Chemotherapy and Cognition
Posted 11/28/2009
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There is lively ongoing investigation and discussion about the impact of chemotherapy on cognition. Whether we call it "chemobrain" or stick with more scientific words, many of us have experienced some (at least temporary) blunting of mental acuity. Here is a summary of a recent article by Andrea Vademaier in Women's Health and then a link if you want to read more.
Breast cancer treatment and cognitive
function: the current state of evidence,
underlying mechanisms and potential
treatments
Andrea Vodermaierâ€
Within the last decade, several studies have
investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have demonstrated inconsistent results regarding whether chemotherapy affects cognitive function.
Approximately half of the studies demonstrated subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and half did not. Concomitant changes in brain structure and function have been identified in neuroimaging and neurophysiologic studies. Estrogenic therapy has been specifically associated with deterioration in verbal memory and processing speed. However, evidence is mostly based on smaller studies with crosssectional data. Breast cancer patients who underwent both chemotherapy and estrogenic therapy showed the most deterioration and the most persistant decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Neuropsychological training has been demonstrated to improve cognitive dysfunction experienced by breast cancer patients after chemotherapy. Future research may examine the unique impact of endocrine therapy on cognitive function with prospective, controlled trials, as well as the role of further confounding variables (e.g., menopausal status, cytokine deregulation, cortisol and concurrent medication).
http://www.futuremedicine.com/doi/pdf/10.2217/whe.09.36
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