Encyclopedia of Clinical Neuropsychology

2018 Edition
| Editors: Jeffrey S. Kreutzer, John DeLuca, Bruce Caplan

Chemo Brain

  • Samantha KnightEmail author
  • Daniel Smith
  • Carol L. Armstrong
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-57111-9_9027

Synonyms

“chemobrain”; “chemo fog”; Post-chemotherapy cognitive impairment

Definition and Overview

“Chemo brain” is the widely used lay term for post-chemotherapy cognitive impairment (PCCI). It is experienced by approximately 20–30% of cancer survivors treated with chemotherapy (Ganz et al. 2013; McDougall et al. 2014). This phenomenon first came to light in breast cancer survivors who reported cognitive deficits in memory, attention, and verbal fluency after their treatments (Tannock et al. 2004). A review by Ahles et al. (2012) found that 17–75% of women experienced deficits in attention, concentration, working memory, and executive function 6 months to 20 years after chemotherapy and that a significant proportion of patients have cognitive impairment prior to any treatment. Cognitive complaints have corresponded with depression, but not with objective neurological deficits (Peralta 2013). PCCI is most widely reported in cancers treated aggressively with chemotherapy: colorectal,...

This is a preview of subscription content, log in to check access.

References

  1. Ahles, T. A., Root, J. C., & Ryan, E. L. (2012). Cancer- and cancer treatment-associated cognitive change: An update on the state of the science. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 30(30), 3675–3686.  https://doi.org/10.1200/JCO.2012.43.0116.PubMedPubMedCentralCrossRefGoogle Scholar
  2. Aluise, C. D., Sultana, R., Tangpong, J., Vore, M., St Clair, D., Moscow, J. A., & Butterfield, D. A. (2010). Chemo brain (chemo fog) as a potential side effect of doxorubicin administration: Role of cytokine-induced, oxidative/nitrosative stress in cognitive dysfunction. Advances in Experimental Medicine and Biology, 678, 147–156.PubMedCrossRefGoogle Scholar
  3. Askren, M. K., Jung, M., Berman, M. G., Zhang, M., Therrien, B., Peltier, S., et al. (2014). Neuromarkers of fatigue and cognitive complaints following chemotherapy for breast cancer: A prospective fMRI investigation. Breast Cancer Research and Treatment, 147(2), 445–455.  https://doi.org/10.1007/s10549-014-3092-6.PubMedPubMedCentralCrossRefGoogle Scholar
  4. Dietrich, J., Han, R., Yang, Y., Mayer-Pröschel, M., & Noble, M. (2006). CNS progenitor cells and oligodendrocytes are targets of chemotherapeutic agents in vitro and in vivo. Journal of Biology, 5(7), 22.  https://doi.org/10.1186/jbiol50.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Ferguson, R. J., Ahles, T. A., Saykin, A. J., McDonald, B. C., Furstenberg, C. T., Cole, B. F., & Mott, L. A. (2007). Cognitive-behavioral management of chemotherapy-related cognitive change. Psycho-Oncology, 16(8), 772–777.  https://doi.org/10.1002/pon.1133.PubMedPubMedCentralCrossRefGoogle Scholar
  6. Ganz, P. A., Kwan, L., Castellon, S. A., Oppenheim, A., Bower, J. E., Silverman, D. H. S., et al. (2013). Cognitive complaints after breast cancer treatments: Examining the relationship with neuropsychological test performance. JNCI Journal of the National Cancer Institute, 105(11), 791–801.  https://doi.org/10.1093/jnci/djt073.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Han, R., Yang, Y. M., Dietrich, J., Luebke, A., Mayer-Pröschel, M., & Noble, M. (2008). Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system. Journal of Biology, 7(4), 12.  https://doi.org/10.1186/jbiol69.PubMedPubMedCentralCrossRefGoogle Scholar
  8. Hede, K. (2008). Chemobrain is real but may need new name. JNCI Journal of the National Cancer Institute, 100(3), 162–169.  https://doi.org/10.1093/jnci/djn007.PubMedCrossRefGoogle Scholar
  9. Inagaki, M., Yoshikawa, E., Matsuoka, Y., Sugawara, Y., Nakano, T., Akechi, T., et al. (2007). Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer, 109(1), 146–156.  https://doi.org/10.1002/cncr.22368.PubMedCrossRefGoogle Scholar
