A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients

Abstract

These results suggest that having a breast cancer diagnosis may be associated with cognitive impairment. While chemotherapy may have a negative impact on cognitive function, chemotherapy-related impairments appear to be more acute than chronic side effects of therapy. Further studies are needed to provide insight into the clinical significance and potential mechanisms of cancer and treatment-related cognitive impairments.

Alterations in Brain Activation During Working Memory Processing Associated With Breast Cancer and Treatment: A Prospective Functional Magnetic Resonance Imaging Study

“…Prior cognitive studies have shown declines after chemotherapy, with improvement over time 3,8,9,30,31 (although see also Wefel et al 5 regarding later-onset cognitive changes and Kreukels et al 32 and Weis et al 33 regarding persistent cognitive deficits in a subgroup of individuals), and our recent finding of GMD changes followed the same pattern. 13 We therefore hypothesized that chemotherapy-related activation changes in WM circuitry would be detectable at M1 and show partial to complete recovery at Y1.…”

“…A growing body of evidence demonstrates that a subgroup of patients with BC have pretreatment cognitive deficits, [1][2][3][4][5] suggesting that aspects of cancer pathogenesis or host factors (potentially including variables related to BC surgery) cause cognitive changes or that there are common risk factors for the development of cancer and cognitive changes. 6 Prospective studies have shown cognitive changes differentially attributable to chemotherapy, radiation, and antiestrogen treatment, [7][8][9][10][11] highlighting the need for better understanding of potentially additive and dissociable effects of cancer treatments and the disease process on cognition in vulnerable individuals.…”

The Effect of Chemotherapy on Cognition in Patients Treated for Colorectal Cancer

“…A significant correlation was revealed only between anxiety and performance on the Trail Making Test; however anxiety was unrelated to the other measures of cognitive functioning while depression and fatigue were not related to performance on any of the neuropsychological tests. This is also inconsistent with literature that has found that cognitive functioning declines in those with depression, anxiety and fatigue (Jansen et al, 2011).…”

“…This is consistent with the existing literature. Jansen et al (2011) also found that those with higher levels of education and intelligence tended to perform better on neuropsychological tests and retain a higher level of cognitive functioning compared to those with lower levels of these.…”

“…Specifically, it is thought that CRCI is less likely to occur and, if it does occur is less severe, in those patients who have higher premorbid IQ or who have received a higher level of education (Jansen et al, 2011). Alternatively, a propensity towards greater anxiety, depression and fatigue, and chemotherapy-induced anaemia and menopause are thought to increase the likelihood and exacerbate the symptoms of CRCI (Jansen et al, 2011).…”