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Du C, Lu C, Li G, Deng D, Chen W. Electroacupuncture for oculomotor nerve palsy after chemotherapy: A case report. Medicine (Baltimore) 2024; 103:e38547. [PMID: 38875429 PMCID: PMC11175888 DOI: 10.1097/md.0000000000038547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
INTRODUCTION Oculomotor nerve palsy (ONP) is often discovered in the ophthalmology department, manifested as ptosis with the same side, eyeball in the fixed external booth, or accompanied by limited inward, upward, and downward movements. The present case report described the effect of electroacupuncture (EA) on a breast cancer patient with ONP after chemotherapy. PATIENT CONCERNS A 56-year-old breast cancer patient presented with severe ptosis and fixed right eye exotropia. Besides, it is challenging to perform the movement inward, upward, and downward, and with obvious diplopia. DIAGNOSES The breast cancer patient was diagnosed with ONP, chemotherapy history. INTERVENTIONS The patient was introduced to acupuncture department to receiving EA treatment. OUTCOMES After 12 times of EA treatments, the symptom of ptosis was significantly improved, and the right upper eyelid can lift autonomously as same as the left eye. Besides, the patient's right lateral eye could move freely, and the symptoms of double vision disappeared. CONCLUSION The case suggests that EA may be an effective alternative treatment for ONP.
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Affiliation(s)
- Chun Du
- Tianshui and Wulin Street Community Health Service Center of Gongshu District, Hangzhou, China
| | - Chao Lu
- Department of Traditional Chinese Medicine, Zhejiang Cancer Hospital, Hangzhou, China
| | - Guangliang Li
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Dehou Deng
- Department of Traditional Chinese Medicine, Zhejiang Cancer Hospital, Hangzhou, China
| | - Weiji Chen
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, China
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Ghotbeddin Z, Peysokhan M, Dezfouli AM, Iraee MA. Nutritional Support of Crocin on Neurobehavioral Disabilities Induced by Cisplatin-Based Chemotherapy in Rats. Neurochem Res 2024; 49:649-659. [PMID: 38010604 DOI: 10.1007/s11064-023-04059-8] [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: 07/27/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
Cisplatin, a chemotherapy drug containing platinum, is considered a neurotoxic agent. On the other hand, crocin, the primary component of saffron, possesses neuroprotective and antioxidant properties. In this study, 28 healthy adult male Wistar rats weighing 200-250 g were used (6-7 weeks old). Rats were divided into a control group (Ctr), a crocin group (Cro), a cisplatin group (Cis), and a crocin with cisplatin group (Cro + Cis). Rotarod, open field, and shuttle box tests were performed to assess balance, explorative behavior, and avoidance memory. After behavioral testing, the hippocampus was extracted to analyze oxidative stress parameters such as GPx (glutathione peroxidase), SOD (superoxide dismutase), CAT (catalase), and MDA (malondialdehyde) activity. Shuttle box, rotarod, and open field results showed that crocin can substantially mitigate the deleterious effects of cisplatin on avoidance memory, explorative behavior, motor coordination, and balance. Crocin was also able to effectively avoid the negative effects of cisplatin on MDA, GPx, and CAT during the assessment of oxidative indicators, while the beneficial effect of crocin on cisplatin was not statistically significant in terms of SOD level. In conclusion, since free radicals produced by cisplatin are a contributing factor to memory loss and movement disorders, crocin, owing to its antioxidant properties, improved passive avoidance learning as well as motor activity.
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Affiliation(s)
- Zohreh Ghotbeddin
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
- Stem Cell and Transgenic Technology Research Center, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
| | - Mohsen Peysokhan
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Anahita Memar Dezfouli
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Asadi Iraee
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Lal R, Dharavath RN, Chopra K. Nrf2 Signaling Pathway: a Potential Therapeutic Target in Combating Oxidative Stress and Neurotoxicity in Chemotherapy-Induced Cognitive Impairment. Mol Neurobiol 2024; 61:593-608. [PMID: 37644279 DOI: 10.1007/s12035-023-03559-6] [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: 12/21/2022] [Accepted: 08/05/2023] [Indexed: 08/31/2023]
Abstract
Chemotherapy-induced cognitive impairment (CICI) is one of the major adverse effects of antineoplastic drugs, which decrease the quality of life in cancer survivors. Extensive experimental and clinical research suggests that chemotherapeutic drugs generate an enormous amount of reactive oxygen species (ROS), contributing to oxidative stress, neuroinflammation, blood-brain barrier (BBB) disruption, and neuronal death, eventually leading to CICI. Despite the progress in exploring different pathological mechanisms of CICI, effective treatment to prevent CICI progression has not been developed yet. Nrf2 is the principal transcription factor that regulates cellular redox balance and inflammation-related gene expression. Emerging evidence suggests that upregulation of Nrf2 and its target genes could suppress oxidative stress, and neuroinflammation, restore BBB integrity, and increase neurogenesis. This review discusses the role of Nrf2 in CICI, how it responds to oxidative stress, inflammation, neurotoxicity, and potential Nrf2 activators that could be used to enhance Nrf2 activation in CICI.
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Affiliation(s)
- Roshan Lal
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014, India
| | - Ravinder Naik Dharavath
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014, India
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
| | - Kanwaljit Chopra
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014, India.
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Haywood D, Wallace IN, Lawrence B, Baughman FD, Dauer E, O'Connor M. Oncology healthcare professionals' perceptions and experiences of 'chemobrain' in cancer survivors and persons undergoing cancer treatment. Gen Hosp Psychiatry 2023; 84:271-272. [PMID: 37407422 DOI: 10.1016/j.genhosppsych.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Darren Haywood
- Department of Mental Health, St Vincent's Hospital Melbourne, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Science, Melbourne, Australia.
| | - India N Wallace
- School of Population Health, Curtin University, Perth, Australia
| | - Blake Lawrence
- School of Population Health, Curtin University, Perth, Australia
| | - Frank D Baughman
- School of Population Health, Curtin University, Perth, Australia
| | - Evan Dauer
- Department of Mental Health, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Moira O'Connor
- School of Population Health, Curtin University, Perth, Australia
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Henneghan AM, Kesler SR. Subjective cancer-related cognitive impairments and salience network connectivity in breast cancer survivors. J Cancer Surviv 2022:10.1007/s11764-022-01307-8. [PMID: 36464750 PMCID: PMC10239781 DOI: 10.1007/s11764-022-01307-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Little is known about the neural basis of subjective cancer-related cognitive changes. The purpose of this study was to explore salience network connectivity in relation to subjective executive and memory dysfunction in breast cancer survivors compared to controls. METHODS A retrospective cross-sectional analysis of neuroimaging, subjective cognitive, clinical, and demographic data in chemotherapy-treated primary breast cancer survivors compared to frequency matched controls was used. Functional connectivity within salience network hubs (anterior cingulate, bilateral insula) was determined using resting state functional MRI. Mann-Whitney U tests were used to evaluate group differences and Spearman's rho correlations were examined among the behavioral measures and salience network connectivity. RESULTS We included 65 breast cancer survivors and 71 controls. Survivors demonstrated greater subjective executive dysfunction and memory complaints (p < .001) and lower salience network connectivity (p < .05) than controls. Executive functioning correlated with bilateral insula and left anterior cingulate connectivity (rho > - 0.29, p < .05). Distress did not correlate with salience network connectivity. CONCLUSION These findings suggest that salience network connectivity may represent a biomarker of subjective cancer-related cognitive changes. IMPLICATIONS FOR CANCER SURVIVORS Subjective cancer-related cognitive changes are common following treatment and associated with objective changes in brain connectivity.
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Affiliation(s)
- Ashley M Henneghan
- School of Nursing, University of Texas at Austin, 1710 Red River St, D0100, Austin, TX, 78712, USA
- Department of Oncology, Dell School of Medicine, University of Texas at Austin, Austin, TX, 78712, USA
| | - Shelli R Kesler
- School of Nursing, University of Texas at Austin, 1710 Red River St, D0100, Austin, TX, 78712, USA.
- Department of Oncology, Dell School of Medicine, University of Texas at Austin, Austin, TX, 78712, USA.
- Department of Diagnostic Medicine, Dell School of Medicine, University of Texas at Austin, Austin, TX, 78712, USA.
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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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Taha M, Elazab ST, Badawy AM, Saati AA, Qusty NF, Al-Kushi AG, Sarhan A, Osman A, Farage AE. Activation of SIRT-1 Pathway by Nanoceria Sheds Light on Its Ameliorative Effect on Doxorubicin-Induced Cognitive Impairment (Chemobrain): Restraining Its Neuroinflammation, Synaptic Dysplasticity and Apoptosis. Pharmaceuticals (Basel) 2022; 15:ph15080918. [PMID: 35893742 PMCID: PMC9394293 DOI: 10.3390/ph15080918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Chemo fog is one of the most serious health concerns encountered by cancer survivors receiving doxorubicin (DOX)-based chemotherapy. Oxidative stress, neuroinflammation, apoptosis and impairment of synaptic plasticity are regarded as the key factors implicated in DOX-induced cognitive impairment. This research aimed to assess the possible neuroprotective effect of cerium oxide nanoparticles (CeNPs) against DOX-induced neurotoxicity. Forty-eight rats were divided into four groups (12 rats/group): control group, CeNPs group (received oral CeNPs solution (35 mg/kg) daily for 4 weeks), and DOX group (were administered DOX intraperitoneally (2 mg/kg, once/week for 4 weeks)) and DOX+ CeNPs group. The findings revealed that CeNPs mitigated behavioral alterations in DOX-induced cognitive deficit. Additionally, CeNPs alleviated the histopathological abnormalities in hippocampus and ameliorated DOX-induced neuroinflammation by downregulating the expression of NF-κB, TNF-α, IL-1β and IL6. In addition, CeNPs antagonized the apoptosis through reducing the protein expression of cytochrome c and caspase 3. In addition, it stimulated the antioxidant defense, as indicated by upregulating the expression of the Nrf2, HO-1 and PGC-1α genes. CeNPs improved synaptic plasticity via acting on the BDNF. These actions were related through the modification of SIRT-1 expression. Based on the aforementioned results, CeNPs antagonized the doxorubicin-induced neurodegeneration by its antioxidant, anti-inflammatory and antiapoptotic effects, alongside its SIRT-1 mediated mechanisms.
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Affiliation(s)
- Medhat Taha
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt;
- Department of Anatomy, Al-Qunfudah Medical College, Umm Al-Qura University, Al-Qunfudhah 28814, Saudi Arabia
- Correspondence:
| | - Sara T. Elazab
- Department of Pharmacology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; or
| | - Alaa. M. Badawy
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt;
| | - Abdullah A. Saati
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Naeem F. Qusty
- Medical Laboratories Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Abdullah G. Al-Kushi
- Department of Human Anatomy, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Anas Sarhan
- Department of Internal Medicine, College of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Amira Osman
- Department of Histology, Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh 33511, Egypt;
| | - Amira E. Farage
- Department of Anatomy and Embryology, Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh 33511, Egypt;
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Patil AD, Kasabe PJ, Dandge PB. Pharmaceutical and nutraceutical potential of natural bioactive pigment: astaxanthin. NATURAL PRODUCTS AND BIOPROSPECTING 2022; 12:25. [PMID: 35794254 PMCID: PMC9259778 DOI: 10.1007/s13659-022-00347-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/09/2022] [Indexed: 05/31/2023]
Abstract
Astaxanthin (3,3'-dihydroxy-β,β-carotene-4,4'-dione) is an orange-red, lipophilic keto-carotenoid pigment. It is majorly found in marine ecosystems particularly in aquatic animals such as salmon, shrimp, trout, krill, crayfish, and so on. It is also synthesized in microalgae Heamatococcus pluvialis, Chlorococcum, Chlorella zofingiensis, red yeast Phaffia rhodozyma and bacterium Paracoccus carotinifaciens. Some aquatic and terrestrial creatures regarded as a primary and secondary sources of the astaxanthin producing and accumulating it through their metabolic pathways. Astaxanthin is the powerful antioxidant, nutritional supplement as well as promising therapeutic compound, observed to have activities against different ravaging diseases and disorders. Researchers have reported remarkable bioactivities of astaxanthin against major non-communicable chronic diseases such as cardiovascular diseases, cancer, diabetes, neurodegenerative, and immune disorders. The current review discusses some structural aspects of astaxanthin. It further elaborates its multiple potencies such as antioxidant, anti-inflammatory, anti-proliferative, anti-cancer, anti-obese, anti-diabetic, anti-ageing, anti-TB, anti-viral, anti-COVID 19, neuro-protective, nephro-protective, and fertility-enhancing properties. These potencies make it a more precious entity in the preventions as well as treatments of prevalent systematic diseases and/or disorders. Also, the review is acknowledging and documenting its powerful bioactivities in relation with the pharmaceutical as well as nutraceutical applicability.
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Affiliation(s)
- Apurva D. Patil
- Department of Biochemistry, Shivaji University, Kolhapur, 416004 Maharashtra India
| | - Pramod J. Kasabe
- School of Nanoscience and Biotechnology, Shivaji University, Kolhapur, Maharashtra India
| | - Padma B. Dandge
- Department of Biochemistry, Shivaji University, Kolhapur, 416004 Maharashtra India
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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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10
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Vachha BA, Gohel S, Root JC, Kryza-Lacombe M, Hensley ML, Correa DD. Altered regional homogeneity in patients with ovarian cancer treated with chemotherapy: a resting state fMRI study. Brain Imaging Behav 2021; 16:539-546. [PMID: 34409561 DOI: 10.1007/s11682-021-00525-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Many patients treated with chemotherapy for non-central nervous system (CNS) cancers experience cognitive dysfunction. However, few studies have investigated treatment-related neurotoxicity in women with ovarian cancer. The goal of this study was to assess regional brain function in patients with ovarian cancer after first-line chemotherapy. Seventeen patients with ovarian cancer and seventeen healthy controls matched for gender, age and education participated in the study. The patients were evaluated 1-4 months after completion of first line taxane/platinum chemotherapy. All participants underwent resting state functional MRI (rsfMRI) and regional homogeneity (ReHo) indices were calculated. The results showed that patients had significantly decreased average ReHo values in the left middle frontal gyrus, medial prefrontal cortex, and right superior parietal lobule, compared to healthy controls. This is the first rsfMRI study showing ReHo alterations in frontal and parietal regions in patients with ovarian cancer treated with first-line chemotherapy. The findings are overall congruent with prior studies in non-CNS cancer populations and provide supporting evidence for the prevailing notion that frontal areas are particularly vulnerable to the adverse effects of chemotherapy.
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Affiliation(s)
- Behroze A Vachha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.,Brain Tumor Center, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.,Department of Radiology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY, 10065, USA
| | - Suril Gohel
- Department of Health Informatics, Rutgers University School of Health Professions, 65 Bergen Street, Newark, NJ, 07107, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Kryza-Lacombe
- Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Martee L Hensley
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Denise D Correa
- Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. .,Department of Neurology and Neuroscience, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY, 10065, USA.
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Kaymak E, Akin AT, Öztürk E, Karabulut D, Kuloğlu N, Yakan B. Thymoquinone has a neuroprotective effect against inflammation, oxidative stress, and endoplasmic reticulum stress in the brain cortex, medulla, and hippocampus due to doxorubicin. J Biochem Mol Toxicol 2021; 35:e22888. [PMID: 34392583 DOI: 10.1002/jbt.22888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/22/2021] [Accepted: 08/06/2021] [Indexed: 01/02/2023]
Abstract
Although doxorubicin (DOX) is used in many cancer treatments, it causes neurotoxicity. In this study, the effect of thymoquinone (THQ), a powerful antioxidant, on DOX-induced neurotoxicity was evaluated. In total, 40 rats were used and 5 groups were formed. Group I: control group (n = 8); Group II: olive oil group (n = 8); Group III: the THQ group (n = 8); THQ 10 mg/kg per day was given intraperitoneally (i.p.) throughout the experiment; group IV: DOX group (n = 8); On Day 7 of the experiment, a single dose of 15 mg/kg intraperitoneally DOX injected; group V: DOX + THQ group (n = 8); Throughout the experiment, 10 mg/kg THQ per day and intraperitoneally 15 mg/kg DOX on Day 7 were injected. Immunohistochemically, tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), hypoxia-inducible factor 1α (HIF1-α), glucose regulatory protein 78 (GRP78), and the gene inducible by growth arrest and DNA damage 153 (GADD153) proteins were evaluated in the brain cortex, medulla, and hippocampus regions. Total oxidant status (TOS) levels and total antioxidant status (TAS) in the brain tissue were measured. TNF-α, IL-17, HIF1-α, GRP78, and GADD153 immunoreactivities significantly increased in the DOX group in the study. THQ significantly reduced these values. THQ increased the TAS level significantly and decreased the TOS level significantly compared to the DOX group. THQ may play a role as a neuroprotective agent in DOX-induced neurotoxicity in the cortex, medulla, and hippocampus regions of the brain.
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Affiliation(s)
- Emin Kaymak
- Department of Histology and Embryology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | | | - Emel Öztürk
- Histology-Embryology Department, Harran University, Harran, Turkey
| | - Derya Karabulut
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nurhan Kuloğlu
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Birkan Yakan
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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12
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Increased resting-state cerebellar-cortical connectivity in breast cancer survivors with cognitive complaints after chemotherapy. Sci Rep 2021; 11:12105. [PMID: 34103606 PMCID: PMC8187392 DOI: 10.1038/s41598-021-91447-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/25/2021] [Indexed: 11/08/2022] Open
Abstract
Cognitive complaints after chemotherapy are common in breast cancer patients, but the neural bases for these complaints remain unclear. This pilot study explored resting-state functional connectivity (FC) as a marker of subtle cognitive changes in breast cancer patients who experience cognitive complaints. Chemotherapy-treated (n = 20, at least 6 months off therapy) and untreated (n = 17, disease-control) female breast cancer patients with cognitive complaints and healthy controls (n = 20) were recruited. The FC of the right dorsolateral prefrontal cortex was calculated, and any correlations between this FC and neuropsychological assessments were determined. Chemotherapy-treated patients with cognitive complaints displayed increased FC between the right dorsolateral prefrontal cortex and both the contralateral cerebellar lobule VII and the cerebellar vermis XI, compared to the disease-control and healthy-control groups, despite unimpaired neuropsychological performance. The increased FC was negatively correlated with executive function and attention in breast cancer survivors with cognitive complaints. Our pilot study findings provide evidence that cerebellar-cortical FC changes may be a pathophysiological basis for chemotherapy-related cognitive complaints. In addition, the FC changes have the potential to reflect minor or compensated cognitive function impairment in breast cancer patients.
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Hartman SJ, Weiner LS, Natarajan L, Sears DD, Palmer BW, Parker B, Ahles T, Irwin ML, Au K. A randomized trial of physical activity for cognitive functioning in breast cancer survivors: Rationale and study design of I Can! Improving Cognition After Cancer. Contemp Clin Trials 2021; 102:106289. [PMID: 33503496 PMCID: PMC8009833 DOI: 10.1016/j.cct.2021.106289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/11/2020] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Difficulties with cognition are extremely common among breast cancer survivors and can significantly impact quality of life, daily functioning, and ability to return to work. One promising intervention is increasing physical activity, as it has been effective in improving cognition in non-cancer populations. Few physical activity intervention trials with cognition outcomes have included cancer survivors. This project builds upon our previous work indicating that increased physical activity can improve objectively measured processing speed and self-reported cognition among breast cancer survivors. METHODS The I Can! study will examine whether a physical activity intervention improves cognition among 250 post-treatment breast cancer survivors (Stages I-III, <5 years post-treatment) who are reporting cognitive difficulties. This 2-arm randomized controlled trial comparing a 6-month physical activity intervention (Exercise Group) to a health & wellness attention-comparison condition (Health & Wellness Group) will examine intervention effects on cognition (at 3 and 6 months) and maintenance of effects at 12 months. The primary aim is to investigate the impact of exercise on objectively measured processing speed and self-reported cognition. Secondary aims are to investigate maintenance of cognitive changes and examine candidate biological mechanisms and psychological mediators. CONCLUSION The I Can! study will contribute to the scientific, public health, and survivorship intervention literature by providing new information on the impact of physical activity for cognitive impairment in breast cancer survivors. Findings from this study will inform guidelines for physical activity to improve the lives of millions of breast cancer survivors.