  10. Joshi, G., Hardas, S., Sultana, R., St Clair, D. K., Vore, M., & Butterfield, D. A. (2007). Glutathione elevation by gamma-glutamyl cysteine ethyl ester as a potential therapeutic strategy for preventing oxidative stress in brain mediated by in vivo administration of adriamycin: Implication for chemobrain. Journal of Neuroscience Research, 85(3), 497–503.  https://doi.org/10.1002/jnr.21158.PubMedCrossRefGoogle Scholar
  11. Kohli, S., Fisher, S. G., Tra, Y. (2007). The cognitive effects of modafinil in breast cancer survivors: A randomized clinical trial. ASCO Annual Cancer, 115, 2605–16.Google Scholar
  12. Matsuda, T., Takayama, T., Tashiro, M., Nakamura, Y., Ohashi, Y., & Shimozuma, K. (2005). Mild cognitive impairment after adjuvant chemotherapy in breast cancer patients – evaluation of appropriate research design and methodology to measure symptoms. Breast Cancer (Tokyo, Japan), 12(4), 279–287.CrossRefGoogle Scholar
  13. McDougall, G. J., Oliver, J. S., & Scogin, F. (2014). Memory and cancer: A review of the literature. Archives of Psychiatric Nursing, 28(3), 180–186.  https://doi.org/10.1016/j.apnu.2013.12.005.PubMedPubMedCentralCrossRefGoogle Scholar
  14. Mustafa, S., Walker, A., & Bennett, G. (2008). 5-fluorouracil chemotherapy affects spatial working memory and newborn neurons in the adult rat hippocampus. European Journal of Neuroscience, 28, 323–330.PubMedCrossRefPubMedCentralGoogle Scholar
  15. Myers, J. S., Pierce, J., & Pazdernik, T. (2008). Neurotoxicology of chemotherapy in relation to cytokine release, the blood-brain barrier, and cognitive impairment. Oncology Nursing Forum, 35, 916–920.PubMedCrossRefPubMedCentralGoogle Scholar
  16. Nelson, C. J., Nandy, N., & Roth, A. J. (2007). Chemotherapy and cognitive deficits: Mechanisms, findings, and potential interventions. Palliative & Supportive Care, 5, 273–280.CrossRefGoogle Scholar
  17. Peralta, E. A. (2013). Neuropsychological sequelae of breast cancer and its treatment. In C. A. Noggle & R. S. Dean (Eds.), The neuropsychology of cancer and oncology. New York: Springer Publishing Co.Google Scholar
  18. Pomykala, K. L., de Ruiter, M. B., Deprez, S., McDonald, B. C., & Silverman, D. H. S. (2013). Integrating imaging findings in evaluating the post-chemotherapy brain. Brain Imaging and Behavior, 7(4), 436–452.  https://doi.org/10.1007/s11682-013-9239-y.PubMedCrossRefPubMedCentralGoogle Scholar
  19. Scherling, C. S., & Smith, A. (2013). Opening up the window into “chemobrain”: A neuroimaging review. Sensors (Basel, Switzerland), 13(3), 3169–3203.  https://doi.org/10.3390/s130303169.PubMedCrossRefPubMedCentralGoogle Scholar
  20. Seigers, R., Schagen, S. B., Beerling, W., Boogerd, W., van Tellingen, O., van Dam, F. S. A. M., et al. (2008). Long-lasting suppression of hippocampal cell proliferation and impaired cognitive performance by methotrexate in the rat. Behavioural Brain Research, 186(2), 168–175.  https://doi.org/10.1016/j.bbr.2007.08.004.PubMedCrossRefPubMedCentralGoogle Scholar
  21. Silverman, D. H. S., Dy, C. J., Castellon, S. A., Lai, J., Pio, B. S., Abraham, L., et al. (2007). Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5–10 years after chemotherapy. Breast Cancer Research and Treatment, 103(3), 303–311.  https://doi.org/10.1007/s10549-006-9380-z.PubMedCrossRefPubMedCentralGoogle Scholar
  22. Taillibert, S., & Voillery, D. (2007). Chemobrain: Is systemic chemotherapy neurotoxic? Current Opinion in Oncology, 19, 623–627.PubMedCrossRefPubMedCentralGoogle Scholar
  23. Tannock, I. F., Ahles, T. A., Ganz, P. A., & Van Dam, F. S. (2004). Cognitive impairment associated with chemotherapy for cancer: Report of a workshop. Journal of Clinical Oncology, 22, 2233–2239. Presented at the Journal of Clinical Oncology : official journal of the American Society of Clinical Oncology.  https://doi.org/10.1200/JCO.2004.08.094.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Samantha Knight
    • 1
    Email author
  • Daniel Smith
    • 2
    • 3
  • Carol L. Armstrong
    • 4
  1. 1.MedicineRoyal College of Surgeons in IrelandDublinIreland
  2. 2.Department of PsychologyDrexel UniversityPhiladelphiaUSA
  3. 3.Winship Cancer InstituteEmory UniversityAtlantaUSA
  4. 4.Child and Adolescent Psychiatry and Behavioral SciencesThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA