the booklet elicited a statistically significant change in self-reported knowledge (Z = - 7.13, p < 0.001). A repeated-measures ANCOVA determined that the means of self-reported CRCD knowledge were significantly different between pre- and post-exposure (F(1, 92) = 7.96, p = 0.006, η2 = 0.08). Exploratory analyses revealed that self-reported CRCD knowledge increased across all educational attainment levels from pre- to post-exposure. Ninety-one percent of participants reported that all patients undergoing cancer treatment would find this booklet helpful. Cancer patients at risk for cognitive challenges gained self-reported CRCD knowledge from the booklet, and they think this knowledge would be helpful to others. A resource that makes CRCD understandable and manageable can bridge the gap in self-rated knowledge across education levels.
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Affiliation(s)
- Eleenor H Abraham
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Bilal Khan
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Erick Ling
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Lori J Bernstein
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Dias-Carvalho A, Ferreira M, Ferreira R, Bastos MDL, Sá SI, Capela JP, Carvalho F, Costa VM. Four decades of chemotherapy-induced cognitive dysfunction: comprehensive review of clinical, animal and in vitro studies, and insights of key initiating events. Arch Toxicol 2021; 96:11-78. [PMID: 34725718 DOI: 10.1007/s00204-021-03171-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/23/2021] [Indexed: 01/22/2023]
Abstract
Cognitive dysfunction has been one of the most reported and studied adverse effects of cancer treatment, but, for many years, it was overlooked by the medical community. Nevertheless, the medical and scientific communities have now recognized that the cognitive deficits caused by chemotherapy have a strong impact on the morbidity of cancer treated patients. In fact, chemotherapy-induced cognitive dysfunction or 'chemobrain' (also named also chemofog) is at present a well-recognized effect of chemotherapy that could affect up to 78% of treated patients. Nonetheless, its underlying neurotoxic mechanism is still not fully elucidated. Therefore, this work aimed to provide a comprehensive review using PubMed as a database to assess the studies published on the field and, therefore, highlight the clinical manifestations of chemobrain and the putative neurotoxicity mechanisms.In the last two decades, a great number of papers was published on the topic, mainly with clinical observations. Chemotherapy-treated patients showed that the cognitive domains most often impaired were verbal memory, psychomotor function, visual memory, visuospatial and verbal learning, memory function and attention. Chemotherapy alters the brain's metabolism, white and grey matter and functional connectivity of brain areas. Several mechanisms have been proposed to cause chemobrain but increase of proinflammatory cytokines with oxidative stress seem more relevant, not excluding the action on neurotransmission and cellular death or impaired hippocampal neurogenesis. The interplay between these mechanisms and susceptible factors makes the clinical management of chemobrain even more difficult. New studies, mainly referring to the underlying mechanisms of chemobrain and protective measures, are important in the future, as it is expected that chemobrain will have more clinical impact in the coming years, since the number of cancer survivors is steadily increasing.
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Affiliation(s)
- Ana Dias-Carvalho
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal. .,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.
| | - Mariana Ferreira
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,LAQV/REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Rita Ferreira
- LAQV/REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Maria de Lourdes Bastos
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal
| | - Susana Isabel Sá
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Paulo Capela
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - Félix Carvalho
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal
| | - Vera Marisa Costa
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal. .,UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.
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7
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Corley C, Allen AR. A Bibliometric Analysis of Cyclophosphamide, Methotrexate, and Fluorouracil Breast Cancer Treatments: Implication for the Role of Inflammation in Cognitive Dysfunction. Front Mol Biosci 2021; 8:683389. [PMID: 34490346 PMCID: PMC8417522 DOI: 10.3389/fmolb.2021.683389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Inflammation is considered one of the possible mechanisms behind long-term cognitive dysfunction persistent after chemotherapy treatment. The chemotherapy combination of cyclophosphamide, methotrexate, and fluorouracil (CMF) was one of the older methods of treating breast cancer patients. Decades later, these patients still report experiencing cognitive side effects. In this present bibliometric review, we applied the VOSviewer tool to describe the existing landscape on literature concerning inflammation as it relates to CMF and cognitive dysfunctions. As time progressed, we saw an increase in interest in the topic. By the mid-2010s there were approximately 1,000 publications per year. Terms related to the brain and CNS did not appear until the later years, and terms related to inflammation and breast cancer were very prevalent throughout the three decades. Also, in more recent years, inflammatory markers and plant-derived compounds used to alleviate side effects of the inflammatory response appeared in the search results. The USA remained the most prolific producer of CMF-, inflammation-, and cognitive dysfunction-related papers throughout the three decades followed by Asia and Europe. As research of cognitive dysfunction caused by inflammation due to chemotherapy treatment progresses, more opportunities emerge for therapeutic methods to improve the quality of life for long-term survivors.
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Affiliation(s)
- Christa Corley
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Pharmaceutical Sciences, The University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Antiño R Allen
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Pharmaceutical Sciences, The University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Neurobiology & Developmental Sciences, The University of Arkansas for Medical Sciences, Little Rock, AR, United States
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8
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Umfress A, Speed HE, Tan C, Ramezani S, Birnbaum S, Brekken RA, Sun X, Plattner F, Powell CM, Bibb JA. Neuropathological Effects of Chemotherapeutic Drugs. ACS Chem Neurosci 2021; 12:3038-3048. [PMID: 34370453 DOI: 10.1021/acschemneuro.1c00338] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Novel treatments, screening, and detection methods have prolonged the lives of numerous cancer patients worldwide. Unfortunately, existing and many promising new chemotherapeutics can cause deleterious, off-target side effects in normal tissue and organ systems. The central and peripheral nervous systems are widely recognized as frequent off-target effectors of anticancer drugs which can produce persistent neurological and neuropsychiatric symptoms collectively termed "chemobrain". Following chemotherapy, patients report several forms of cognitive impairment occurring acutely and sometimes persisting years after treatment. There are no effective treatments for cognitive decline induced by chemotherapeutics, and the underlying molecular mechanisms are poorly characterized and understood. In this study, we find that chronic treatment with two common chemotherapeutic agents, cisplatin and gemcitabine, impairs brain region-specific metabolism, hippocampus-dependent memory formation, and stress response behavior. This corresponds to reduced hippocampal synaptic excitability, altered neuronal signal transduction, and neuroinflammation. These findings underline that a better understanding of the basic pathological consequences of chemotherapy-induced cognitive impairment is the first step toward improving cancer treatment survivorship.
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Affiliation(s)
- Alan Umfress
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35233, United States
| | | | | | | | | | | | | | | | | | - James A. Bibb
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35233, United States
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9
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Anderson JE, Trujillo M, McElroy T, Groves T, Alexander T, Kiffer F, Allen AR. Early Effects of Cyclophosphamide, Methotrexate, and 5-Fluorouracil on Neuronal Morphology and Hippocampal-Dependent Behavior in a Murine Model. Toxicol Sci 2021; 173:156-170. [PMID: 31651976 DOI: 10.1093/toxsci/kfz213] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Breast cancer (BC) is the most common cancer among women. Fortunately, BC survival rates have increased because the implementation of adjuvant chemotherapy leading to a growing population of survivors. However, chemotherapy-induced cognitive impairments (CICIs) affect up to 75% of BC survivors and may be driven by inflammation and oxidative stress. Chemotherapy-induced cognitive impairments can persist 20 years and hinder survivors' quality of life. To identify early effects of CMF administration in mice, we chose to evaluate adult female mice at 2-week postchemotherapy. Mice received weekly IP administration of CMF (or saline) for 4 weeks, completed behavioral testing, and were sacrificed 2 weeks following their final CMF injection. Behavioral results indicated long-term memory (LTM) impairments postchemotherapy, but did not reveal short-term memory deficits. Dendritic morphology and spine data found increases in overall spine density within CA1 basal and CA3 basal dendrites, but no changes in DG, CA1 apical, or CA3 apical dendrites. Further analysis revealed decreases in arborization across the hippocampus (DG, CA1 apical and basal, CA3 apical and basal). These physiological changes within the hippocampus correlate with our behavioral data indicating LTM impairments following CMF administration in female mice 2-week postchemotherapy. Hippocampal cytokine analysis identified decreases in IL-1α, IL-1β, IL-3, IL-10, and TNF-α levels.
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Affiliation(s)
- Julie E Anderson
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Madison Trujillo
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Taylor McElroy
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Thomas Groves
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Tyler Alexander
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Frederico Kiffer
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Antiño R Allen
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205.,Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
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10
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Yu H, Kong H, Li C, Dong X, Wu Y, Zhuang Y, Han S, Lei T, Yang H. Bruton's tyrosine kinase inhibitors in primary central nervous system lymphoma-evaluation of anti-tumor efficacy and brain distribution. Transl Cancer Res 2021; 10:1975-1983. [PMID: 35116520 PMCID: PMC8798964 DOI: 10.21037/tcr-21-50] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
Background Primary central nervous system lymphoma (PCNSL) is an aggressive lymphoma confined to central nervous system. Current treatments including surgery, chemotherapy and whole-brain radiotherapy often fail to achieve satisfactory effect, especially in elderly. As a regimen in targeted therapy, Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib has been tested in several clinical trials against PCNSL, offering hope for patients unfit for chemotherapy. We aim to evaluate and compare the anti-PCNSL ability of three different BTK inhibitors, ibrutinib, zanubrutinib and tirabrutinib, providing direct evidence for the targeted therapy of PCNSL. Methods Retrospective study was done on patients who received ibrutinib-based therapy in our hospital. Cerebrospinal fluid (CSF) from one patient was collected to measure the concentration of ibrutinib. Inhibition assay and apoptosis assay were done on lymphoma cells to determine the anti-tumoral effects of three inhibitors. Pharmacokinetic study was conducted to evaluate their ability in penetrating blood brain barrier and distributing in brain. Results In retrospective study, we found three patients with PCNSL who had good clinical response to ibrutinib-based therapy (2 complete remission, 1 partial remission), which further support the use of BTK inhibitors in PCNSL. In vitro studies show that ibrutinib has the best anti-tumoral ability among three inhibitors. In vivo study on pharmacokinetic profiles indicate that both ibrutinib and tirabrutinib are good in distributing in brain parenchyma. Conclusions In conclusion, our study results suggest that BTK inhibitors can be promising candidates for PCNSL treatment, preferring the use of ibrutinib and tirabrutinib as anti-PCNSL agents among the three inhibitors.
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Affiliation(s)
- Haifeng Yu
- Department of Lymphoma, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Haiying Kong
- Department of Pharmacy, Zhejiang Medical and Health Group Hangzhou Hospital (Hangzhou Hanggang Hospital), Hangzhou, China
| | - Cong Li
- Department of Lymphoma, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xiaowu Dong
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Yizhe Wu
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Yuxin Zhuang
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Shuiyun Han
- Department of Lymphoma, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Tao Lei
- Department of Lymphoma, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Haiyan Yang
- Department of Lymphoma, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
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11
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Leung WS, Kuo WW, Ju DT, Wang TD, Shao-Tsu Chen W, Ho TJ, Lin YM, Mahalakshmi B, Lin JY, Huang CY. Protective effects of diallyl trisulfide (DATS) against doxorubicin-induced inflammation and oxidative stress in the brain of rats. Free Radic Biol Med 2020; 160:141-148. [PMID: 32745770 DOI: 10.1016/j.freeradbiomed.2020.07.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/22/2022]
Abstract
Doxorubicin (DOX) is a widely used antitumor drug that causes severe neurotoxicity in patients. Diallyl trisulfide (DATS) is an organosulfur compound with established potent antioxidant and anti-inflammatory properties. Herein, we investigated the neuroprotective efficacy of DATS in preventing DOX-induced neurotoxicity in a rat model. Specifically, DATS (40 mg/kg) was administered to rats 24 h after DOX treatment, once a week for 8 weeks. Our results showed that DATS treatment led to a decrease in plasma levels of tumor necrosis factor-alpha (TNF-α) induced by DOX. DATS restored cerebral cortex and hippocampus histopathological architecture and neuronal loss. Immunohistochemical staining indicated that DATS decreased the expression of glial fibrillar acidic protein (GFAP) in DOX treated rats. Components of stress-related inflammatory proteins (TNF-α, phospho nuclear factor kappa B (NF-κB), inducible nitricoxide synthase (iNOS) and cyclooxygenase-2 (COX-2)) were all significantly increased in the DOX group, in comparison with the control group, whereas they were decreased after DATS treatment. In addition, the mRNA of antioxidant enzymes (superoxide dismutase 2 (SOD2), catalase, glutathione peroxidase 1, 4 (GPx1 and GPx4)) and antioxidant proteins (heme oxygenase-1 (HO-1), superoxide dismutase 1, 2 (SOD1 and SOD2), Γ-glutamylcysteine synthase (Γ-GCSc)) were markedly increased in DOX group compared with the control group, which were significantly attenuated by DATS treatment. The upregulation of antioxidants enzymes in DOX group was probably a compensatory effect against elevated oxidative stress induced by DOX. DATS treatment could ameliorate this oxidative stress in brain. Our results suggested that DATS has potential clinical applications in the prevention of DOX-induced neurotoxicity by ameliorating inflammatory insults and oxidative stress.
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Affiliation(s)
- Wai-Shing Leung
- Department of Emergency Medicine, Jen-Ai Hospital, Taichung, 403, Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, 404, Taiwan
| | - Da-Tong Ju
- Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan
| | - Tian-De Wang
- Department of Biological Science and Technology, China Medical University, Taichung, 404, Taiwan
| | - William Shao-Tsu Chen
- Department of Psychiatry, Tzu Chi General Hospital, Hualien, 970, Taiwan; School of Medicine Tzu Chi University, Hualien, 970, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, 970, Taiwan
| | - Yu Min Lin
- Department of Emergency Medicine, Jen-Ai Hospital, Taichung, 403, Taiwan
| | - B Mahalakshmi
- Institute of Research and Development, Duy Tan University, Da Nang, 550000, Viet Nam
| | - Jing-Ying Lin
- Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, 406, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 404, Taiwan; Center of General Education, Buddhist Tzu Chi Medical Foundation, Tzu Chi University of Science and Technology, Hualien, 970, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan; Department of Biotechnology, Asia University, Taichung, 413, Taiwan.
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12
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Protective Effects of ACY-1215 Against Chemotherapy-Related Cognitive Impairment and Brain Damage in Mice. Neurochem Res 2019; 44:2460-2469. [DOI: 10.1007/s11064-019-02882-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/29/2019] [Accepted: 09/18/2019] [Indexed: 11/26/2022]
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13
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Fahim A, Rehman Z, Bhatti MF, Virk N, Ali A, Rashid A, Paracha RZ. The Route to 'Chemobrain' - Computational probing of neuronal LTP pathway. Sci Rep 2019; 9:9630. [PMID: 31270411 PMCID: PMC6610097 DOI: 10.1038/s41598-019-45883-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/19/2019] [Indexed: 02/08/2023] Open
Abstract
Chemotherapy causes deleterious side effects during the course of cancer management. The toxic effects may be extended to CNS chronically resulting in altered cognitive function like learning and memory. The present study follows a computational assessment of 64 chemotherapeutic drugs for their off-target interactions against the major proteins involved in neuronal long term potentiation pathway. The cancer chemo-drugs were subjected to induced fit docking followed by scoring alignment and drug-targets interaction analysis. The results were further probed by electrostatic potential computation and ligand binding affinity prediction of the top complexes. The study identified novel off-target interactions by Dactinomycin, Temsirolimus, and Everolimus against NMDA, AMPA, PKA and ERK2, while Irinotecan, Bromocriptine and Dasatinib were top interacting drugs for CaMKII. This study presents with basic foundational knowledge regarding potential chemotherapeutic interference in LTP pathway which may modulate neurotransmission and synaptic plasticity in patient receiving these chemotherapies.
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Affiliation(s)
- Ammad Fahim
- Atta ur Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Zaira Rehman
- Atta ur Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Muhammad Faraz Bhatti
- Atta ur Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Nasar Virk
- Atta ur Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan
- EBS Universität für Wirtschaft und Recht, EBS Business School, Rheingaustrasse 1, Oestrich-Winkel, 65375, Germany
| | - Amjad Ali
- Atta ur Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Amir Rashid
- Department of Biochemistry, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Rehan Zafar Paracha
- Research Centre for Modeling and Simulation, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
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14
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Zhou Y, Qiu Y. Propofol alleviates cisplatin-related cognitive impairment. Neurol Sci 2019; 40:1645-1649. [PMID: 31016408 DOI: 10.1007/s10072-019-03895-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 04/11/2019] [Indexed: 12/13/2022]
Abstract
Chemotherapy-related cognitive impairment (CRCI) is commonly reported following the administration of chemotherapeutic agents and comprises a wide variety of neurological problems. Many patients after chemotherapy need further surgery under anesthesia. Thus, in this study, we examined whether propofol, one of the most commonly used anesthetics in surgery, could further affect the cognitive abilities in mouse CRCI models. The mice were injected intraperitoneally with cisplatin (2 mg/kg/day) for continuous 10 days and showed significantly reduced body weights. After 10 days reconversion, mice with cisplatin injection showed impaired memory retention in the inhibitory avoidance (IA) task, mimicking the CRCI in patients. Then, we found that a single injection of propofol with the sub-anesthetic dosage (50 mg/kg) but not the anesthetic dosage (250 mg/kg) could significantly alleviate the cisplatin-induced memory impairment. These results imply the possible clinical application of propofol, especially at the sub-anesthetic dosage, in the surgery of patients after chemotherapy.
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Affiliation(s)
- Yu Zhou
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yimin Qiu
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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15
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Alexander TC, Kiffer F, Groves T, Anderson J, Wang J, Hayar A, Chen MT, Rodriguez A, Allen AR. Effects of thioTEPA chemotherapy on cognition and motor coordination. Synapse 2019; 73:e22085. [PMID: 30586195 DOI: 10.1002/syn.22085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/15/2018] [Accepted: 12/20/2018] [Indexed: 01/10/2023]
Abstract
Cancer survivorship has increased greatly as therapies have become more advanced and effective. Thus, we must now focus on improving the quality of life of patients after treatment. After chemotherapy, many patients experience chemotherapy-induced cognitive decline, indicating a need to investigate pathologies associated with this condition. In this study, we addressed cognitive impairment after thioTEPA treatment by assessing behavior and assaying cytokine production and the structure of dendrites in the hippocampus. Male mice were given three intraperitoneal injections of thioTEPA. Five weeks later, the mice underwent behavior testing, and brains were collected for Golgi staining and cytokine analysis. Behavior tests included y-maze and Morris water maze and licking behavioral task. Cytokines measured include: IL-1α, IL-1β, IL-2, IL-3, IL-4, IL-5, IL-10, IL-12p70, MCP-1, TNF-α, GMCSF, and RANTES. We observed decreased memory retention in behavioral tasks. Also, dendritic arborization and length were decreased after chemotherapy treatment. Finally, thioTEPA decreased cytokine production in animals treated with chemotherapy, compared to saline-treated controls. Here, we used a mouse model to correlate the decreases in dendritic complexity and inflammatory cytokine production with cognitive impairment after chemotherapy.
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Affiliation(s)
- Tyler C Alexander
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Frederico Kiffer
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thomas Groves
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Ocala West Veterans Affairs, Ocala, Florida
| | - Julie Anderson
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jing Wang
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Abdallah Hayar
- Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Antiño R Allen
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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16
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Loughan AR, Braun SE, Lanoye A. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary utility in adult neuro-oncology. Neurooncol Pract 2018; 6:289-296. [PMID: 31386070 DOI: 10.1093/nop/npy050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Neurocognitive assessments have become integral to comprehensive neuro-oncology care. Existing screening tools may be insensitive to cognitive changes caused by medical treatments. Research supports the clinical value and psychometric properties of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in various medical populations; however, there is minimal evidence for its use in neuro-oncology. The purpose of the current study was to further explore the cognitive profile of patients with primary brain tumor (PBT) using the RBANS and to assess rates of below-expectation performance compared to normative data and estimated intellectual functioning. Methods Data were collected on 82 PBT patients (54% male; age range, 19-81 years). All patients were administered the RBANS-Update and the Advanced Clinical Solutions-Test of Premorbid Functioning (TOPF) according to standardized instructions. Cognitive strengths and weaknesses were identified for PBT patients. Descriptive analyses, t tests, and chi-squared tests were utilized to identify and compare cognitive profiles. Results Overall, cognitive performance was low average for PBT patients. When compared to standardization data, PBT patients performed significantly worse across all 5 RBANS indexes, with Attention and Memory showing the largest discrepancies. Estimated intelligence analyses reflected greater deficits in cognitive functioning than when compared to a normal distribution. Conclusions Preliminary research demonstrates the RBANS is an efficient screening tool to assess cognitive deficits in PBT patients. Data also support the importance of comparison to self, rather than normative distribution in ensuring proper identification and classification of patients.
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Affiliation(s)
- Ashlee R Loughan
- Department of Neurology, Division of Neuro-oncology, Virginia Commonwealth University and Massey Cancer Center, McGlothlin Medical Education Center, Richmond
| | - Sarah E Braun
- Department of Psychology, Virginia Commonwealth University, Richmond
| | - Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond
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17
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Hlubocky FJ, Sachs GA, Larson ER, Nimeiri HS, Cella D, Wroblewski KE, Ratain MJ, Peppercorn JM, Daugherty CK. Do Patients With Advanced Cancer Have the Ability to Make Informed Decisions for Participation in Phase I Clinical Trials? J Clin Oncol 2018; 36:2483-2491. [PMID: 29985748 DOI: 10.1200/jco.2017.73.3592] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose Patients with advanced cancer (ACPs) participating in phase I clinical trials inadequately understand many elements of informed consent (IC); however, the prevalence and impact of cognitive impairment has not been described. Patients and Methods ACPs enrolled onto phase I trials underwent neuropsychological assessment to evaluate cognitive functioning (CF) covering the following domains: memory (Hopkins Verbal Learning Test), executive functioning (Trail Making Test B), language (Boston Naming Test-Short Version and Controlled Oral Word Association Test), attention (Trail Making Test A and Wechsler Adult Intelligenence Scale-IV Digit Span), comprehension (Wechsler Adult Intelligence Scale-IV), and quality of life (Functional Assessment of Cancer Therapy-Cognitive Function). Structured interviews evaluated IC and decisional capacity. Psychological measures included distress (Hospital Anxiety Depression Scale) and depression (Beck Depression Inventory-II). Results One hundred eighteen ACPs on phase I trials were evaluated, with CF ranging from mild impairment to superior performance. Only 45% of ACPs recalled physician disclosure of the phase I trial purpose. The 50% of ACPs who correctly identified the phase I research purpose had greater CF compared with ACPs who did not, as revealed by the mean T scores for memory (37.2 ± 5.6 v 32.5 ± 5.1, respectively; P = .001), attention (29 ± 2.7 v 26.9 ± 2.4, respectively; P < .001), visual attention (35.2 ± 6.6 v 31.5 ± 6.2, respectively; P = .001), and executive function (38.9 ± 7.5 v 34 ± 7.1, respectively; P < .001). Older ACPs (≥ 60 years) were less likely to recall physician disclosure of phase I purpose than younger ACPs (30% v 70%, respectively; P = .02) and had measurable deficits in total memory (34.2 ± 5.0 v 37.3 ± 5.6, respectively; P = .002), attention (24.5 ± 2.6 v 28 ± 2.8, respectively; P < .001), and executive function (32.8 ± 7.3 v 36.4 ± 7.6, respectively; P = .01). Older ACPs, compared with younger ACPs, also had greater depression scores (10.6 ± 9.2 v 8.1 ± 5.2, respectively; P = .03) and lower quality-of-life scores (152 ± 29.6 v 167 ± 20, respectively; P = .03). After adjustment by age, no psychological or neuropsychological variable was further significantly associated with likelihood of purpose identification. Conclusion CF seems to play a role in ACP recall and comprehension of IC for early-phase clinical trials, especially among older ACPs.
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Affiliation(s)
- Fay J Hlubocky
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Greg A Sachs
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Eric R Larson
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Halla S Nimeiri
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - David Cella
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Kristen E Wroblewski
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Mark J Ratain
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Jeffery M Peppercorn
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
| | - Christopher K Daugherty
- Fay J. Hlubocky, Kristen E. Wroblewski, Mark J. Ratain, and Christopher K. Daugherty, The University of Chicago, Chicago; Halla S. Nimeiri and David Cella, Northwestern University, Evanston, IL; Greg A. Sachs, Indiana University and Regenstrief Institute, Indianapolis, IN; Eric R. Larson, Department of Veterans Affairs, Milwaukee, WI; and Jeffery M. Peppercorn, Massachusetts General Hospital, Dana-Farber Partners/Harvard Health System, Boston, MA
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18
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Mohammadi AS, Li X, Ewing AG. Mass Spectrometry Imaging Suggests That Cisplatin Affects Exocytotic Release by Alteration of Cell Membrane Lipids. Anal Chem 2018; 90:8509-8516. [PMID: 29912552 DOI: 10.1021/acs.analchem.8b01395] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We used time-of-flight secondary ion mass spectrometry (TOF-SIMS) imaging to investigate the effect of cisplatin, the first member of the platinum-based anticancer drugs, on the membrane lipid composition of model cells to see if lipid changes might be involved in the changes in exocytosis observed. Platinum-based anticancer drugs have been reported to affect neurotransmitter release resulting in what is called the "chemobrain"; however, the mechanism for the influence is not yet understood. TOF-SIMS imaging was carried out using a high energy 40 keV (CO2)6000+ gas cluster ion beam with improved sensitivity for intact lipids in biological samples. Principal components analysis showed that cisplatin treatment of PC12 cells significantly affects the abundance of different lipids and their derivatives, particularly phosphatidylcholine and cholesterol, which are diminished. Treatment of cells with 2 μM and 100 μM cisplatin showed similar effects on induced lipid changes. Lipid content alterations caused by cisplatin treatment at the cell surface are associated with the molecular and bimolecular signaling pathways of cisplatin-induced apoptosis of cells. We suggest that lipid alterations measured by TOF-SIMS are involved, at least in part, in the regulation of exocytosis by cisplatin.
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Affiliation(s)
- Amir Saeid Mohammadi
- Department of Chemistry and Molecular Biology , University of Gothenburg , 40530 Gothenburg , Sweden.,National Center for Imaging Mass Spectrometry , 41296 Gothenburg , Sweden
| | - Xianchan Li
- Department of Chemistry and Molecular Biology , University of Gothenburg , 40530 Gothenburg , Sweden
| | - Andrew G Ewing
- Department of Chemistry and Molecular Biology , University of Gothenburg , 40530 Gothenburg , Sweden.,National Center for Imaging Mass Spectrometry , 41296 Gothenburg , Sweden.,Department of Chemistry and Chemical Engineering , Chalmers University of Technology , 41296 Gothenburg , Sweden
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19
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Toxicities Associated with Cisplatin-Based Chemotherapy and Radiotherapy in Long-Term Testicular Cancer Survivors. Adv Urol 2018; 2018:8671832. [PMID: 29670654 PMCID: PMC5835297 DOI: 10.1155/2018/8671832] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/06/2017] [Indexed: 12/16/2022] Open
Abstract
Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year relative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by long-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and second malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse outcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular necrosis. Future research efforts should focus on delineation of the genetic underpinning of these long-term toxicities to understand their biologic basis and etiopathogenetic pathways, with the goal of developing targeted prevention and intervention strategies to optimize risk-based care and minimize chronic morbidities. In the interim, health care providers should advise TCS to adhere to national guidelines for the management of cardiovascular disease risk factors, as well as to adopt behaviors consistent with a healthy lifestyle, including smoking cessation, a balanced diet, and a moderate to vigorous intensity exercise program. TCS should also follow national guidelines for cancer screening as currently applied to the general population.
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20
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Pendergrass JC, Targum SD, Harrison JE. Cognitive Impairment Associated with Cancer: A Brief Review. INNOVATIONS IN CLINICAL NEUROSCIENCE 2018; 15:36-44. [PMID: 29497579 PMCID: PMC5819720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This brief review explores the areas of cognitive impairment that have been observed in cancer patients and survivors, the cognitive assessment tools used, and the management of the observed cognitive changes. Cognitive changes and impairment observed in patients with cancer and those in remission can be related to the direct effects of cancer itself, nonspecific factors or comorbid conditions that are independent of the actual disease, and/or the treatments or combination of treatments administered. Attention, memory, and executive functioning are the most frequently identified cognitive domains impacted by cancer. However, the prevalence and extent of impairment remains largely unknown due to marked differences in methodology, definitions of cognitive impairment, and the assessment measures used. Assessment of cognitive functioning is an important and necessary part of a comprehensive oncological care plan. Research is needed to establish a better understanding of cognitive changes and impairments associated with cancer so that optimal patient outcomes can be achieved.