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Affiliation(s)
- Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA.
| | - Lauren S Weiner
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D Sears
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA; UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA; Department of Medicine, UC San Diego, La Jolla, CA, USA; College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Barton W Palmer
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Barbara Parker
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA; Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Tim Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Kaylene Au
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
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14
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Akushevich I, Yashkin AP, Kravchenko J, Kertai MD. Chemotherapy and the Risk of Alzheimer's Disease in Colorectal Cancer Survivors: Evidence From the Medicare System. JCO Oncol Pract 2021; 17:e1649-e1659. [PMID: 33630665 DOI: 10.1200/op.20.00729] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Evidence on the nature of the relationship between patients receiving chemotherapy as an essential part of guideline-concordant cancer care and the onset of Alzheimer's Disease (AD) and other adverse cognitive outcomes has been mixed. Biological mechanisms were proposed to support both a potentially beneficial and an adverse role. To explore the relationship between chemotherapy and onset of AD and other neurocognitive disorders (ND) in colorectal cancer survivors. METHODS We conducted a retrospective cohort study of 135,834 individuals older than 65 years diagnosed with colorectal cancer between 1998 and 2007, using SEER-Medicare data. A proportional hazards model was used before and after the use of inverse probability weighting to account for populational differences between the chemotherapy and nonchemotherapy groups. Weights were normalized to the total sample size. RESULTS After inverse probability weighting, chemotherapy was associated with decreased AD risk (hazard ratio [HR]: 0.791; 95% CI: 0.758 to 0.824) and lower risk for the majority of other ND including AD-related diseases (HR: 0.823; CI: 0.802 to 0.844), dementia (permanent mental disorder) (HR: 0.807; CI: 0.782 to 0.832), and dementia (senile) (HR: 0.772; CI: 0.745 to 0.801). The only adverse effect to remain significant was cerebral degeneration (excluding AD) (HR: 1.067; CI: 1.033 to 1.102). The effects for AD remained after treatment was stratified by chemotherapy agent type and remained significant for up to 6 years past diagnosis. CONCLUSION Chemotherapy use in colorectal cancer survivors demonstrated an association with reduced risk for AD and other ND.
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Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC
| | - Arseniy P Yashkin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC
| | - Julia Kravchenko
- Department of Surgery, Duke University School of Medicine, Durham, NC
| | - Miklos D Kertai
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
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15
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Ku M, Gates P, Renehan S. Feasibility of an online cognitive rehabilitation programme in patients with a haematological malignancy undergoing autologous stem cell transplantation. Intern Med J 2021; 51:1665-1672. [PMID: 33465274 DOI: 10.1111/imj.15204] [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: 08/30/2020] [Revised: 11/25/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chemotherapy-related cognitive impairment (CRCI) is a known adverse event that can impact cancer survivors, resulting in long-standing effect on quality of life and activities of daily living. Currently, there is limited knowledge regarding the aetiology and therapy for CRCI. Although CRCI following autologous stem cell transplantation (AuSCT) is emerging as a potentially significant concern for patients with underlying haematological malignancies, it is an area that requires further research. AIMS This pilot study aimed to assess (i) the prevalence of CRCI in patients with haematological malignancies both pre-AuSCT and post-AuSCT and (ii) the feasibility of a cognitive rehabilitation programme (CRP) in survivorship care post-AuSCT. METHODS Over a 12-month period, consecutive patients planned for AuSCT were approached for the study. Enrolled patients were administered a 9-week course of CRP, commencing day 40 ± 5 post-AuSCT. Participants were evaluated using a neuropsychological tool and validated questionnaires at baseline, pre-CRP (day 40 ± 5 post-AuSCT), post-CRP and 6 months post-CRP. RESULTS Thirty-two patients were enrolled. The mean age was 59 years (SD = 11.5), 23 (72%) were male and 18 (56%) had multiple myeloma. Participants reported high satisfaction using the CRP, and most devoted significant amount of time as requested. CONCLUSIONS While there appeared to be a low incidence of significant CRCI in our patient population, the incorporation of CRP in survivorship care appeared to be feasible. A larger randomised study examining the efficacy of CRP should be further explored.
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Affiliation(s)
- Matthew Ku
- Department of Clinical Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Priscilla Gates
- Autologous Bone Marrow Transplant/Survivorship, Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia.,Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
| | - Steffi Renehan
- Clinical Haematology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
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16
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Tong T, Lu H, Zong J, Lv Q, Chu X. Chemotherapy-related cognitive impairment in patients with breast cancer based on MRS and DTI analysis. Breast Cancer 2020; 27:893-902. [PMID: 32301096 DOI: 10.1007/s12282-020-01094-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022]
Abstract
The purpose of this study is to investigate chemotherapy-related cognitive impairment (CRCI) in breast cancer patients, analyze absolute concentration and structural changes of metabolites in different brain regions by multimodal neuroimaging technology, and explore correlation between them. Breast cancer patients with chemotherapy treatment group (Ctx+, N = 24) and control group without treatment (Ctx-, N = 20) underwent neuropsychological tests, multivoxel magnetic resonance spectroscopy (MRS), and diffusion tensor imaging (DTI) before and after chemotherapy. Regions of interest (ROls) in magnetic resonance scan include bilateral posterior cingulate gyrus (PCG), bilateral dorsal thalamus (DT), bilateral lenticular nucleus (LN), bilateral posterior horn of the lateral ventricle paratrigonal white matter (PWM). In MRS, absolute concentrations of N-acetylaspartate (NAA), myo-inositol (MI), choline-containing compounds (Cho), total creatine (tCr), glutamine + glutamate (Glx) were quantified using LC Model and SAGE software. In DTI, we used fractional anisotropy (FA) and mean diffusivity (MD) to reflect white matter integrity. In Ctx+ patients, scores of functional assessment of cancer treatment cognition test (FACT-Cog), perceived cognitive impairments (PCI), impact of perceived impairments on quality of life (QOL), perceived cognitive abilities (PCA), auditory-verbal learning test (AVLT) recognition and clock drawing test (CDT) were lower than those before chemotherapy (p < 0.05). In MRS, Ctx+ patients had significantly lower NAA values in bilateral PCG, DT, respectively. The concentrations of tCr were observed to decline in bilateral PCG and right DT. Glx values decreased in right DT. Cho values decreased significantly in bilateral DT. In DTI, Ctx+ patients had lower FA values in bilateral PCG compared with patients before chemotherapy. Among imaging metrics and cognitive scores, positive correlations were observed between changes in AVLT recognition scores and changes in NAA values in bilateral PCG (left PCG: r = 0.470, p < 0.01; right PCG: r = 0.500, p < 0.01). Positive correlations were also found between changes in AVLT recognition and changes in FA values in bilateral PCG (left PCG: r = 0.513, p < 0.01; right PCG: r = 0.563, p < 0.01). Chemotherapy can lead to a decrease in memory function, accompanied by changes in brain metabolite concentration and white matter integrity in some parts of brain.
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Affiliation(s)
- Taishan Tong
- Department of Psychology and Psychiatry, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, 214000, Jiangsu, China
| | - Heng Lu
- Department of Psychology and Psychiatry, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, 214000, Jiangsu, China
| | - Jian Zong
- Department of Magnetic Resonance Imaging, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Qing Lv
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Xing Chu
- Department of Psychology and Psychiatry, Affiliated Hospital of Jiangnan University, 200 Huihe Road, Wuxi, 214000, Jiangsu, China.
