Chemo-brain: prevalence, why it happens, and how to help

  • The largest study to date of chemo-brain shows that 45% of women with breast cancer report it's a substantial problem for months after chemotherapy.
  • A rat study suggests an effect of chemotherapy on dopamine and serotonin may be partly responsible.
  • Better cognitive function, and improved mood, are linked to frequent moderate-to-vigorous physical exercise among breast cancer survivors.
  • A new cognitive-behavioral treatment program has been trialed with positive results.

Chemo-brain common among women with breast cancer

A study involving 581 breast cancer patients and 364 healthy age-matched people (mean age 53) has found that women with breast cancer reported significantly greater cognitive difficulties for up to six months after chemotherapy. Cognitive difficulties were evaluated using FACT-Cog, an assessment that examines a person's own perceived impairment as well as cognitive impairment perceived by others.

Compared to healthy controls, the FACT-Cog scores of women with breast cancer were 45% lower at outset. This difference increased substantially after chemotherapy (see graph). The first assessment after chemotherapy was at 4.8 months, with the second 6 months after that (i.e, nearly a year after chemotherapy). Patients were also much more likely to report significant cognitive decline from diagnosis to the first post-chemotherapy assessment (45.2% vs 10.4% of the controls), and from prechemotherapy to second post-chemotherapy assessment (36.5% v 13.6%).

Having more anxiety and depressive symptoms at the outset, and having lower cognitive reserve (assessed by a reading score), were significantly associated with lower scores.

Those who received hormone therapy and/or radiation treatment after chemotherapy had similar cognitive problems to women who received chemotherapy alone.

Chemobrain a product of dysfunction in dopamine & serotonin release?

A rat study suggests one reason for chemo-brain is an effect of chemotherapy on the neurotransmitters dopamine and serotonin. Both of these are important for both mood and cognition.

After giving carboplatin (commonly used with breast, bladder, colon and other cancers) to rats over four weeks, researchers found that the release and uptake of both dopamine and serotonin in their brains became impaired, although overall levels didn’t change. The rats also showed impaired cognition.

Exercise helps memory for breast cancer survivors

A role for dopamine and serotonin in chemo-brain is consistent with findings that anxiety and depression are risk factors for chemo-brain. No surprise then, that a study has found that physical exercise helps improve cognition in breast cancer survivors.

The study used self-reported data from 1,477 breast cancer survivors, as well as from accelerometers worn by 362 of the women. It found that breast cancer survivors who did more moderate or vigorous physical activity (including brisk walking, biking, jogging, or an exercise class) had fewer subjective memory problems.

Higher levels of physical activity were associated with lower levels of fatigue and distress, and higher levels of physical confidence. The researchers suggest that exercise reduces subjective memory problems via these factors.

Cognitive-behavioral therapy may help

A cognitive-behavioral therapy called "Memory and Attention Adaptation Training" (MAAT), which helps cancer survivors to increase their awareness of situations where memory problems can arise and to develop skills to either prevent memory failure or to compensate for memory dysfunction, has been trialed in a small randomized study involving 47 Caucasian breast cancer survivors. The patients were an average of four years post-chemotherapy.

The participants were either assigned to eight visits of MAAT (30 to 45 minutes each visit) or supportive talk therapy for the same length of time. Both treatments were delivered over a videoconference network between health centers.

MAAT participants reported significantly fewer memory problems as well as improved processing speed two months after treatment. They also reported much less anxiety about cognitive problems.

https://www.eurekalert.org/pub_releases/2017-01/uorm-caw010317.php

http://www.eurekalert.org/pub_releases/2016-05/acs-ih052516.php

http://www.futurity.org/exercise-breast-cancer-memory-1200372-2/

http://www.eurekalert.org/pub_releases/2016-05/w-ctm050216.php

Reference: 

Related News

A six-month pilot study involving 101 healthy older adults (65+), who were randomly put into one of three exercise interventions or a no-change control, has found that the exercise groups all showed significant improvement in visual-spatial processing and attention, with more improvement in visu

A six-week study involving 619 cancer patients has found that those who took part in a simple home-based exercise program significantly reduced their cognitive impairment ('chemo-brain').

A review and a large study have recently added to the growing evidence that type 2 diabetes is not only a risk factor for Alzheimer's, but is also linked to poorer cognitive function and faster age-related cognitive decline.

Three recent studies point to the importance of cardiorespiratory fitness for older adults wanting to prevent cognitive decline.

Several recent studies add to the evidence that physical fitness boosts cognitive processing in children.

A new review from The Cochrane Library, based on six trials involving 289 people, has concluded that exercise can improve cognition and the ability of older people with dementia to carry out daily activities, such as walking short distances or getting up from a chair.

There are five healthy behaviors that appear to significantly reduce the risk of dementia,

A pilot study involving 17 older adults with mild cognitive impairment and 18 controls (aged 60-88; average age 78) has found that a 12-week exercise program significantly improved performance on a semantic memory task, and also significantly improved brain efficiency, for both groups.

Data from 1.1 million young Swedish men (conscription information taken at age 18) has shown that those with poorer cardiovascular fitness were 2.5 times more likely to develop early-onset dementia later in life and 3.5 times more likely to develop mild cognitive impairment, while those with a l

A study involving 97 healthy older adults (65-89) has found that those with the “Alzheimer’s gene” (APOe4) who didn’t engage in much physical activity showed a decrease in hippocampal volume (3%) over 18 months.

Pages

Subscribe to Latest newsSubscribe to Latest newsSubscribe to Latest health newsSubscribe to Latest news
Error | About memory

Error

The website encountered an unexpected error. Please try again later.