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Affiliation(s)
- J Cara Pendergrass
- Drs. Pendergrass and Targum are with Bracket Global and Clintara LLC, A Bracket Company, in Boston, Massachusetts
- Dr. Harrison is with the Alzheimer's Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center in Amsterdam, Netherlands; Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom; and Metis Cognition Ltd, Park House, Kilmington Common in Wiltshire, United Kingdom
| | - Steven D Targum
- Drs. Pendergrass and Targum are with Bracket Global and Clintara LLC, A Bracket Company, in Boston, Massachusetts
- Dr. Harrison is with the Alzheimer's Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center in Amsterdam, Netherlands; Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom; and Metis Cognition Ltd, Park House, Kilmington Common in Wiltshire, United Kingdom
| | - John E Harrison
- Drs. Pendergrass and Targum are with Bracket Global and Clintara LLC, A Bracket Company, in Boston, Massachusetts
- Dr. Harrison is with the Alzheimer's Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center in Amsterdam, Netherlands; Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom; and Metis Cognition Ltd, Park House, Kilmington Common in Wiltshire, United Kingdom
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21
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Kerner JF, Cazap E, Yach D, Pierotti MA, Daidone MG, de Blasio P, Geary P, Schacter B, Sant M, Habbema JDF, Sankaranarayanan R, Sutcliffe C, Sutcliffe S. Comprehensive cancer control-research & development: knowing what we do and doing what we know. TUMORI JOURNAL 2018; 95:610-22. [DOI: 10.1177/030089160909500504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Comprehensive cancer control is defined as an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality across the cancer control continuum from primary prevention to end-of-life care. This approach assumes that when the public sector, non-governmental organizations, academia, and the private sector share with each other their skills, knowledge, and resources, a country can take advantage of all its talents and resources to more quickly reduce the burden of cancer for all its population. One critical issue for comprehensive cancer control is the extent to which the private sector can contribute to cancer prevention and control programs and policies that have historically been lead by the public health sector, and similarly how can the public sector increase its investment and involvement in clinical research and practice issues that are largely driven by the private sector worldwide? In addition, building capacity to integrate research that is appropriate to the culture and context of the population will be important in different settings, in particular research related to cancer control interventions that have the capacity to influence outcomes. To whatever extent cancer control research is ultimately funded through the private and public sectors, if investments in research discoveries are ultimately to benefit the populations that bear the greatest burden of disease, then new approaches to integrating the lessons learned from science with the lessons learned from service (public health, clinical, and public policy) must be found to close the gap between what we know and what we do. Communities of practice for international cancer control, like the ones fostered by the first three International Cancer Control Congresses, represent an important forum for knowledge exchange opportunities to accelerate the translation of new knowledge into action to reduce the burden of cancer worldwide.
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Affiliation(s)
- Jon F Kerner
- Canadian Partnership Against Cancer, Toronto, Canada
| | - Eduardo Cazap
- Sociedad Latinoamericana y del Caribe de Oncologia Medica (SLACOM), Buenos Aires, Argentina
| | | | | | | | | | - Peter Geary
- Canadian Tumor Repository Network, Manitoba, Canada
| | | | - Milena Sant
- Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - J Dik F Habbema
- Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Simon Sutcliffe
- Canadian Partnership Against Cancer Board of Directors, Vancouver, Canada
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22
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Huehnchen P, Boehmerle W, Springer A, Freyer D, Endres M. A novel preventive therapy for paclitaxel-induced cognitive deficits: preclinical evidence from C57BL/6 mice. Transl Psychiatry 2017; 7:e1185. [PMID: 28763058 PMCID: PMC5611721 DOI: 10.1038/tp.2017.149] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/18/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022] Open
Abstract
Chemotherapy-induced central nervous system (CNS) neurotoxicity presents an unmet medical need. Patients often report a cognitive decline in temporal correlation to chemotherapy, particularly for hippocampus-dependent verbal and visuo-spatial abilities. We treated adult C57Bl/6 mice with 12 × 20 mg kg-1 paclitaxel (PTX), mimicking clinical conditions of dose-dense chemotherapy, followed by a pulse of bromodesoxyuridine (BrdU) to label dividing cells. In this model, mice developed visuo-spatial memory impairments, and we measured peak PTX concentrations in the hippocampus of 230 nm l-1, which was sevenfold higher compared with the neocortex. Histologic analysis revealed a reduced hippocampal cell proliferation. In vitro, we observed severe toxicity in slowly proliferating neural stem cells (NSC) as well as human neuronal progenitor cells after 2 h exposure to low nanomolar concentrations of PTX. In comparison, mature post-mitotic hippocampal neurons and cell lines of malignant cells were less vulnerable. In PTX-treated NSC, we observed an increase of intracellular calcium levels, as well as an increased activity of calpain- and caspase 3/7, suggesting a calcium-dependent mechanism. This cell death pathway could be specifically inhibited with lithium, but not glycogen synthase kinase 3 inhibitors, which protected NSC in vitro. In vivo, preemptive treatment of mice with lithium prevented PTX-induced memory deficits and abnormal adult hippocampal neurogenesis. In summary, we identified a molecular pathomechanism, which invokes PTX-induced cytotoxicity in NSC independent of cell cycle status. This pathway could be pharmacologically inhibited with lithium without impairing paclitaxel's tubulin-dependent cytostatic mode of action, enabling a potential translational clinical approach.
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Affiliation(s)
- P Huehnchen
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany,Berlin Institute of Health (BIH), Berlin, Germany
| | - W Boehmerle
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany,Berlin Institute of Health (BIH), Berlin, Germany,Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, Chariteplatz 1, Berlin 10117, Germany. E-mail:
| | - A Springer
- Großgerätezentrum BioSupraMol, Department of Biology, Chemistry and Pharmacy, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany
| | - D Freyer
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Stroke Research Berlin, Berlin, Germany
| | - M Endres
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany,Berlin Institute of Health (BIH), Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Stroke Research Berlin, Berlin, Germany,German Centre for Neurodegenerative Diseases (DZNE), Berlin, Germany,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
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23
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In vivo neuroimaging and behavioral correlates in a rat model of chemotherapy-induced cognitive dysfunction. Brain Imaging Behav 2017; 12:87-95. [DOI: 10.1007/s11682-017-9674-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Lomeli N, Di K, Czerniawski J, Guzowski JF, Bota DA. Cisplatin-induced mitochondrial dysfunction is associated with impaired cognitive function in rats. Free Radic Biol Med 2017; 102:274-286. [PMID: 27908784 PMCID: PMC5308450 DOI: 10.1016/j.freeradbiomed.2016.11.046] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/22/2016] [Accepted: 11/27/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Chemotherapy-related cognitive impairment (CRCI) is commonly reported following the administration of chemotherapeutic agents and comprises a wide variety of neurological problems. No effective treatments for CRCI are currently available. Here we examined the mechanisms involving cisplatin-induced hippocampal damage following cisplatin administration in a rat model and in cultured rat hippocampal neurons and neural stem/progenitor cells (NSCs). We also assessed the protective effects of the antioxidant, N-acetylcysteine in mitigating these damages. EXPERIMENTAL DESIGN Adult male rats received 6mg/kg cisplatin in the acute studies. In chronic studies, rats received 5mg/kg cisplatin or saline injections once per week for 4 weeks. N-acetylcysteine (250mg/kg/day) or saline was administered for five consecutive days during cisplatin treatment. Cognitive testing was performed 5 weeks after treatment cessation. Cisplatin-treated cultured hippocampal neurons and NSCs were examined for changes in mitochondrial function, oxidative stress production, caspase-9 activation, and neuronal dendritic spine density. RESULTS Acute cisplatin treatment reduced dendritic branching and spine density, and induced mitochondrial degradation. Rats receiving the chronic cisplatin regimen showed impaired performance in contextual fear conditioning, context object discrimination, and novel object recognition tasks compared to controls. Cisplatin induced mitochondrial DNA damage, impaired respiratory activity, increased oxidative stress, and activated caspase-9 in cultured hippocampal neurons and NSCs. N-acetylcysteine treatment prevented free radical production, ameliorated apoptotic cellular death and dendritic spine loss, and partially reversed the cisplatin-induced cognitive impairments. CONCLUSIONS Our results suggest that mitochondrial dysfunction and increased oxidative stress are involved in cisplatin-induced cognitive impairments. Therapeutic agents, such as N-acetylcysteine, may be effective in mitigating the deleterious effects of cisplatin.