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17
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Jean-Pierre P, Cheng Y, Paxton RJ. Item-level psychometrics of a brief self-reported memory problem screening measure in breast cancer survivors. Acta Oncol 2020; 59:358-364. [PMID: 31702413 DOI: 10.1080/0284186x.2019.1687935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: We previously developed and psychometrically validated a self-reported memory problem (SRMP) measure using principal component analysis. In the present study, we applied item response theory (IRT) analysis to further examined the construct validity and determine item-level psychometric properties for the SRMP.Methods: The sample included 530 female breast cancer survivors (61% non-Hispanic White, mean age = 57 years) who were recruited from community-based organizations and large health care systems. We examined the construct validity, item-level psychometric properties, and differential item functioning (DIF) of the SRMP using confirmatory factor analysis (CFA), IRT and logistic regression analysis models.Results: The CFA confirmed a one-factor structure for the SRMP (comparative fit index [CFI] = 0.996, root-mean-square-error-approximation [RMSEA] = 0.059). As expected, SRMP scores correlated significantly with pain, mood, and fatigue; but not spiritual health locus of control (SPR). DIF analysis showed no measurement differences based on race/ethnicity and age groups.Conclusion: The CFA and DIF analysis supported the construct validity of the SRMP and its use in an ethnically diverse breast cancer population. These findings provide further evidence of the generalizability for the SRMP, and support its utilization as a psychometrically valid and reliable screening measure of cancer and treatment-related memory difficulties.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Behavioral Sciences and Social Medicine, Cancer Neurocognitive Translational Research Laboratory, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Ying Cheng
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Raheem J. Paxton
- Department of Community Medicine and Population Health, College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, USA
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18
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Deprez S, Kesler SR, Saykin AJ, Silverman DHS, de Ruiter MB, McDonald BC. International Cognition and Cancer Task Force Recommendations for Neuroimaging Methods in the Study of Cognitive Impairment in Non-CNS Cancer Patients. J Natl Cancer Inst 2019; 110:223-231. [PMID: 29365201 DOI: 10.1093/jnci/djx285] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/13/2017] [Indexed: 02/07/2023] Open
Abstract
Cancer- and treatment-related cognitive changes have been a focus of increasing research since the early 1980s, with meta-analyses demonstrating poorer performance in cancer patients in cognitive domains including executive functions, processing speed, and memory. To facilitate collaborative efforts, in 2011 the International Cognition and Cancer Task Force (ICCTF) published consensus recommendations for core neuropsychological tests for studies of cancer populations. Over the past decade, studies have used neuroimaging techniques, including structural and functional magnetic resonance imaging (fMRI) and positron emission tomography, to examine the underlying brain basis for cancer- and treatment-related cognitive declines. As yet, however, there have been no consensus recommendations to guide researchers new to this field or to promote the ability to combine data sets. We first discuss important methodological issues with regard to neuroimaging study design, scanner considerations, and sequence selection, focusing on concerns relevant to cancer populations. We propose a minimum recommended set of sequences, including a high-resolution T1-weighted volume and a resting state fMRI scan. Additional advanced imaging sequences are discussed for consideration when feasible, including task-based fMRI and diffusion tensor imaging. Important image data processing and analytic considerations are also reviewed. These recommendations are offered to facilitate increased use of neuroimaging in studies of cancer- and treatment-related cognitive dysfunction. They are not intended to discourage investigator-initiated efforts to develop cutting-edge techniques, which will be helpful in advancing the state of the knowledge. Use of common imaging protocols will facilitate multicenter and data-pooling initiatives, which are needed to address critical mechanistic research questions.
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Affiliation(s)
- Sabine Deprez
- University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Shelli R Kesler
- Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences and Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN
| | - Daniel H S Silverman
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Michiel B de Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Brenna C McDonald
- Center for Neuroimaging, Department of Radiology and Imaging Sciences and Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN
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Galasso C, Orefice I, Pellone P, Cirino P, Miele R, Ianora A, Brunet C, Sansone C. On the Neuroprotective Role of Astaxanthin: New Perspectives? Mar Drugs 2018; 16:md16080247. [PMID: 30042358 PMCID: PMC6117702 DOI: 10.3390/md16080247] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022] Open
Abstract
Astaxanthin is a carotenoid with powerful antioxidant and anti-inflammatory activity produced by several freshwater and marine microorganisms, including bacteria, yeast, fungi, and microalgae. Due to its deep red-orange color it confers a reddish hue to the flesh of salmon, shrimps, lobsters, and crayfish that feed on astaxanthin-producing organisms, which helps protect their immune system and increase their fertility. From the nutritional point of view, astaxanthin is considered one of the strongest antioxidants in nature, due to its high scavenging potential of free radicals in the human body. Recently, astaxanthin is also receiving attention for its effect on the prevention or co-treatment of neurological pathologies, including Alzheimer and Parkinson diseases. In this review, we focus on the neuroprotective properties of astaxanthin and explore the underlying mechanisms to counteract neurological diseases, mainly based on its capability to cross the blood-brain barrier and its oxidative, anti-inflammatory, and anti-apoptotic properties.
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Affiliation(s)
- Christian Galasso
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Ida Orefice
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Paola Pellone
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Paola Cirino
- Research Infrastructures for marine biological resources Department, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Roberta Miele
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Adrianna Ianora
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Christophe Brunet
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
| | - Clementina Sansone
- Marine BiotechnologyDepartment, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy.
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20
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Keeney JTR, Ren X, Warrier G, Noel T, Powell DK, Brelsfoard JM, Sultana R, Saatman KE, Clair DKS, Butterfield DA. Doxorubicin-induced elevated oxidative stress and neurochemical alterations in brain and cognitive decline: protection by MESNA and insights into mechanisms of chemotherapy-induced cognitive impairment ("chemobrain"). Oncotarget 2018; 9:30324-30339. [PMID: 30100992 PMCID: PMC6084398 DOI: 10.18632/oncotarget.25718] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 06/13/2018] [Indexed: 12/21/2022] Open
Abstract
Chemotherapy-induced cognitive impairment (CICI) is now widely recognized as a real and too common complication of cancer chemotherapy experienced by an ever-growing number of cancer survivors. Previously, we reported that doxorubicin (Dox), a prototypical reactive oxygen species (ROS)-producing anti-cancer drug, results in oxidation of plasma proteins, including apolipoprotein A-I (ApoA-I) leading to tumor necrosis factor-alpha (TNF-α)-mediated oxidative stress in plasma and brain. We also reported that co-administration of the antioxidant drug, 2-mercaptoethane sulfonate sodium (MESNA), prevents Dox-induced protein oxidation and subsequent TNF-α elevation in plasma. In this study, we measured oxidative stress in both brain and plasma of Dox-treated mice both with and without MESNA. MESNA ameliorated Dox-induced oxidative protein damage in plasma, confirming our prior studies, and in a new finding led to decreased oxidative stress in brain. This study also provides further functional and biochemical evidence of the mechanisms of CICI. Using novel object recognition (NOR), we demonstrated the Dox administration resulted in memory deficits, an effect that was rescued by MESNA. Using hydrogen magnetic resonance imaging spectroscopy (H1-MRS) techniques, we demonstrated that Dox administration led to a dramatic decrease in choline-containing compounds assessed by (Cho)/creatine ratios in the hippocampus in mice. To better elucidate a potential mechanism for this MRS observation, we tested the activities of the phospholipase enzymes known to act on phosphatidylcholine (PtdCho), a key component of phospholipid membranes and a source of choline for the neurotransmitter, acetylcholine (ACh). The activities of both phosphatidylcholine-specific phospholipase C (PC-PLC) and phospholipase D were severely diminished following Dox administration. The activity of PC-PLC was preserved when MESNA was co-administered with Dox; however, PLD activity was not protected. This study is the first to demonstrate the protective effects of MESNA on Dox-related protein oxidation, cognitive decline, phosphocholine (PCho) levels, and PC-PLC activity in brain and suggests novel potential therapeutic targets and strategies to mitigate CICI.
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Affiliation(s)
| | - Xiaojia Ren
- Department of Chemistry, University of Kentucky, Lexington, KY 40506, USA
| | - Govind Warrier
- Department of Chemistry, University of Kentucky, Lexington, KY 40506, USA
| | - Teresa Noel
- Department of Toxicology and Cancer Biology, University of Kentucky, Lexington, KY 40536, USA
| | - David K. Powell
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky Medical Center, Lexington, KY 40536, USA
| | - Jennifer M. Brelsfoard
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, USA
| | - Rukhsana Sultana
- Department of Chemistry, University of Kentucky, Lexington, KY 40506, USA
| | - Kathryn E. Saatman
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY 40536, USA
| | - Daret K. St. Clair
- Department of Toxicology and Cancer Biology, University of Kentucky, Lexington, KY 40536, USA
- Department of Radiation Medicine, University of Kentucky, Lexington, KY 40502, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40502, USA
| | - D. Allan Butterfield
- Department of Chemistry, University of Kentucky, Lexington, KY 40506, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40502, USA
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY 40536, USA
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Brain structure and function in patients with ovarian cancer treated with first-line chemotherapy: a pilot study. Brain Imaging Behav 2018; 11:1652-1663. [PMID: 27766586 DOI: 10.1007/s11682-016-9608-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Women with ovarian cancer often undergo chemotherapy involving multiple agents. However, little is known about treatment-related central neurotoxicity in this population. The goal of this cross-sectional study was to assess brain structure and function and neurocognitive abilities in patients with ovarian cancer following first-line chemotherapy. Eighteen patients with ovarian, peritoneal and fallopian tube cancer and eighteen healthy controls matched for gender, age and education participated in the study. The patients were evaluated 1-4 months following completion of first-line taxane/platinum chemotherapy. All participants underwent structural and functional magnetic resonance imaging (MRI), and completed neuropsychological tests of attention, memory and executive functions. Neuroimaging assessments included voxel-based morphometry (VBM) for measuring gray matter (GM) volume, and functional MRI (fMRI) during the N-back working memory task. The results of VBM showed that patients had significantly reduced GM volume compared to healthy controls in the right middle/superior frontal gyrus, and in the left supramarginal gyrus and left inferior parietal lobule. fMRI results indicated significantly decreased activation in patients relative to healthy controls in the left middle frontal gyrus and left inferior parietal lobule during the N-back task (1/2/3-back >0-back). There were no statistically significant differences between the two groups on the neuropsychological tests. This is the first study showing structural and functional alterations involving frontal and parietal regions in patients with ovarian cancer treated with first-line chemotherapy. These findings are congruent with studies involving women with breast cancer, and provide additional supporting evidence for central neurotoxicity associated with taxane/platinum chemotherapy.
