Longitudinal assessment of chemotherapy-induced changes in brain and cognitive functioning: A systematic review

Li, Mingmei; Caeyenberghs, Karen

doi:10.1016/j.neubiorev.2018.05.019

Cited by 95 publications

(80 citation statements)

References 68 publications

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“…Biological mechanisms, if they exist, may help clarify the direct impact of chemotherapy. Despite substantial evidence of chemotherapy‐induced brain structural changes, its direct associations with SCI were not confirmed in the reviewed studies. Other hypothesized biological mechanisms include cytokine‐induced inflammatory response associated with tissue damage; chemotherapy‐induced anemia, neural toxicity, and menopause; and genetic predisposition .…”

Section: Discussionmentioning

confidence: 91%

“…Some studies focused on objective cognitive impairment assessed by neuropsychological tests; others examined patient‐reported subjective cognitive impairment (SCI). Prevalence rates of subjective impairment reached as high as 90%, often unadjusted for potential confounders. As the association between subjective impairment report and objective test results of cognitive function are often weak or absent in cancer patients, it is essential to approach SCI as a separate patient experience.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

et al. 2020

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Objectives: This systematic review of longitudinal studies, assessing subjective cognitive impairment (SCI) reported by adult cancer patients, aimed to summarize evidence on the impact of chemotherapy on SCI, identify moderators of SCI, and evaluate methodological issues. Methods: Data accrued from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library. Inclusion criteria were original studies, an exclusively adult sample, valid and reliable subjective cognitive measures, and at least one baseline data point prior to and another after the initiation of chemotherapy. Data were collected on the sample composition, data-collection time points, outcome measures, statistical analysis, and major findings (ie, longitudinal changes in prevalence, severity, and associated factors).Results: Forty articles published between 2004 and 2019 were retained: 21 examined chemotherapy-treated patients only, and 19 employed control groups. Findings were mixed, with slightly more studies supporting the impact of chemotherapy on SCI. SCI tended to be more prevalent and severe after initiating chemotherapy, compared with patients' own baseline and controls not treated with chemotherapy. Impact appeared to be acute and more likely limited to subsamples. Most studies examining non-breast-cancer samples reported the lack or limited impact of chemotherapy on SCI. The most consistent moderators were depression and fatigue. Methodological issues regarding sampling design, measurement, and statistical analysis were discussed.Conclusion: More rigorously designed longitudinal studies would clarify direct and indirect effects of chemotherapy on SCI. K E Y W O R D S anxiety, cancer, cognitive function, cognitive impairment, depression, fatigue, oncology, systematic review

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

et al. 2020

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“…Although rates of ultimate reversibility of CRCI differ across studies, in part because of differences in the sensitivity and types of cognitive assessments administered, most affected patients appear to normalize within 1 to 2 y. CRCI can nevertheless persist for periods exceeding 1-2 decades, and imaging studies have been performed documenting cerebral alterations across short-term and long-term time frames (Table 1). Although several CRCI neuroimaging review articles have recently been published, these have focused primarily on MRI modalities (14); none has been previously focused on nuclear medicine imaging. The discussion here will concentrate on the latter, highlighting findings particularly from those studies examining metabolism with 18 F-FDG PET, by far the best studied in this field among nuclear medicine modalities.…”

Section: Crci: Neuroimagingmentioning

confidence: 99%

Long-Term Clinical and Neuronuclear Imaging Sequelae of Cancer Therapy, Trauma, and Brain Injury

et al. 2019

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe clinical features and therapeutic approaches in the evaluation and management of cancer-and chemotherapy-related cognitive impairment (CRCI), posttraumatic stress disorder (PTSD), and traumatic brain injury (TBI); (2) discuss the role of neuroimaging in contributing to understanding of relationships between clinical features of CRCI, PTSD, and TBI, with aspects of underlying regional cerebral function; and (3) identify which brain processes are most consistently shown to be affected in CRCI, PTSD, and TBI.

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“…It is also possible that the symptoms could have shared antecedents, such as physical inactivity, the increased state of inflammation induced by cancer and its treatments, or a combination of biological and psycho‐social factors that affect the course of the symptoms . As for cognitive difficulties, indications exist showing that this group of symptoms is caused by changes hippocampal and prefrontal brain regions or a decrease in grey matter density caused by chemotherapy agents. This evidence may explain the lower rate of improvement in cognitive functioning found in the present study and in previous studies …”

Section: Discussionmentioning

confidence: 99%

“…As for cognitive difficulties, indications exist showing that this group of symptoms is caused by changes hippocampal and prefrontal brain regions or a decrease in grey matter density caused by chemotherapy agents. This evidence may explain the lower rate of improvement in cognitive functioning found in the present study and in previous studies …”

Section: Discussionmentioning

confidence: 99%

Stability and change of postchemotherapy symptoms in relation to optimism and subjective stress: A prospective study of breast cancer survivors

et al. 2019

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Objectives: Inconsistent findings were reported about the course of postchemotherapy symptoms; specifically, the effect of changes in optimism and perception of subjective stress on the evolution of symptoms remains understudied. This prospective study aimed (a) to examine the course of postchemotherapy symptoms of emotional distress, fatigue, and cognitive difficulties among breast cancer survivors and (2) to assess the effect of changes in optimism and subjective stress on the trajectory of these symptoms. Methods: Ninety-eight breast cancer survivors, diagnosed at stages I to III, aged 30 to 74, recruited consecutively (response rate 84.7%) completed fatigue, emotional distress, self-reported cognitive difficulties, optimism, and subjective stress questionnaires at three points in time: upon enrollment (1-6 months after completing treatment, Time 1) posttreatment, 6 months (Time 2), and 12 months (Time 3). A linear mixed-effects model was used to analyze the data. Results: Emotional distress decreased between time-points, level of cognitive difficulties remained stable, and a marginal decrease in fatigue was evident. Optimism or subjective stress predicted changes in each of the symptoms (P<.01), except for the effect of optimism on cognitive difficulties (P=.06). The interactions between time and optimism and between time and subjective stress were only significant regarding their effect on emotional distress (P<.05), showing that the strongest effect of these variables was at Time 2. Conclusion:The course of postchemotherapy symptoms shows patterns of stability and change over a 1-year period. Optimism and subjective perceptions of stress were shown to affect the decrease of symptoms. Therefore, these two factors should be specifically targeted in psycho-social interventions.

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Longitudinal assessment of chemotherapy-induced changes in brain and cognitive functioning: A systematic review

Cited by 95 publications

References 68 publications

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

Systematic review of longitudinal studies on chemotherapy‐associated subjective cognitive impairment in cancer patients

Long-Term Clinical and Neuronuclear Imaging Sequelae of Cancer Therapy, Trauma, and Brain Injury

Stability and change of postchemotherapy symptoms in relation to optimism and subjective stress: A prospective study of breast cancer survivors

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