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Affiliation(s)
- Naomi Lomeli
- Department of Pathology & Laboratory Medicine, University of California Irvine, Irvine, CA, USA.
| | - Kaijun Di
- Department of Neurological Surgery, University of California Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA.
| | - Jennifer Czerniawski
- Department of Neurobiology & Behavior, University of California Irvine, Irvine, CA, USA; Center for the Neurobiology of Learning & Memory, University of California Irvine, Irvine, CA, USA.
| | - John F Guzowski
- Department of Neurobiology & Behavior, University of California Irvine, Irvine, CA, USA; Center for the Neurobiology of Learning & Memory, University of California Irvine, Irvine, CA, USA.
| | - Daniela A Bota
- Department of Pathology & Laboratory Medicine, University of California Irvine, Irvine, CA, USA; Department of Neurological Surgery, University of California Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA; Department of Neurology, University of California Irvine, Irvine, CA, USA.
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25
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5-Fluorouracil chemotherapy upregulates cytokines and alters hippocampal dendritic complexity in aged mice. Behav Brain Res 2016; 316:215-224. [PMID: 27599618 DOI: 10.1016/j.bbr.2016.08.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 08/16/2016] [Accepted: 08/20/2016] [Indexed: 01/12/2023]
Abstract
5-Fluorouracil (5-Fu) is commonly used chemotherapy drug, but it can lead to the impairment of cognitive function. The pathogenesis of this injury is unknown but may involve modifications to dendritic structure and/or alterations in dendritic spine density and morphology. Dendritic spines are sites of excitatory synaptic transmission and changes in spine structure and dendrite morphology are thought to represent a morphological correlate of altered brain functions associated with hippocampal dependent learning and memory. A total of 28 one-year-old C57BL6/J male mice were used in this study; 14 mice received 5-Fu treatment and 14 were given saline injections. One month post treatment, 14 cytokines were measured at the same time Golgi samples were taken. 8 analytes were significantly elevated in mice treated with 5-Fu. 5-Fu significantly compromised the dendritic architecture and reduced spine density throughout the hippocampal tri-synaptic network. The present data provide the evidence that 5-Fu has deleterious effects on mature neurons associated with hippocampal learning and memory.
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26
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Grisold W. Fulfilling the purpose and scope of Neuro-Oncology Practice. Neurooncol Pract 2016; 3:137-138. [PMID: 31386092 PMCID: PMC6668284 DOI: 10.1093/nop/npw018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Affiliation(s)
- Wolfgang Grisold
- Department Neurology, Kaiser Franz Josef Hospital Vienna, Vienna, Austria
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27
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Kaplan SV, Limbocker RA, Gehringer RC, Divis JL, Osterhaus GL, Newby MD, Sofis MJ, Jarmolowicz DP, Newman BD, Mathews TA, Johnson MA. Impaired Brain Dopamine and Serotonin Release and Uptake in Wistar Rats Following Treatment with Carboplatin. ACS Chem Neurosci 2016; 7:689-99. [PMID: 27145395 PMCID: PMC4911621 DOI: 10.1021/acschemneuro.5b00029] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
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Chemotherapy-induced
cognitive impairment, known also as “chemobrain”,
is a medical complication of cancer treatment that is characterized
by a general decline in cognition affecting visual and verbal memory,
attention, complex problem solving skills, and motor function. It
is estimated that one-third of patients who undergo chemotherapy treatment
will experience cognitive impairment. Alterations in the release and
uptake of dopamine and serotonin, central nervous system neurotransmitters
that play important roles in cognition, could potentially contribute
to impaired intellectual performance in those impacted by chemobrain.
To investigate how chemotherapy treatment affects these systems, fast-scan
cyclic voltammetry (FSCV) at carbon-fiber microelectrodes was used
to measure dopamine and serotonin release and uptake in coronal brain
slices containing the striatum and dorsal raphe nucleus, respectively.
Measurements were taken from rats treated weekly with selected doses
of carboplatin and from control rats treated with saline. Modeling
the stimulated dopamine release plots revealed an impairment of dopamine
release per stimulus pulse (80% of saline control at 5 mg/kg and 58%
at 20 mg/kg) after 4 weeks of carboplatin treatment. Moreover, Vmax, the maximum uptake rate of dopamine, was
also decreased (55% of saline control at 5 mg/kg and 57% at 20 mg/kg).
Nevertheless, overall dopamine content, measured in striatal brain
lysates by high performance liquid chromatography, and reserve pool
dopamine, measured by FSCV after pharmacological manipulation, did
not significantly change, suggesting that chemotherapy treatment selectively
impairs the dopamine release and uptake processes. Similarly, serotonin
release upon electrical stimulation was impaired (45% of saline control
at 20 mg/kg). Measurements of spatial learning discrimination were
taken throughout the treatment period and carboplatin was found to
alter cognition. These studies support the need for additional neurochemical
and behavioral analyses to identify the underlying mechanisms of chemotherapy-induced
cognitive disorders.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Brooke D. Newman
- Department
of Chemistry, Wayne State University, Detroit, Michigan 48202 United States
| | - Tiffany A. Mathews
- Department
of Chemistry, Wayne State University, Detroit, Michigan 48202 United States
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28
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Ponto LLB, Menda Y, Magnotta VA, Yamada TH, Denburg NL, Schultz SK. Frontal hypometabolism in elderly breast cancer survivors determined by [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET): a pilot study. Int J Geriatr Psychiatry 2015; 30:587-94. [PMID: 25176562 PMCID: PMC4345151 DOI: 10.1002/gps.4189] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 12/20/2022]
Abstract
PURPOSE The term "chemobrain" is sometimes used to denote deficits in neuropsychological functioning that may occur as a result of cancer treatment. As breast cancer survivors now commonly reach late life, it is not known whether previous exposure to chemotherapy may affect long-term risk for cognitive impairment. To help address this concern, this study tested whether successfully surviving chemotherapy earlier in life was associated with later differences in brain metabolic function as an older adult compared to controls. This question was examined using positron emission tomography measures of brain glucose metabolism in elderly women cancer survivors. METHODS Breast cancer survivors (N = 10), currently free of recurrent cancer and without a diagnosis of a cognitive disorder, were compared to matched healthy controls (N = 10). All subjects were imaged at rest with [(18)F]fluorodeoxyglucose. Images were analyzed semi-quantitatively using the Alzheimer's Discrimination Tool and a volume of interest-based approach derived from co-registered magnetic resonance imaging. RESULTS Relative [(18)F]fluorodeoxyglucose uptake (normalized to global) was significantly lower in the survivors compared with control subjects in bilateral orbital frontal regions, consistent with differences between the groups in cognition and executive function (i.e., Trail Making Test, Part B and mini-mental state examination) and despite no significant differences with respect to age, education, intelligence, or working memory. None of the survivors and only one control manifested a global positron emission tomography score consistent with an Alzheimer's disease metabolic pattern. CONCLUSION Breast cancer survivors treated with chemotherapy may manifest long-term changes in brain glucose metabolism indicative of subtle frontal hypometabolism, a finding consistent with results from neuropsychological testing and other imaging modalities.