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22
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Marusak HA, Iadipaolo AS, Harper FW, Elrahal F, Taub JW, Goldberg E, Rabinak CA. Neurodevelopmental consequences of pediatric cancer and its treatment: applying an early adversity framework to understanding cognitive, behavioral, and emotional outcomes. Neuropsychol Rev 2018; 28:123-175. [PMID: 29270773 PMCID: PMC6639713 DOI: 10.1007/s11065-017-9365-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 11/08/2017] [Indexed: 01/29/2023]
Abstract
Today, children are surviving pediatric cancer at unprecedented rates, making it one of modern medicine's true success stories. However, we are increasingly becoming aware of several deleterious effects of cancer and the subsequent "cure" that extend beyond physical sequelae. Indeed, survivors of childhood cancer commonly report cognitive, emotional, and psychological difficulties, including attentional difficulties, anxiety, and posttraumatic stress symptoms (PTSS). Cognitive late- and long-term effects have been largely attributed to neurotoxic effects of cancer treatments (e.g., chemotherapy, cranial irradiation, surgery) on brain development. The role of childhood adversity in pediatric cancer - namely, the presence of a life-threatening disease and endurance of invasive medical procedures - has been largely ignored in the existing neuroscientific literature, despite compelling research by our group and others showing that exposure to more commonly studied adverse childhood experiences (i.e., domestic and community violence, physical, sexual, and emotional abuse) strongly imprints on neural development. While these adverse childhood experiences are different in many ways from the experience of childhood cancer (e.g., context, nature, source), they do share a common element of exposure to threat (i.e., threat to life or physical integrity). Therefore, we argue that the double hit of early threat and cancer treatments likely alters neural development, and ultimately, cognitive, behavioral, and emotional outcomes. In this paper, we (1) review the existing neuroimaging research on child, adolescent, and adult survivors of childhood cancer, (2) summarize gaps in our current understanding, (3) propose a novel neurobiological framework that characterizes childhood cancer as a type of childhood adversity, particularly a form of early threat, focusing on development of the hippocampus and the salience and emotion network (SEN), and (4) outline future directions for research.
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Affiliation(s)
- Hilary A Marusak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA.
| | - Allesandra S Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
| | - Felicity W Harper
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Farrah Elrahal
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Children's Hospital of Michigan, Detroit, MI, USA
| | - Elimelech Goldberg
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Kids Kicking Cancer, Southfield, MI, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA
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Machado AMC, Fagundes TC, Mafra A, Silva RG, Castro ACG, Mamede M. Effects on 18F-FDG PET/CT Brain Glucose Metabolism in Rectal Cancer Patients Undergoing Neoadjuvant Chemotherapy. Clin Nucl Med 2018; 42:e484-e490. [PMID: 29035999 DOI: 10.1097/rlu.0000000000001862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Retrospective study of the effects of anticancer treatment on the brain metabolism of patients diagnosed with rectal cancer based on a large and homogeneous sample of 40 paired F-FDG PET/CT volumes taken from 20 patients. The results are compared to the ones presented by related works to help elucidating the mechanisms of neurotoxicity associated to a decrease in memory, learning and motor skills. PATIENTS AND METHODS Twenty patients with rectal adenocarcinoma were scanned before and after neoadjuvant chemoradiation based exclusively on 5-fluorouracil and leucovorin. The sample was non-rigidly registered to a common template to allow for the comparison of regional metabolism. Statistical analysis was based on adjusted paired t-tests. RESULTS The analysis primarily revealed a statistically significant decrease in the metabolism after neoadjuvant chemotherapy at the hypothalamus, putamen, head of the caudate, globus pallidus, red nucleus, substantia nigra, amygdala, cerebellum and the parahippocampal gyrus. The analysis also revealed smaller regions of increased metabolic activity at the middle temporal gyrus, precuneus of the parietal lobe and cuneus of the occipital lobe. CONCLUSIONS The regions of decreased metabolism detected in the study are related to memory, learning and voluntary movement which is consistent with previous findings based on clinical studies and neuropsychological tests that report impairments on neurocognitive and motor skills associated to these therapies.
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Affiliation(s)
- Alexei M C Machado
- From the *Department of Anatomy and Imaging, School of Medicine, Federal University of Minas Gerais, Belo Horizonte; †Graduate Program in Electrical Engineering and in Vertebrate Biology, Pontifical Catholic University of Minas Gerais, Belo Horizonte; ‡Oncology Section, University Hospital, Federal University of Minas Gerais, Belo Horizonte; §Radiation Therapy Section, Mario Penna Institute, Belo Horizonte; and ∥Department of Surgery, and ¶Molecular Imaging Center, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Hartman SJ, Nelson SH, Myers E, Natarajan L, Sears DD, Palmer BW, Weiner LS, Parker BA, Patterson RE. Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: The memory & motion study. Cancer 2018; 124:192-202. [PMID: 28926676 PMCID: PMC5735009 DOI: 10.1002/cncr.30987] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/17/2017] [Accepted: 08/16/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Increasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors. METHODS Sedentary breast cancer survivors were randomized to an exercise arm (n = 43) or a control arm (n = 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores. RESULTS On average, participants (n = 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b = 2.01; P < .05). The between-group differences in improvement on self-reported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were ≤2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b = 4.00; P < .01), but no significant improvement was observed in patients who were >2 years postsurgery (b = -1.19; P = .40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm. CONCLUSIONS The exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer. Cancer 2018;124:192-202. © 2017 American Cancer Society.
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Affiliation(s)
- Sheri J. Hartman
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Sandahl H. Nelson
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Emily Myers
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
- Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Barton W. Palmer
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Lauren S. Weiner
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Barbara A. Parker
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
- Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Ruth E. Patterson
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
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El-Agamy SE, Abdel-Aziz AK, Wahdan S, Esmat A, Azab SS. Astaxanthin Ameliorates Doxorubicin-Induced Cognitive Impairment (Chemobrain) in Experimental Rat Model: Impact on Oxidative, Inflammatory, and Apoptotic Machineries. Mol Neurobiol 2017; 55:5727-5740. [DOI: 10.1007/s12035-017-0797-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/03/2017] [Indexed: 11/29/2022]
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Vitolo U, Seymour J, Martelli M, Illerhaus G, Illidge T, Zucca E, Campo E, Ladetto M. Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27:v91-v102. [DOI: 10.1093/annonc/mdw175] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Abdel-Aziz AK, Mantawy EM, Said RS, Helwa R. The tyrosine kinase inhibitor, sunitinib malate, induces cognitive impairment in vivo via dysregulating VEGFR signaling, apoptotic and autophagic machineries. Exp Neurol 2016; 283:129-41. [PMID: 27288242 DOI: 10.1016/j.expneurol.2016.06.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 05/14/2016] [Accepted: 06/06/2016] [Indexed: 01/29/2023]
Abstract
Chemobrain refers to a cluster of cognitive deficits which affects almost 4-75% of chemotherapy-treated cancer patients. Sunitinib, an FDA-approved multityrosine kinase inhibitor, is currently used in treating different types of tumors. Despite being regarded as targeted therapy which blunts sustained angiogenesis in cancer milieu through inhibiting vascular endothelial growth factor receptor 2 (VEGFR2) signaling, the latter has a cardinal role in cognition. Recent clinical reports warned that sunitinib adversely affected memory processing in cancer patients. Nevertheless, the underlying mechanisms have not been investigated yet. Hence, we explored the impact of a clinically relevant dose of sunitinib on memory processing in vivo and questioned the implication of VEGFR2 signaling, autophagy and apoptosis. Strikingly, sunitinib preferentially impaired spatial cognition as evidenced in Morris water maze, T-maze and passive avoidance task. Consistently, sunitinib degenerated cortical and hippocampal neurons as assessed by histopathological examination and toluidine blue staining. Ultrastructural examination also depicted chromatin condensation, mitochondrial damage and accumulated autophagosomes. Digging deeper, central VEGF/VEGFR2/mTOR signaling was robustly suppressed. Besides, sunitinib boosted cortical and hippocampal p53 and executioner caspase-3 and decreased nuclear factor kappa B and Bcl-2 levels promoting apoptotic cell death. It also profoundly impeded neuronal autophagic flux as shown by decreased beclin-1 and Atg5 and increased p62/SQTSM1 levels. To our knowledge, this is the first study to provide molecular insights into sunitinib-induced chemofog where impeded VEGFR2 signaling and autophagic and hyperactivated apoptotic machineries act in neurodegenerative concert. Importantly, our findings shed light on potential therapeutic strategies to be exploited in the management of sunitinib-induced chemobrain.
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Affiliation(s)
- Amal Kamal Abdel-Aziz
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
| | - Eman M Mantawy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Riham Soliman Said
- National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt
| | - Reham Helwa
- Zoology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
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The Development of a Mindfulness-Based Music Therapy (MBMT) Program for Women Receiving Adjuvant Chemotherapy for Breast Cancer. Healthcare (Basel) 2016; 4:healthcare4030053. [PMID: 27517966 PMCID: PMC5041054 DOI: 10.3390/healthcare4030053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/21/2016] [Accepted: 07/28/2016] [Indexed: 11/22/2022] Open
Abstract
Problems with attention and symptom distress are common clinical features reported by women who receive adjuvant chemotherapy for breast cancer. Mindfulness practice significantly improves attention and mindfulness programs significantly reduce symptom distress in patients with cancer, and, more specifically, in women with breast cancer. Recently, a pilot investigation of a music therapy program, built on core attitudes of mindfulness practice, reported significant benefits of enhanced attention and decreased negative mood and fatigue in women with breast cancer. This paper delineates the design and development of the mindfulness-based music therapy (MBMT) program implemented in that pilot study and includes clients’ narrative journal responses. Conclusions and recommendations, including recommendation for further exploration of the function of music in mindfulness practice are provided.
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Jean-Pierre P, McDonald B. Neuroepidemiology of cancer and treatment-related neurocognitive dysfunction in adult-onset cancer patients and survivors. Neuroepidemiology 2016; 138:297-309. [DOI: 10.1016/b978-0-12-802973-2.00017-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Postoperative Structural Brain Changes and Cognitive Dysfunction in Patients with Breast Cancer. PLoS One 2015; 10:e0140655. [PMID: 26536672 PMCID: PMC4633203 DOI: 10.1371/journal.pone.0140655] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 09/29/2015] [Indexed: 12/25/2022] Open
Abstract
Objective The primary purpose of this study was to clarify the influence of the early response to surgery on brain structure and cognitive function in patients with breast cancer. It was hypothesized that the structure of the thalamus would change during the early response after surgery due to the effects of anesthesia and would represent one aspect of an intermediate phenotype of postoperative cognitive dysfunction (POCD). Methods We examined 32 postmenopausal females with breast cancer and 20 age-matched controls. We assessed their cognitive function (attention, memory, and executive function), and performed brain structural MRI 1.5 ± 0.5 days before and 5.6 ± 1.2 days after surgery. Results We found a significant interaction between regional grey matter volume (rGMV) in the thalamus (P < 0.05, familywise error (FWE), small volume correction (SVC)) and one attention domain subtest (P = 0.001, Bonferroni correction) after surgery in the patient group compared with the control group. Furthermore, the changes in attention were significantly associated with sevoflurane anesthetic dose (r2 = 0.247, β = ‒0.471, P = 0.032) and marginally associated with rGMV changes in the thalamus (P = 0.07, FWE, SVC) in the Pt group. Conclusion Our findings suggest that alterations in brain structure, particularly in the thalamus, may occur shortly after surgery and may be associated with attentional dysfunction. This early postoperative response to anesthesia may represent an intermediate phenotype of POCD. It was assumed that patients experiencing other risk factors of POCD, such as the severity of surgery, the occurrence of complications, and pre-existing cognitive impairments, would develop clinical POCD with broad and multiple types of cognitive dysfunction.
