Summary: A new study reports inflammation in the blood may play a role in cognitive problems following chemotherapy. Researchers report identifying the inflammatory biomarkers and reducing inflammation may prevent some of the symptoms of chemo brain.
Source: University of Rochester.
Inflammation in the blood plays a key role in “chemo-brain,” according to a published pilot study that provides evidence for what scientists have long believed.
The research is important because it could lead to a new practice of identifying inflammatory biomarkers in cancer patients and then treating the inflammation with medications or exercise to improve cognition and other symptoms, said senior author Michelle C. Janelsins, Ph.D., associate professor of Surgery in the Cancer Control and Survivorship program at the Wilmot Cancer Institute.
Published in the Journal of Neuroimmunology, the preliminary research is believed to be among the first studies to look at cancer patients in active treatment and whether inflammation is involved in their chemo-brain symptoms.
Results showed that among 22 breast cancer patients taking chemotherapy, those with higher levels of inflammatory biomarkers in their blood did worse on neuropsychological tests for visual memory and concentration.
Chemo-brain, or cancer-related cognitive impairment, is estimated to impact 80 percent of people in treatment. Patients report fogginess, forgetfulness, and difficulty with multitasking and other problem-solving skills.
Researchers discovered that one particular biomarker for acute inflammation—tumor necrosis factor-alpha—was the strongest indicator of cognitive problems. Generally, higher levels of inflammation can be caused by cancer, its treatment, or other health problems; but until lately little had been known about the interplay of inflammation, cancer, and quality of life.
Last year another study led by Janelsins —one of the largest to date for this problem—showed that women with breast cancer continued to report cognitive deficits for as long as six months after finishing treatment. That study not only validated that chemo-brain was pervasive, but Janelsins and her team also began parsing the data to understand the biological mechanisms, such as inflammation, that may put some patients at greater risk for chemo-brain.
“I’m happy that my team’s research is starting to shed light on what might be causing cognitive problems in patients with cancer,” Janelsins said, “and I’m hopeful that we’ll be able to come up with treatments in the future.”
Funding: The current study’s first author was AnnaLynn Williams, M.S., a doctoral student in UR’s Division of Epidemiology and a researcher in Janelsins’ lab. Williams recently received a $372,000 National Cancer Institute F99/K00 Award supporting six years of pre-doctoral and postdoctoral research and career development. She is studying cognitive impairment in people with chronic lymphocytic leukemia under the guidance of Janelsins and Edwin van Wijngaarden, Ph.D., chief of the Division of Epidemiology in the Department of Public Health Sciences.
Source: Leslie Orr – University of Rochester
Publisher: Organized by NeuroscienceNews.com.
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Original Research: Abstract for “Associations between inflammatory markers and cognitive function in breast cancer patients receiving chemotherapy” by AnnaLynn M. Williams, Raven Shah, Michelle Shayne, Alissa J. Huston, Marcia Krebs, Nicole Murray, Bryan D. Thompson, Kassandra Doyle, Jenna Korotkin, Edwinvan Wijngaarden, Sharon Hyland, Jan A. Moynihan, Deborah A. Cory-Slechta, and Michelle C. Janelsins in Journal of Neuroimmunology. Published online October 18 2017 doi:10.1016/j.jneuroim.2017.10.005
Associations between inflammatory markers and cognitive function in breast cancer patients receiving chemotherapy
Cancer-related cognitive impairment (CRCI) is often related to chemotherapy. Increased chronic inflammation is believed to play a key role in the development of CRCI related to chemotherapy but studies assessing this hypothesis specifically in patients receiving chemotherapy are rare.
We assessed several cognitive domains using the Cambridge Neuropsychological Test Automated Battery (CANTAB) in twenty-two breast cancer patients currently receiving chemotherapy. We also measured inflammatory cytokine and receptor (MCP-1, TNF-α, sTNFRI, sTNFRII) concentrations in patient sera using Luminex assays. These concentrations were log-transformed to obtain a normal distribution. Associations between log-transformed cytokines and cognition were evaluated using Pearson correlations and linear regression, taking into account relevant covariates.
Increased concentrations of sTNFRI and sTNFRII were associated with poorer performance on the CANTAB Delayed Matching to Sample (DMS, tests visual memory). Increasing sTNFRI levels were negatively correlated with DMS percent correct (r = − 0.47, p = 0.029) and DMS percent correct after a 12 second (s) delay (r = − 0.65, p = 0.001). Increasing levels of sTNFRII negatively correlated with DMS percent correct after 12 s delay (r = − 0.57, p = 0.006). After controlling for relevant demographic (i.e. age, education) and clinical variables (i.e. disease stage, regimen type), we found that increased sTNFRI remained significantly related to decline on the DMS at the 12 s delay (p = 0.018).
This preliminary study shows a significant association between higher sTNFRI and lower scores on the short-term visual memory delayed match to sample test in breast cancer patients receiving chemotherapy, supporting the hypothesis that sTNFRI is involved in CRCI.
“Associations between inflammatory markers and cognitive function in breast cancer patients receiving chemotherapy” by AnnaLynn M. Williams, Raven Shah, Michelle Shayne, Alissa J. Huston, Marcia Krebs, Nicole Murray, Bryan D. Thompson, Kassandra Doyle, Jenna Korotkin, Edwinvan Wijngaarden, Sharon Hyland, Jan A. Moynihan, Deborah A. Cory-Slechta, and Michelle C. Janelsins in Journal of Neuroimmunology. Published online October 18 2017 doi:10.1016/j.jneuroim.2017.10.005