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Affiliation(s)
- Laura L. Boles Ponto
- Department of Radiology, Division of Nuclear Medicine, University of Iowa Carver College of Medicine,Positron Emission Tomography Imaging Center, Department of Radiology, University of Iowa Carver College of Medicine
| | - Yusuf Menda
- Department of Radiology, Division of Nuclear Medicine, University of Iowa Carver College of Medicine,Positron Emission Tomography Imaging Center, Department of Radiology, University of Iowa Carver College of Medicine
| | - Vincent A. Magnotta
- Department of Radiology, Division of Nuclear Medicine, University of Iowa Carver College of Medicine,Department of Psychiatry, University of Iowa Carver College of Medicine
| | | | | | - Susan K. Schultz
- Department of Psychiatry, University of Iowa Carver College of Medicine
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29
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Challenges in the treatment of elderly patients with primary central nervous system lymphoma. Curr Opin Neurol 2014; 27:697-701. [DOI: 10.1097/wco.0000000000000145] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Selamat MH, Loh SY, Mackenzie L, Vardy J. Chemobrain experienced by breast cancer survivors: a meta-ethnography study investigating research and care implications. PLoS One 2014; 9:e108002. [PMID: 25259847 PMCID: PMC4178068 DOI: 10.1371/journal.pone.0108002] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 08/24/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cognitive impairment, colloquially termed "chemobrain", occurs in 10-40% of all cancer patients, and is an emerging target of cancer survivorship research. AIM This study reviews published qualitative studies to explore cognitive impairments or chemobrain among breast cancer survivors, with particular attention given to the impact on quality of life. METHOD Using keywords, we searched ten electronic databases (CINAHL, EMBASE, Proquest, OVID SP, MEDLINE, Oxford Journal, Science Direct, PubMED). FINDINGS Of 457 papers, seven relevant papers were included. Data was extracted and concepts were analysed using a meta ethnography approach. Four second order intepretations were identified, on the basis of which, four third order intrepretations were constructed. Linked together in a line of argument, was a consistent account on their struggles to self-manage the chemobrain impairments that impact their daily lives. Five concepts emerged from the analysis of the primary findings: i) real experiences of cognitive changes, ii) calls for help, iii) impact of cognitive impairments, iv) coping and v) survivorship and meaning. Further synthesis resulted in four new order intepretations: i) The chemobrain struggle, ii) The substantial impact of chemobrain on life domains, iii) The struggle to readjust and to self manage, and iv) 'thankful yet fearful' representation. DISCUSSION Awareness of cognitive changes were context-dependent on healthcare settings and cultural contexts as strong determinants. Subjects verified the existence of chemobrain but healthcare providers mis-recognised, under-recognised, and sometimes negated it perhaps due to its unknown aetiology. Asian breast cancer survivors appear less vocal than their western counterparts. CONCLUSION The current literature on the lived experiences of how women experienced chemobrain provides a consistent report that chemobrain is real, persistent and with detrimental impacts on quality of life - manifested as a constant struggles. A greater awareness of the effects of chemobrain with improved functional assessment and interventions is warranted.
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Affiliation(s)
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Discipline of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Janette Vardy
- Concord Cancer Centre, Concord Repatriation and General Hospital, Concord, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
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Dysregulation in myelination mediated by persistent neuroinflammation: possible mechanisms in chemotherapy-related cognitive impairment. Brain Behav Immun 2014; 35:23-32. [PMID: 23916895 PMCID: PMC3858476 DOI: 10.1016/j.bbi.2013.07.175] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 07/28/2013] [Accepted: 07/28/2013] [Indexed: 12/14/2022] Open
Abstract
Cognitive impairment is commonly reported as a consequence of chemotherapy and can have considerable impact on everyday life on cancer patients. Thus, it is imperative to have a clear understanding of this phenomenon and the underlying mechanism involved. In the present study we examined the role of neuroinflammation and myelination in chemotherapy-related cognitive impairment. Female Sprague-Dawley rats (12-months old) were used in the study (total n=52, 13rats/group). Rats were randomly assigned to either the chemotherapy or saline control group. The drug combination of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) was given i.p. once a week for 4weeks. Rats in the control group received normal saline of equal volume. Animals from each group were further randomized to receive either: cyclooxygenase (COX-2) inhibitor, NS-393, to block the inflammatory response or vehicle. NS-398 was given at 10mg/kg i.p. and equal volume of saline (vehicle) was injected i.p. as vehicle. Both NS-398 and vehicle were injected 1h after the first CMF dose and then given daily for 28days then rats were tested in the Y maze. Our data showed that: (1) CMF led to the increase in the levels of inflammatory mediators IL-1β, TNF-α, and COX-2 while levels of the anti-inflammatory cytokine IL-10 decreased; (2) cognitive impairment and neuroinflammation resulting from CMF persisted 4weeks after the treatment ended; and (3) administration of NS-398 attenuated CMF-induced neuroinflammation and effects on myelin and cognitive impairment. These findings suggest the involvement of neuroinflammation in CMF-induced changes in myelin and myelination, and cognitive impairment.
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32
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Cisplatin inhibits hippocampal cell proliferation and alters the expression of apoptotic genes. Neurotox Res 2013; 25:369-80. [PMID: 24277158 DOI: 10.1007/s12640-013-9443-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 12/13/2022]
Abstract
The hippocampus, which is critical for memory and spatial navigation, contains a proliferating stem cell niche that is especially vulnerable to antineoplastic drugs such as cisplatin. Although the damaging effects of cisplatin have recently been recognized, the molecular mechanisms underlying its toxic effects on this vital region are largely unknown. Using a focused apoptosis gene array, we analyzed the early cisplatin-induced changes in gene expression in the hippocampus of adult Sprague-Dawley rats and compared the results to those from the inferior colliculus, a non-mitotic auditory region resistant to cisplatin-induced cell death. Two days after a 12 mg/kg dose of cisplatin, significant increases were observed in five proapoptotic genes: Bik, Bid, Bok, Trp53p2, and Card6 and a significant decrease in one antiapoptotic gene Bcl2a1. In contrast, Nol3, an antiapoptotic gene, showed a significant increase in expression. The cisplatin-induced increase in Bid mRNA and decrease in Bcl2a1 mRNA were accompanied by a corresponding increase and decrease of their respective proteins in the hippocampus. In contrast, the cisplatin-induced changes in Bcl2a1, Bid, Bik, and Bok gene expression in the inferior colliculus were strikingly different from those in the hippocampus consistent with the greater susceptibility of the hippocampus to cisplatin toxicity. Cisplatin also significantly reduced immunolabeling of the cell proliferation marker Ki67 in the subgranular zone of the hippocampus 2 days post-treatment. These results indicate that cisplatin-induced hippocampal cell death is mediated by increased expression of proapoptotic and decreased antiapoptotic genes and proteins that likely inhibit hippocampal cell proliferation.
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33
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Hodgson KD, Hutchinson AD, Wilson CJ, Nettelbeck T. A meta-analysis of the effects of chemotherapy on cognition in patients with cancer. Cancer Treat Rev 2012; 39:297-304. [PMID: 23219452 DOI: 10.1016/j.ctrv.2012.11.001] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 10/30/2012] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to assess whether chemotherapy-related cognitive impairment is consistently observed in cancer patients and to identify the areas of cognition affected. METHODS The meta-analysis included 13 studies and examined the effects of chemotherapy on seven different cognitive domains, across five cancer types. It was the intention of this meta-analysis to stringently exclude many studies, allowing for examination of cognition in carefully selected studies of chemotherapy recipients who do not have current mood or anxiety diagnoses (or psychiatric or substance abuse histories), without brain cancer and who have not had radiotherapy or hormone treatment. A moderator analysis examined whether patient age, treatment duration and time since treatment end significantly contributed to chemotherapy-related cognitive impairment. RESULTS Evidence for the presence of cognitive impairment following cancer treatment was established for executive function and memory. No relationship was found between cognitive impairment and time since treatment cessation but a significant negative relationship was found for treatment duration. Age had no impact on treatment-related cognitive impairment. CONCLUSIONS Future research must be conducted on chemotherapy-related cognitive impairment in cancer types such as lymphoma and leukaemia, which have received a moderate amount of attention and colorectal cancer, which has received little attention. This would enable us to determine the extent to which chemotherapy-related cognitive impairment is a universal phenomenon associated with the cancer experience and its treatment regardless of cancer type.