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Cognitive function during and six months following chemotherapy for front-line treatment of ovarian, primary peritoneal or fallopian tube cancer: An NRG oncology/gynecologic oncology group study. Gynecol Oncol 2015; 139:541-5. [PMID: 26456812 DOI: 10.1016/j.ygyno.2015.10.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/30/2015] [Accepted: 10/03/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Changes in cognitive function have been identified in and reported by many cancer survivors. These changes have the potential to impact patient quality of life and functional ability. This prospective longitudinal study was designed to quantify the incidence of change in cognitive function in newly diagnosed ovarian cancer patients throughout and following primary chemotherapy. METHODS Eligible patients had newly diagnosed, untreated ovarian cancer and had planned to receive chemotherapy. Web-based and patient reported cognitive assessments and quality of life questionnaires were conducted prior to chemotherapy, prior to cycle four, after cycle six, and six months after completion of primary therapy. RESULTS Two-hundred-thirty-one evaluable patients entered this study between May 2010 and October 2011. At the cycle 4 time point, 25.2% (55/218) of patients exhibited cognitive impairment in at least one domain. At the post-cycle 6 and 6-month follow up time points, 21.1% (44/208) and 17.8% (30/169) of patients, respectively, demonstrated impairment in at least one domain of cognitive function. There were statistically significant, but clinically small, improvements in processing speed (p<0.001) and attention (p<0.001) but not in motor response time (p=0.066), from baseline through the six-month follow up time period. CONCLUSIONS This was a large, prospective study designed to measure cognitive function in ovarian cancer. A subset of patients had evidence of cognitive decline from baseline during chemotherapy treatment in this study as measured by the web-based assessment; however, changes were generally limited to no more than one domain.
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Kwakkenbos L, Minton O, Stone PC, Alexander S, Baron M, Hudson M, Thombs BD. Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis. J Rheumatol 2015; 42:1156-62. [DOI: 10.3899/jrheum.141421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
Objective.Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue.Methods.The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model.Results.Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms.Conclusion.The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.
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Jean-Pierre P, Grandner MA, Garland SN, Henry E, Jean-Louis G, Burish TG. Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia. Sleep Med 2015; 16:845-9. [PMID: 26026625 DOI: 10.1016/j.sleep.2015.02.531] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 02/06/2015] [Accepted: 02/17/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems. OBJECTIVE To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors. METHODS We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health. RESULTS The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p < 0.01) significantly predicted SRMP, uniquely explaining 12% of the variance. Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p < 0.05). The large CI is a consequence of analyzing a sub-group of a subpopulation. Among participants without a cancer history, cardiovascular disease and insomnia were not associated with SRMP (p > 0.05). LIMITATIONS We could not determine severity and time-related changes in SRMP. CONCLUSION Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA.
| | - Michael A Grandner
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA
| | - Sheila N Garland
- Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA; Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Henry
- Department of Hematology/Oncology, Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, IL, USA
| | - Girardin Jean-Louis
- Department of Population Health, Center for Healthful Behavior Change, New York University, New York, NY, USA
| | - Thomas G Burish
- Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA
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Wefel JS, Kesler SR, Noll KR, Schagen SB. Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. CA Cancer J Clin 2015; 65:123-38. [PMID: 25483452 PMCID: PMC4355212 DOI: 10.3322/caac.21258] [Citation(s) in RCA: 320] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Answer questions and earn CME/CNE Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported-that cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed.
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Affiliation(s)
- Jeffrey S. Wefel
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Corresponding author: Jeffrey S. Wefel, PhD, Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 431, Houston, TX 77030;
| | - Shelli R. Kesler
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kyle R. Noll
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sanne B. Schagen
- Associate Professor, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Philpot RM. Potential Use of Nicotinic Receptor Agonists for the Treatment of Chemotherapy-Induced Cognitive Deficits. Neurochem Res 2015; 40:2018-31. [DOI: 10.1007/s11064-015-1528-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/09/2015] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
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Natori A, Ogata T, Sumitani M, Kogure T, Yamauchi T, Yamauchi H. Potential Role of pNF-H, a Biomarker of Axonal Damage in the Central Nervous System, as a Predictive Marker of Chemotherapy-Induced Cognitive Impairment. Clin Cancer Res 2015; 21:1348-52. [DOI: 10.1158/1078-0432.ccr-14-2775] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mandelblatt JS, Jacobsen PB, Ahles T. Cognitive effects of cancer systemic therapy: implications for the care of older patients and survivors. J Clin Oncol 2014; 32:2617-26. [PMID: 25071135 PMCID: PMC4129505 DOI: 10.1200/jco.2014.55.1259] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The number of patients with cancer who are age 65 years or older (hereinafter "older") is increasing dramatically. One obvious aspect of cancer care for this group is that they are experiencing age-related changes in multiple organ systems, including the brain, which complicates decisions about systemic therapy and assessments of survivorship outcomes. There is a consistent body of evidence from studies that use neuropsychological testing and neuroimaging that supports the existence of impairment following systemic therapy in selected cognitive domains among some older patients with cancer. Impairment in one or more cognitive domains could have important effects in the daily lives of older patients. However, an imperfect understanding of the precise biologic mechanisms underlying cognitive impairment after systemic treatment precludes development of validated methods for predicting which older patients are at risk. From what is known, risks may include lifestyle factors such as smoking, genetic predisposition, and specific comorbidities such as diabetes and cardiovascular disease. Risk also interacts with physiologic and cognitive reserve, because even at the same chronological age and with the same number of illnesses, older patients vary from having high reserve (ie, biologically younger than their age) to being frail (biologically older than their age). Surveillance for the presence of cognitive impairment is also an important component of long-term survivorship care with older patients. Increasing the workforce of cancer care providers who have geriatrics training or who are working within multidisciplinary teams that have this type of expertise would be one avenue toward integrating assessment of the cognitive effects of cancer systemic therapy into routine clinical practice.
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Affiliation(s)
- Jeanne S Mandelblatt
- Jeanne S. Mandelblatt, Georgetown University, Washington, DC; Paul B. Jacobsen, Moffitt Cancer Center, Tampa, FL; and Tim Ahles, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY.
| | - Paul B Jacobsen
- Jeanne S. Mandelblatt, Georgetown University, Washington, DC; Paul B. Jacobsen, Moffitt Cancer Center, Tampa, FL; and Tim Ahles, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | - Tim Ahles
- Jeanne S. Mandelblatt, Georgetown University, Washington, DC; Paul B. Jacobsen, Moffitt Cancer Center, Tampa, FL; and Tim Ahles, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY
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Pomykala KL, Ganz PA, Bower JE, Kwan L, Castellon SA, Mallam S, Cheng I, Ahn R, Breen EC, Irwin MR, Silverman DHS. The association between pro-inflammatory cytokines, regional cerebral metabolism, and cognitive complaints following adjuvant chemotherapy for breast cancer. Brain Imaging Behav 2014; 7:511-23. [PMID: 23835929 DOI: 10.1007/s11682-013-9243-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
To examine relationships following adjuvant chemotherapy between circulating pro-inflammatory cytokines, regional cerebral metabolism, and cognitive complaints in early stage breast cancer patients. 33 breast cancer patients who had completed initial treatment (surgery, ± radiation, 23 chemotherapy, 10 no chemotherapy) obtained resting (18)F-FDG PET/CT brain imaging at baseline and 1 year later. Pro-inflammatory cytokine markers (IL-1ra, sTNF-RII, CRP, and IL-6) and cognitive complaints were also assessed at both time points. At baseline, consistent correlations were seen between the left medial frontal and right inferior lateral anterior temporal cortices and inflammatory markers within the chemotherapy group, and not in the no chemotherapy group. After 1 year, correlations persisted in the medial frontal cortex and the temporal cortex, the latter shifting superiorly. Both of these regional correlations demonstrated the highest levels of significance when looking across the 1 year time frame (IL-1ra: peak voxel p < 0.0005; cluster size p < 0.0005, p = 0.001 after correction (medial prefrontal), p < 0.0005; cluster size p = 0.001, p = 0.029 corr. (anterior temporal), sTNF-RII: p < 0.0005; cluster size p = 0.001, p = 0.040 corr. (medial prefrontal)). Positive correlations were also seen within the chemotherapy group between baseline memory complaints and the medial frontal (p < 0.0005; cluster size p < 0.0005, p < 0.0005 corr.) and anterior temporal (p < 0.0005; cluster size p < 0.0005, p = 0.002 corr.) cortices at baseline and 1 year later. Metabolism in the medial prefrontal cortex and anterior temporal cortex was found to correlate with both memory complaints and cytokine marker levels in chemotherapy patients.
