Worry & fatigue main reason for ‘chemo-brain’?

January, 2013

A new study points to pre-treatment reasons for declined cognitive function following chemotherapy, and suggests that anxiety may be the main driver.

The issue of ‘chemo-brain’ — cognitive impairment following chemotherapy — has been a controversial one. While it is now (I hope) accepted by most that it is, indeed, a real issue, there is still an ongoing debate over whether the main cause is really the chemotherapy. A new study adds to the debate.

The study involved 28 women who received adjuvant chemotherapy for breast cancer, 37 who received radiotherapy, and 32 age-matched healthy controls. Brain scans while doing a verbal working memory task were taken before treatment and one month after treatment.

Women who underwent chemotherapy performed less accurately on the working memory task both before treatment and one month after treatment. They also reported a significantly higher level of fatigue. Greater fatigue correlated with poorer test performance and more cognitive problems, across both patient groups and at both times (although the correlation was stronger after treatment).

Both patient groups showed reduced function in the left inferior frontal gyrus, before therapy, but those awaiting chemotherapy showed greater impairment than those in the radiotherapy group. Pre-treatment difficulty in recruiting this brain region in high demand situations was associated with greater fatigue after treatment.

In other words, reduced working memory function before treatment began predicted how tired people felt after treatment, and how much their cognitive performance suffered. All of which suggests it is not the treatment itself that is the main problem.

But the fact that reduced working memory function precedes the fatigue indicates it’s not the fatigue that’s the main problem either. The researchers suggest that the main driver is level of worry —worry interfered with the task; level of worry was related to fatigue. And worry, as we know, can reduce working memory capacity (because it uses up part of it).

All of which is to say that support for cancer patients aimed at combating stress and anxiety might do more for ‘chemo-brain’ than anything else. In this context, I note also that there have been suggestions that sleep problems have also been linked to chemo-brain — a not unrelated issue!

Reference: 

Cimprich, B. et al. 2012. Neurocognitive impact in adjuvant chemotherapy for breast cancer linked to fatigue: A Prospective functional MRI study. Presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium, Dec. 4-8

Related News

A small study of the sleep patterns of 100 people aged 45-80 has found a link between sleep disruption and level of amyloid plaques (characteristic of Alzheimer’s disease).

One survey of nearly 200 undergraduate college students who were not living with a parent or legal guardian found that 55% reported getting less than seven hours sleep. This is consistent with other surveys.

Sleep can boost classroom performance of college students

Growing evidence links obesity and poorer cognitive performance. Many factors associated with obesity, such as high blood pressure, type 2 diabetes and sleep apnea, damage the brain.

A study involving 200 older adults (70+) experiencing a stay in hospital has found that at discharge nearly a third (31.5%) had previously unrecognized low cognitive function (scoring below 25 on the MMSE if high-school-educated, or below 18 if not).

A study involving 1426 long-term survivors of childhood cancer (survivors of eight different childhood cancers who were treated between 1970 and 1986) has revealed cognitive impairment in over a fifth.

From the Whitehall II study, data involving 5431 older participants (45-69 at baseline) has revealed a significant effect of midlife sleep changes on later cognitive function. Sleep duration was assessed at one point between 1997 and 1999, and again between 2002 and 2004.

In a study involving 44 young adults given a rigorous memorizing task at noon and another such task at 6pm, those who took a 90-minute nap during the interval improved their ability to learn on the later task, while those who stayed awake found it harder to learn.

Comparison of 17 people with severe obstructive sleep apnea (OSA) with 15 age-matched controls has revealed that those with OSA had reduced gray matter in several brain regions, most particularly in the left

A study involving 48 healthy adults aged 18-39 has found that extraverts who were deprived of sleep for 22 hours after spending 12 hours in group activities performed worse on a vigilance task that did those extraverts who engaged in the same activities on their own in a private room.

Pages

Subscribe to Latest newsSubscribe to Latest newsSubscribe to Latest health newsSubscribe to Latest news