A call to neuroscientists to help reveal root causes of chemobrain

June 12, 2018, Cell Press

A substantial fraction of non-central nervous system cancer survivors, especially those who have received chemotherapy, experience long-lasting cognitive difficulties, including problems with concentration, word-finding, short-term memory, and multitasking. Though well documented, cancer-related cognitive impairment (CRCI), known colloquially as chemobrain or chemofog, remains a mystery regarding its underlying neurological causes. In a Forum paper published June 12 in the journal Trends in Neurosciences, researchers at the National Cancer Institute propose a new approach to studying CRCI and call for changes in the way it's diagnosed.

"In our opinion, we need an infusion of new ideas from neuroscience," says lead author Todd S. Horowitz, Program Director in the Behavioral Research Program's (BRP) Basic Biobehavioral and Psychological Sciences Branch (BBPSB), located in the Division of Cancer Control and Population Sciences (DCCPS) at the NCI. "The current state of the art of our understanding of CRCI is not sufficient. Cognitive neuroscience would help us characterize the deficits people have and allow us to connect them to particular brain systems."

Better diagnosis tools will also help patients in their choices of options, as they will provide a clearer picture of who is likely to experience CRCI and which cognitive functions are likely to be affected.

The researchers stress the importance of developing better behavioral measurements of CRCI, an understanding of which are affected, and a better understanding of what the causes may be at the cellular level. They stress the need for development of new kinds of diagnostic testing, including behavioral measures, electrophysiological measures, and functional imaging, among others, to better understand the neurological basis of CRCI.

"As cancer treatments are improving long-term survivorship, there is increased focus on the long-term effects of treatment," says Horowitz. "CRCI is real and those of us in the field are intent on figuring it out."

Many studies confirm that CRCI develops in a subset of , persisting months and sometimes years after treatment is complete. But diagnosing it is remains inconsistent as current testing methods use standard neuropsychological tests, designed primarily for diagnosing focal brain lesions like stroke. "The kind of problems that people have with CRCI are more diffuse and they don't always show up in these neuropsychological tests," says Horowitz. For this reason, the prevalence of CRCI ranges from 17% to 75%, a range that confirms the insufficiency of current measurement techniques.

This lack of a reliable approach to identifying CRCI makes it harder to determine what causes it. "Patients and their families want to know what to expect during and after treatment," says Horowitz. For cancer patients and their families, a better understanding of who is likely to experience CRCI and what causes it may be helpful when deciding what forms of cancer treatment to pursue and ultimately finding ways to mitigate or prevent long-term cognitive difficulties.

Research suggests that those with a higher cognitive reserve or cognitive capacity—such as a stronger memory—are less likely to experience CRCI but those who are already experiencing memory or other cognitive problems may be more likely to have lingering difficulties.

"We believe taking a neuroscience approach to CRCI will help us figure out who is more likely to have these problems," says Horowitz. "If we can figure out what the specific cognitive limitations are, we can better come up with strategies for people to deal with them."

Explore further: Early 'chemobrain' intervention needed for breast cancer patients undergoing chemotherapy

More information: Trends in Neuroscience, Horowitz et al: "A call for a neuroscience approach to cancer-related cognitive impairment." https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(18)30114-0 , DOI: 10.1016/j.tins.2018.05.001

Related Stories

Early 'chemobrain' intervention needed for breast cancer patients undergoing chemotherapy

April 10, 2018
More support is needed to help breast cancer patients and survivors manage 'chemobrain' symptoms, such as memory loss, short attention span and mental confusion, according to a study led by researchers from the National University ...

Newest data links inflammation to chemo-brain

December 14, 2017
Inflammation in the blood plays a key role in "chemo-brain," according to a published pilot study that provides evidence for what scientists have long believed.

Breast cancer survivors struggle with cognitive problems several years after treatment

December 12, 2011
A new analysis has found that breast cancer survivors may experience problems with certain mental abilities several years after treatment, regardless of whether they were treated with chemotherapy plus radiation or radiation ...

Cancer treatment during childhood linked to cognitive problems later in life

June 14, 2017
Young adults who had chemotherapy as a child have decreased cognitive flexibility and a weaker short-term memory. Their ability to concentrate and long-term memory are largely unaffected. Researchers from KU Leuven (University ...

Cognitive rehabilitation improves brain function in cancer survivors

September 20, 2013
Cancer survivors who experience memory and thinking problems may benefit from cognitive rehabilitation, according to a new study led by Monique Cherrier, a UW associate professor of psychiatry and behavioral sciences.

Web-based cognitive exercises improve memory and attention in cancer survivors

October 31, 2016
A new study suggests that a widely available web-based program (Insight) can help cancer survivors reporting cognitive symptoms. The 15-week program markedly improved participants' self-reported (perceived) cognitive function, ...

Recommended for you

New study finds 'timing cells' in the brain may underlie an animal's inner clock

October 23, 2018
Are you taking your time when feeding your pet? Fluffy and Fido are on to you—and they can tell when you are dawdling.

Neurons reliably respond to straight lines

October 23, 2018
Single neurons in the brain's primary visual cortex can reliably detect straight lines, even though the cellular makeup of the neurons is constantly changing, according to a new study by Carnegie Mellon University neuroscientists, ...

Scientists reveal new details of how a naturally occurring hormone can boost memory in aging mice

October 23, 2018
A Columbia study in mice has revealed new details of how a naturally occurring bone hormone reverses memory loss in the aging brain. These findings about the hormone, called osteocalcin, stand to spur further investigations ...

Mutation in common protein triggers tangles, chaos inside brain cells

October 23, 2018
A pioneer in the study of neural cells revealed today (Oct. 23, 2018) how a single mutation affecting the most common protein in a supporting brain cell produces devastating, fibrous globs. These, in turn, disturb the location ...

Nerve-on-a-chip platform makes neuroprosthetics more effective

October 23, 2018
EPFL scientists have developed a miniaturized electronic platform for the stimulation and recording of peripheral nerve fibers on a chip. By modulating and rapidly recording nerve activity with a high signal-to-noise ratio, ...

The smell of lavender is relaxing, science confirms

October 23, 2018
Lavender works its relaxing magic all around us: from garden borders to bath bombs to fabric softener. But why not in our hospitals and clinics? And what is the science behind the magic?

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.