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Affiliation(s)
- K L Pomykala
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite B114, Mail Code: 737024, Los Angeles, CA, 90095-7370, USA
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Jean-Pierre P, Johnson-Greene D, Burish TG. Neuropsychological care and rehabilitation of cancer patients with chemobrain: strategies for evaluation and intervention development. Support Care Cancer 2014; 22:2251-60. [PMID: 24671433 PMCID: PMC4256074 DOI: 10.1007/s00520-014-2162-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 02/05/2014] [Indexed: 12/20/2022]
Abstract
Malignant tumors and their various treatments such as chemotherapy, radiotherapy and hormonal therapy can deleteriously affect a large number of cancer patients and survivors on multiple dimensions of psychosocial and neurocognitive functioning. Oncology researchers and clinicians are increasingly cognizant of the negative effects of cancer and its treatments on the brain and its mental processes and cognitive outcomes. Nevertheless, effective interventions to treat cancer and treatment-related neurocognitive dysfunction (CRND), also known as chemobrain, are still lacking. The paucity of data on effective treatments for CRND is due, at least partly, to difficulties understanding its etiology, and a lack of reliable methods for assessing its presence and severity. This paper provides an overview of the incidence, etiology, and magnitude of CRND, and discusses the plausible contributions of psychological, motor function, and linguistic and behavioral complications to CRND. Strategies for reliable neuropsychological screening and assessment, and development and testing of effective ways to mitigate CRND are also discussed.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Psychology, Neurocognitive Translational Research Laboratory, Cancer Control and Survivorship Program, University of Notre Dame, 109 Haggar Hall, Notre Dame, IN, 46566, USA,
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Mandelblatt JS, Stern RA, Luta G, McGuckin M, Clapp JD, Hurria A, Jacobsen PB, Faul LA, Isaacs C, Denduluri N, Gavett B, Traina TA, Johnson P, Silliman RA, Turner RS, Howard D, Van Meter JW, Saykin A, Ahles T. Cognitive impairment in older patients with breast cancer before systemic therapy: is there an interaction between cancer and comorbidity? J Clin Oncol 2014; 32:1909-18. [PMID: 24841981 PMCID: PMC4050204 DOI: 10.1200/jco.2013.54.2050] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To determine if older patients with breast cancer have cognitive impairment before systemic therapy. PATIENTS AND METHODS Participants were patients with newly diagnosed nonmetastatic breast cancer and matched friend or community controls age > 60 years without prior systemic treatment, dementia, or neurologic disease. Participants completed surveys and a 55-minute battery of 17 neuropsychological tests. Biospecimens were obtained for APOE genotyping, and clinical data were abstracted. Neuropsychological test scores were standardized using control means and standard deviations (SDs) and grouped into five domain z scores. Cognitive impairment was defined as any domain z score two SDs below or ≥ two z scores 1.5 SDs below the control mean. Multivariable analyses evaluated pretreatment differences considering age, race, education, and site; comparisons between patient cases also controlled for surgery. RESULTS The 164 patient cases and 182 controls had similar neuropsychological domain scores. However, among patient cases, those with stage II to III cancers had lower executive function compared with those with stage 0 to I disease, after adjustment (P = .05). The odds of impairment were significantly higher among older, nonwhite, less educated women and those with greater comorbidity, after adjustment. Patient case or control status, anxiety, depression, fatigue, and surgery were not associated with impairment. However, there was an interaction between comorbidity and patient case or control status; comorbidity was strongly associated with impairment among patient cases (adjusted odds ratio, 8.77; 95% CI, 2.06 to 37.4; P = .003) but not among controls (P = .97). Only diabetes and cardiovascular disease were associated with impairment among patient cases. CONCLUSION There were no overall differences between patients with breast cancer and controls before systemic treatment, but there may be pretreatment cognitive impairment within subgroups of patient cases with greater tumor or comorbidity burden.
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Affiliation(s)
- Jeanne S Mandelblatt
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN.
| | - Robert A Stern
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Gheorghe Luta
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Meghan McGuckin
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Jonathan D Clapp
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Arti Hurria
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Paul B Jacobsen
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Leigh Anne Faul
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Claudine Isaacs
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Neelima Denduluri
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Brandon Gavett
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Tiffany A Traina
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Patricia Johnson
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Rebecca A Silliman
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - R Scott Turner
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Darlene Howard
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - John W Van Meter
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Andrew Saykin
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
| | - Tim Ahles
- Jeanne S. Mandelblatt, Gheorghe Luta, Meghan McGuckin, Jonathan D. Clapp, Leigh Anne Faul, Claudine Isaacs, Neelima Denduluri, R. Scott Turner, Darlene Howard, and John W. Van Meter, Georgetown University, Washington, DC; Robert A. Stern, Brandon Gavett, Patricia Johnson, and Rebecca A. Silliman, Boston University School of Medicine, Boston, MA; Arti Hurria, City of Hope Comprehensive Cancer Center, Duarte, CA; Paul B. Jacobsen, Moffitt Cancer Center; Patricia Johnson, University of South Florida, Tampa, FL; Neelima Denduluri, Virginia Cancer Specialists, Arlington, VA; Tiffany A. Traina and Tim Ahles, Memorial Sloan-Kettering Cancer Center; Tiffany A. Traina, Weill Medical College of Cornell University, New York, NY; and Andrew Saykin, Indiana University School of Medicine, Indianapolis, IN
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Pradhan KR, Stump TE, Monahan P, Champion V. Relationships among attention function, exercise, and body mass index: a comparison between young breast cancer survivors and acquaintance controls. Psychooncology 2014; 24:325-32. [PMID: 24934396 DOI: 10.1002/pon.3598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/08/2014] [Accepted: 05/16/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although regular physical activity is associated with lower all-cause and disease-specific mortality among breast cancer survivors (BCS), most BCS do not meet its recommended guidelines. Attention function, a domain of cognition, is essential for daily tasks such as exercising, a form of planned physical activity. We tested the hypotheses that lower self-reported attention function in BCS would be associated with less exercise and higher body mass index (BMI) by comparing a group of 505 young BCS (45 years or younger at diagnosis and 3-8 years post-treatment) with 466 acquaintance controls (AC). METHODS The groups were compared on self-reported physical and psychological outcomes. Mplus software was used to perform confirmatory structural equation modeling with a robust maximum likelihood estimator to evaluate hypothesized relationships among variables. The criteria for good model fit were having root mean square error of approximation (RMSEA) < 0.06, comparative fit index (CFI) > 0.95, and standardized root mean square residual (SRMR) < 0.08. Modification indices were used to better fit the model. RESULTS The final model demonstrated good fit, with RMSEA = 0.05, CFI = 0.98, and SRMR = 0.03. After controlling for demographics, parameter estimates revealed that, compared with AC, young BCS reported worse attention function (p < 0.001), more depressive symptoms (p < 0.001), and more fatigue (p < 0.001). Controlling for fatigue, depression, and anxiety, better attention function was associated with a greater likelihood of exercise in the past 3 months (p = 0.039), which in turn was associated with a lower BMI (p < 0.001). CONCLUSIONS The significant association between attention function and physical activity, if confirmed in a longitudinal study, will provide new targets for interventions aimed at improving physical activity and decreasing BMI among BCS.
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Affiliation(s)
- Kamnesh R Pradhan
- Department of Pediatric Hematology-Oncology, Indiana University School of Medicine, Indianapolis, IN, USA
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Cheung YT, Lim SR, Ho HK, Chan A. Cytokines as mediators of chemotherapy-associated cognitive changes: current evidence, limitations and directions for future research. PLoS One 2013; 8:e81234. [PMID: 24339912 PMCID: PMC3855252 DOI: 10.1371/journal.pone.0081234] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 10/10/2013] [Indexed: 12/29/2022] Open
Abstract
Objectives While various clinical and pharmacological determinants for chemotherapy-associated cognitive impairment have been identified, conflicting evidence suggests that cytokines might play an intermediary role. The objective of this systematic review was to evaluate the current evidence pertaining to the associations among chemotherapy, cytokines induction and cognitive impairment in cancer patients. Methods A literature search with PubMed and SciVerse Scopus was conducted in March 2013 to gather relevant articles and abstracts that fulfilled the inclusion and exclusion criteria. This review included studies that had performed objective and/or subjective cognitive assessments and cytokine measurements on defined populations of cancer patients who received chemotherapy. Results High methodological heterogeneity existed among the selected studies which differed in cancer populations, subject characteristics, cognitive endpoints, types of cytokines tested and their measurement methods. Weak to moderate correlations were observed between IL-1β, IL-6, TNF-α levels, and different degrees of cognitive impairment. Different types of chemotherapy treatments might lead to varying presentations and severities of cytokine-induced cognitive impairment. Notably, the time concordance between the onset of cytokine induction and occurrence of cognitive impairment was not well elucidated. A number of confounding factors was identified to interfere with the expression levels of cytokines; these confounders included subjects' cancer types, ages, genders, genetics and psychosocial characteristics such as anxiety, depression and fatigue. Conclusion Although existing studies observed cognitive impairment and cytokine dysregulation in patients who receive chemotherapy, our results suggest that the intermediary role of cytokines in post-chemotherapy cognitive impairment is still controversial and requires further evaluation. A list of methodological recommendations is proposed to harmonize future studies of this subject matter.
