Decision-making impairments in breast cancer patients treated with tamoxifen

Chen, Xingui; Li, Jingjing; Chen, Juluo; Li, Dandan; Ye, Rong; Zhang, Jingjie; Zhu, Chunyan; Tian, Yanghua; Wang, Kai

doi:10.1016/j.yhbeh.2014.07.005

Cited by 36 publications

(40 citation statements)

References 52 publications

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“…35 However, to the best of our knowledge, the current study is one of the largest and longest to date and joins other cross-sectional and longitudinal studies that have similarly failed to find any cognitive effects of ET within the first year after treatment. 3,5,39 This methodological issue may be obscuring effects: menopausal status itself is associated with cognitive changes 40 in addition to influencing the type of ET agent recommended, leading to different alterations in estrogen-related functioning in the brain. 38 The majority of studies regarding the cognitive effects of ET are complicated by methodological issues.…”

Section: Discussionmentioning

confidence: 99%

“…2 To the best of our knowledge, our team was among the first to report worse neuropsychological functioning in survivors of breast cancer (BCS) 2 to 5 years after diagnosis that was related to adjuvant tamoxifen treatment. [4][5][6][7][8][9][10] However, sample sizes across studies tend to be small and longitudinal studies often have limited durations of follow-up. [4][5][6][7][8][9][10] However, sample sizes across studies tend to be small and longitudinal studies often have limited durations of follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…3 Several cross-sectional and longitudinal studies have since reported mixed results. [4][5][6][7][8][9][10] However, sample sizes across studies tend to be small and longitudinal studies often have limited durations of follow-up. There remains substantial uncertainty regarding the cognitive effects of ET given its protracted use.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment

Dyk

Crespi

Bower

et al. 2018

Cancer

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BACKGROUND: After treatment of primary breast cancer, endocrine therapy (ET) is prescribed for patients with hormone receptor-positive cancers. Despite ET recommendations of 5 to 10 years of treatment, to the authors' knowledge there is little prospective study of its impact on cognitive function over an extended period of time. ET has known pharmacologic effects on the brain. Cognitive side effects are a concern for many women, with mixed findings reported in various studies. The current prospective longitudinal study examined the neuropsychological effects of ET over time, up to 6 years after treatment. METHODS: A total of 189 survivors of early-stage breast cancer enrolled in the study prior to initiating ET if prescribed, and were followed at 6 months (175 patients), 12 months (173 patients), and for 3 to 6 years (102 patients) with self-report and neuropsychological assessments. Using linear mixed models, the authors examined whether neuropsychological performance or impairment rates differed over time based on whether or not ET was received. RESULTS: The authors did not find any effect of ET on neuropsychological performance or impairment at any time point among survivors who received it compared with women who did not. However, those who participated in the 3-year to 6-year year visit demonstrated better executive function at baseline. CONCLUSIONS: In the current observational cohort study, no detrimental effect of ET on cognitive function was identified in survivors of early-stage breast cancer receiving treatment with ET compared with those who were not. Cancer 2019;125:681-689.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment

Dyk

Crespi

Bower

et al. 2018

Cancer

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“…Some studies have demonstrated agonist effects of tamoxifen in the CNS, particularly at G-protein coupled estrogen receptors (Gibbs et al, 2014). In contrast, recent research has led to the assumption that tamoxifen acts as an antagonist in the brain due to its opposite effect on cognition as estrogen (Chen et al, 2014). In order to properly understand the context of our investigation into the dopamine-modulating effects of tamoxifen, we must first explore the mechanisms of action of the drug.…”

Section: Tamoxifenmentioning

confidence: 99%

“…There are reports of impairments in verbal fluency (Boele et al, 2015), decision making (Chen et al, 2014), visuo-spatial ability and processing speed (Palmer et al, 2008) in breast cancer patients taking tamoxifen. Conversely, one study found that in postmenopausal women tamoxifen may act as an estrogen-like agonist to enhance cholinergic system activity and hippocampus-mediated learning (Newhouse et al, 2013).…”

Section: Tamoxifen As a Potential Treatment Of Amphetamine Abuse?mentioning

confidence: 99%

Tamoxifen and amphetamine abuse: Are there therapeutic possibilities?

Mikelman

Mardirossian

Gnegy

2017

Journal of Chemical Neuroanatomy

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Although best known as a selective estrogen receptor modulator (SERM), tamoxifen is a drug with a wide range of activities. Tamoxifen has demonstrated some efficacy has a therapeutic for bipolar mania and is believed to exert these effects through inhibition of protein kinase C (PKC). As the symptoms of amphetamine treatment in rodents are believed to mimic the symptoms of a manic episode, many of the preclinical studies for this indication have demonstrated that tamoxifen inhibits amphetamine action. The amphetamine-induced increase in extracellular dopamine which gives rise to the ‘manic’ effects is due to interaction of amphetamine with the dopamine transporter. We and others have demonstrated that PKC reduces amphetamine-induced reverse transport through the dopamine transporter. In this review, we will outline the actions of tamoxifen as a SERM and further detail another known action of tamoxifen—inhibition of PKC. We will summarize the literature showing how tamoxifen affects amphetamine action. Finally, we will present our hypothesis that tamoxifen, or an analog, could be used therapeutically to reduce amphetamine abuse in addition to treating mania.

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Prevalence of cognitive impairment and change in patients with breast cancer: A systematic review of longitudinal studies

et al. 2021

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Objective Patients with breast cancer face cognitive impairment that affects their quality of life; partially attributable to treatment. Our aim was to detail the prevalence and change of cognitive impairment during the course of treatment. We also investigated the effect of therapy (chemotherapy [CT]) vs. radiotherapy and/or endocrine therapy vs. healthy controls). Methods This article reviews longitudinal cohort studies published to date in Medline and Embase that (i) assess cognition before and after therapy, (ii) report prevalence cognitive impairment or change, and (iii) use standardized and valid neuropsychological tests. We used the original authors' criteria for cognitive impairment. Results The title and abstract of 891 articles were screened, resulting in the identification of 90 potentially relevant articles while applying the eligibility criteria. After full‐text examination, 17 studies were included. Prevalence of cognitive impairment range from 25% before therapy, through 24% after therapy to 21% at maximal 1‐year follow‐up (FU). Compared to their pretreatment cognitive functioning, 24% of patients decline after treatment and 24% at 1‐year FU. Some studies also reported cognitive improvement showing that 15% and 31% of patients improve, respectively. In general, patients undergoing CT have a higher chance of cognitive impairment and decline than no‐CT patients and healthy controls. Conclusions This study shows that one out of four breast cancer patients shows cognitive impairment prior to treatment administration CT and a significant number of patients decline during the course of disease, suggesting that cognitive impairment is not exclusively related to CT and/or no‐CT therapies. This study shows that assessment of cognitive functioning, ideally over time, is crucial and may help the implementation of personalized rehabilitation pathways.

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Decision-making impairments in breast cancer patients treated with tamoxifen

Cited by 36 publications

References 52 publications

The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment

The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment

Tamoxifen and amphetamine abuse: Are there therapeutic possibilities?

Prevalence of cognitive impairment and change in patients with breast cancer: A systematic review of longitudinal studies

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