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Affiliation(s)
- Kristy D Hodgson
- School of Psychology, University of Adelaide, Adelaide, SA, Australia.
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Taillia H. [What's new concerning the chemobrain?]. Rev Neurol (Paris) 2012; 169:216-22. [PMID: 23107881 DOI: 10.1016/j.neurol.2012.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Revised: 05/22/2012] [Accepted: 06/20/2012] [Indexed: 01/15/2023]
Abstract
Chemobrain, a subtle cognitive decline after chemotherapy in non-cerebral cancer, remains a debated issue, which has nevertheless been widely described for more than 15 years in the international literature. This phenomenon is almost unknown in France to experts, neurologists and oncologists. Experimental evidence from animal models and from human functional imagery is reliable but contrasts with the observations made during clinical studies. Indeed, in clinical practice, the difficulty in proving the occurrence of chemobrain may be explained by a large number of methodological skews. However, considering the International Cognition and Cancer Task Force (ICCTF) guidelines, we propose a methodology applicable in daily practice and capable of improving awareness of this phenomenon.
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Affiliation(s)
- H Taillia
- Service de neurologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France.
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35
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Legriel S, Azoulay E. Complications neurologiques des traitements anticancéreux. MEDECINE INTENSIVE REANIMATION 2012. [DOI: 10.1007/s13546-012-0508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Kanaskie ML. Chemotherapy-Related Cognitive Change: A Principle-Based Concept Analysis. Oncol Nurs Forum 2012; 39:E241-8. [DOI: 10.1188/12.onf.e241-e248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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Adriamycin-related anxiety-like behavior, brain oxidative stress and myelotoxicity in male Wistar rats. Pharmacol Biochem Behav 2011; 99:639-47. [DOI: 10.1016/j.pbb.2011.06.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 06/08/2011] [Accepted: 06/10/2011] [Indexed: 11/20/2022]
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39
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Towards a more robust approach to selecting and prosecuting promising targets and compounds. Future Med Chem 2011; 2:25-34. [PMID: 21426044 DOI: 10.4155/fmc.09.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
There are many factors that influence predictivity in drug discovery and impact on productivity within the pharmaceutical industry. This article will concentrate on just two aspects; first, the role of investigating target modulation within a (human) disease setting, from target selection through screening to animal models, and second, potential developments in the analysis and probing of the chemical space appropriate for drug discovery and, in particular, steps to improve predictivity thus moving to a more forward-looking process. The activities associated with target selection should develop significantly over the next 5-10 years leading to a more robust association of target modulation with disease modification. In addition, better understanding of the opportunities for target modulators should drive and improve the selection of ligands suitable for therapeutic applications. Within these areas it will be important to move away from a retrospective consideration of druggable targets towards a forward-looking approach based on holistic (disease context) profiling of both (progressable) targets and subsequently their ligands. Improvements in the predictive analysis and probing of the chemical space will be needed to confront both safety and efficacy end points that currently remain major reasons for failure in the clinic. It is hoped that improvements in data visualization together with chemocentric mining of the literature will facilitate better interrogation of development and clinical data, potentially modifying research project plans to better address these key issues.
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40
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Evaluation of multiple neurotoxic outcomes in cancer chemotherapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2010. [PMID: 20738011 DOI: 10.1007/978-1-4419-6306-2_13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Although it is now clear that cognitive dysfunction is a common accompaniment of cancer chemotherapy, its implications await further research and direction. Most of the clinical research relies on standard neuropsychological tests that were developed to diagnose stable traits. Cognitive dysfunction in patients undergoing treatment varies with time, however. Its dimensions will vary during the course of treatment, which generally consists of cycles of drug administration followed by recovery periods. To effectively determine the connection between chemotherapy and cognitive function requires neuropsychological tests based on performance, so that they can be administered repeatedly at specified times during the entire course of treatment and beyond. A number of computerized test batteries, many of which have been developed for environmental neurotoxicology, are now available that fit such criteria. Moreover, cognitive impairment is only one aspect of chemotherapy-induced neurotoxicity. A full appreciation of its scope requires assessment of sensory functions such as vision, audition and somatosensory properties and assessment of motor function. A program of research based on animal models is also essential. Only with animal models is it possible to determine dose-response relationships and to couple behavioral with mechanistic indices such as neuroplasticity. Animal behavior models play a vital role in environmental toxicology because, from them, it is possible to derive some index of exposure that limits adverse effects. However, as in human testing, it is critical to choose situations whose properties remain stable over long periods of time so as to trace the time course of neurotoxicity. Schedule-controlled operant behavior offers the most promising source of animal models.
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Robaey P, Krajinovic M, Marcoux S, Moghrabi A. Pharmacogenetics of the neurodevelopmental impact of anticancer chemotherapy. ACTA ACUST UNITED AC 2009; 14:211-20. [PMID: 18924160 DOI: 10.1002/ddrr.29] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Pharmacogenetics holds the promise of minimizing adverse neurodevelopmental outcomes of cancer patients by identifying patients at risk, enabling the individualization of treatment and the planning of close follow-up and early remediation. This review focuses first on methotrexate, a drug often implicated in neurotoxicity, especially when used in combination with brain irradiation. The second focus is on glucocorticoids that have been found to be linked to adverse developmental effects in relation with the psychosocial environment. For both examples, we review how polymorphisms of genes encoding enzymes involved in specific mechanisms of action could moderate adverse neurodevelopmental consequences, eventually through common final pathways such as oxidative stress. We discuss a multiple hit model and possible strategies required to rise to the challenge of this integrative research.
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Affiliation(s)
- Philippe Robaey
- Centre de Recherche de l'Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec.
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Weiss B. The first 83 and the next 83: perspectives on neurotoxicology. Neurotoxicology 2009; 30:832-50. [PMID: 19822264 DOI: 10.1016/j.neuro.2009.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 01/19/2009] [Accepted: 01/28/2009] [Indexed: 10/21/2022]
Abstract
This commentary depicts the author's history, and how it became interwoven with neurotoxicology. Born in 1925, most of his life spanned a century burdened with calamitous wars as well as revolutionary developments in science. Aviation played a large role in the century's wars and in the author's outlook on the world. He moved from a literary perspective, after his war experiences, to one governed by science, his earliest bent. During his career, which embodied the early development of both behavioral pharmacology and behavioral toxicology, he emphasized the critical need for precise measures, a point of view illustrated by his adoption of digital computer technology in 1962 as a means to secure such measures. The commentary also describes the author's views of some of the new directions open to neurotoxicology, such as the pursuit of questions about endocrine disruptors, countermeasures for brain aging, and epigenetics.
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Affiliation(s)
- Bernard Weiss
- Department of Environmental Medicine, Environmental Health Sciences Center, and Center for Reproductive Epidemiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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