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Affiliation(s)
- Yin Ting Cheung
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Si Rong Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Han Kiat Ho
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
- * E-mail:
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Mandelblatt JS, Hurria A, McDonald BC, Saykin AJ, Stern RA, VanMeter JW, McGuckin M, Traina T, Denduluri N, Turner S, Howard D, Jacobsen PB, Ahles T. Cognitive effects of cancer and its treatments at the intersection of aging: what do we know; what do we need to know? Semin Oncol 2013; 40:709-25. [PMID: 24331192 PMCID: PMC3880205 DOI: 10.1053/j.seminoncol.2013.09.006] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There is a fairly consistent, albeit non-universal body of research documenting cognitive declines after cancer and its treatments. While few of these studies have included subjects aged 65 years and older, it is logical to expect that older patients are at risk of cognitive decline. Here, we use breast cancer as an exemplar disease for inquiry into the intersection of aging and cognitive effects of cancer and its therapies. There are a striking number of common underlying potential biological risks and pathways for the development of cancer, cancer-related cognitive declines, and aging processes, including the development of a frail phenotype. Candidate shared pathways include changes in hormonal milieu, inflammation, oxidative stress, DNA damage and compromised DNA repair, genetic susceptibility, decreased brain blood flow or disruption of the blood-brain barrier, direct neurotoxicity, decreased telomere length, and cell senescence. There also are similar structure and functional changes seen in brain imaging studies of cancer patients and those seen with "normal" aging and Alzheimer's disease. Disentangling the role of these overlapping processes is difficult since they require aged animal models and large samples of older human subjects. From what we do know, frailty and its low cognitive reserve seem to be a clinically useful marker of risk for cognitive decline after cancer and its treatments. This and other results from this review suggest the value of geriatric assessments to identify older patients at the highest risk of cognitive decline. Further research is needed to understand the interactions between aging, genetic predisposition, lifestyle factors, and frailty phenotypes to best identify the subgroups of older patients at greatest risk for decline and to develop behavioral and pharmacological interventions targeting this group. We recommend that basic science and population trials be developed specifically for older hosts with intermediate endpoints of relevance to this group, including cognitive function and trajectories of frailty. Clinicians and their older patients can advance the field by active encouragement of and participation in research designed to improve the care and outcomes of the growing population of older cancer patients.
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Affiliation(s)
- Jeanne S Mandelblatt
- Departments of Oncology and Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
| | - Arti Hurria
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Brenna C McDonald
- Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN
| | - Robert A Stern
- Departments of Neurology and Neurosurgery and Director, Clinical Core, BU Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA
| | - John W VanMeter
- Department of Neurology, Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Meghan McGuckin
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Tiffani Traina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Neelima Denduluri
- Department of Medicine, Georgetown University; Virginia Cancer Specialists, US Oncology, Arlington, VA
| | - Scott Turner
- Department of Neurology, Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Darlene Howard
- Department of Psychology, Georgetown University, Washington, DC
| | - Paul B Jacobsen
- Division of Population Science, Moffitt Cancer Center, Tampa, FL
| | - Tim Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Psychiatry, Weill Cornell Medical College, New York, NY
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Chen X, Zhu C, Li J, Qiu L, Zhang L, Yu F, Ye R, Zhang J, Wang K. Dissociation of decision making under ambiguity and decision making under risk in breast cancer patients receiving adjuvant chemotherapy: A neuropsychological study. Brain Res 2013; 1533:63-72. [DOI: 10.1016/j.brainres.2013.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/02/2013] [Accepted: 08/06/2013] [Indexed: 01/17/2023]
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Rollin-Sillaire A, Delbeuck X, Pollet M, Mackowiak MA, Lenfant P, Noel MP, Facon T, Leleu X, Pasquier F, Le Rhun E. Memory loss during lenalidomide treatment: a report on two cases. BMC Pharmacol Toxicol 2013; 14:41. [PMID: 23937917 PMCID: PMC3751879 DOI: 10.1186/2050-6511-14-41] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 06/11/2013] [Indexed: 12/20/2022] Open
Abstract
Background There are many reports of cognitive dysfunction in patients receiving chemotherapy or targeted therapies. Many antineoplastic agents may be involved in the condition also known as “chemo brain” or “chemo fog”. Case presentation Two male patients (aged 41 and 70) with multiple myeloma developed severe, rapidly progressing cognitive impairment (mostly involving episodic memory) and loss of independence in activities of daily living during lenalidomide-based treatment. On withdrawal of the drug, one patient recovered normal cognitive function and independence in activities of daily living, whereas mild cognitive impairment persisted in the other patient. The Naranjo Adverse Drug Reaction Probability Scale score was 6 out of 13 for the first patient and 5 out of 13 for the second, suggesting a probable causal relationship between the adverse event and lenalidomide administration. Conclusion Lenalidomide may induce particular cognitive disorders (notably episodic memory impairments) in some patients. The drug’s putative neurotoxicity is probably promoted by specific risk factors (such as previous chemotherapy, prior mild cognitive impairment, age and the presence of cerebrovascular lesions).
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Koppelmans V, Breteler MMB, Boogerd W, Seynaeve C, Schagen SB. Late effects of adjuvant chemotherapy for adult onset non-CNS cancer; cognitive impairment, brain structure and risk of dementia. Crit Rev Oncol Hematol 2013; 88:87-101. [PMID: 23768778 DOI: 10.1016/j.critrevonc.2013.04.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 04/03/2013] [Accepted: 04/23/2013] [Indexed: 01/19/2023] Open
Abstract
Few studies have investigated the late (i.e. ≥ 5 years post-treatment) effects of chemotherapy for non-central nervous system (non-CNS) cancer on the brain. Here we discuss the studies that have investigated the late effects of adjuvant chemotherapy for non-CNS cancer on cognitive function (n=6); brain structure and function (n=5); and incidence of dementia (n=4). The neuropsychological studies showed long-term adverse cognitive problems in chemotherapy-exposed breast cancer survivors. This is in line with results from neuroimaging studies that report long-term brain structural alterations after chemotherapy. The studies exploring the association between chemotherapy and the incidence of dementia were contradictive and showed no clear relationship between the two phenomena. Although several methodological issues limit the validity and interpretation of some of the results of these studies, they suggest that chemotherapy is associated with subtle, yet long-lasting cognitive deficits, possibly related to brain structural and functional differences, but as yet not with an increased risk of dementia.
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Affiliation(s)
- Vincent Koppelmans
- Erasmus University Medical Center, Department of Epidemiology, Rotterdam, The Netherlands; Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Division of Psychosocial Research & Epidemiology, Amsterdam, The Netherlands
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Paquet L, Collins B, Song X, Chinneck A, Bedard M, Verma S. A pilot study of prospective memory functioning in early breast cancer survivors. Breast 2013; 22:455-61. [PMID: 23648279 DOI: 10.1016/j.breast.2013.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/17/2013] [Accepted: 04/03/2013] [Indexed: 01/06/2023] Open
Abstract
AIMS To evaluate prospective memory (PM) functioning in early breast cancer (BC) survivors and its association with fatigue and depression. METHODS The Memory for Intention Screening Test, the Center for Epidemiologic Studies Depression Scale and the Functional Assessment of Cancer Therapy-Fatigue subscale were administered to 80 patients and 80 aged-matched healthy controls. RESULTS Patients performed more poorly than controls on the memory test (p < 0.001) and had a higher rate of impairment (odds ratio = 5.5, p < 0.01). Fatigue mediated the relationship between Group membership and PM performance. CONCLUSIONS BC survivors exhibited a clear pattern of PM deficit and fatigue was a major contributor to this deficit. This suggests that a common mechanism may be involved in fatigue symptoms and memory disturbances experienced by patients. Further research is needed to evaluate the role of adjuvant therapy in PM deficits and to explore whether interventions targeted at improving fatigue may also improve memory functioning in BC survivors.
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Affiliation(s)
- Lise Paquet
- Carleton University, Ottawa, Ontario, Canada
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Kesler S, Hadi Hosseini SM, Heckler C, Janelsins M, Palesh O, Mustian K, Morrow G. Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors. Clin Breast Cancer 2013; 13:299-306. [PMID: 23647804 DOI: 10.1016/j.clbc.2013.02.004] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/25/2013] [Accepted: 02/04/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND A majority of breast cancer (BC) survivors, particularly those treated with chemotherapy, experience long-term cognitive deficits that significantly reduce quality of life. Among the cognitive domains most commonly affected include executive functions (EF), such as working memory, cognitive flexibility, multitasking, planning, and attention. Previous studies in other populations have shown that cognitive training, a behavioral method for treating cognitive deficits, can result in significant improvements in a number of cognitive skills, including EF. MATERIALS AND METHODS In this study, we conducted a randomized controlled trial to investigate the feasibility and preliminary effectiveness of a novel, online EF training program in long-term BC survivors. A total of 41 BC survivors (21 active, 20 wait list) completed the 48 session training program over 12 weeks. The participants were, on average, 6 years after therapy. RESULTS Cognitive training led to significant improvements in cognitive flexibility, verbal fluency and processing speed, with marginally significant downstream improvements in verbal memory as assessed via standardized measures. Self-ratings of EF skills, including planning, organizing, and task monitoring, also were improved in the active group compared with the wait list group. CONCLUSIONS Our findings suggest that EF skills may be improved even in long-term survivors by using a computerized, home-based intervention program. These improvements may potentially include subjective EF skills, which suggest a transfer of the training program to real-world behaviors.
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Affiliation(s)
- Shelli Kesler
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305-5795, USA.
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Klimmek R, Wenzel J. Adaptation of the illness trajectory framework to describe the work of transitional cancer survivorship. Oncol Nurs Forum 2013; 39:E499-510. [PMID: 23107863 DOI: 10.1188/12.onf.e499-e510] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE/OBJECTIVES To examine and refine the Illness Trajectory Framework, and to address transitional cancer survivorship. DATA SOURCES CINAHL®, PubMed, and relevant Institute of Medicine reports were searched for survivors' experiences during the year following treatment. DATA SYNTHESIS Using an abstraction tool, 68 articles were selected from the initial search (N > 700). Abstracted data were placed into a priori categories refined according to recommended procedures for theory derivation, followed by expert review. CONCLUSIONS Derivation resulted in a framework describing the work of transitional cancer survivorship, defined as survivor tasks, performed alone or with others, to carry out a plan of action for managing one or more aspects of life following primary cancer treatment. Theoretically, survivors engage in three reciprocally interactive lines of work: (a) illness-related, (b) biographical, and (c) everyday life work. Adaptation resulted in refinement of these domains and the addition of survivorship care planning under "illness-related work." IMPLICATIONS FOR NURSING Understanding this process of work may allow survivors and those who support them to better prepare for the post-treatment period. This adaptation provides a framework for future testing and development. Validity and utility of this framework within specific survivor populations also should be explored.
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Affiliation(s)
- Rachel Klimmek
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
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