Candidate mechanisms for chemotherapy-induced cognitive changes.
The mechanism(s) for chemotherapy-induced cognitive changes are largely unknown; however, several candidate mechanisms have been identified. We suggest that shared genetic risk factors for the development of cancer and cognitive problems, including low-efficiency efflux pumps, deficits in DNA-repair mechanisms and/or a deregulated immune response, coupled with the effect of chemotherapy on these systems, might contribute to cognitive decline in patients after chemotherapy. Furthermore, the genetically modulated reduction of capacity for neural repair and neurotransmitter activity, as well as reduced antioxidant capacity associated with treatment-induced reduction in oestrogen and testosterone levels, might interact with these mechanisms and/or have independent effects on cognitive function.
Ahles
Tim A
TA
Department of Psychiatry and Behavioural Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. ahlest@mskcc.org
Saykin
Andrew J
AJ
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000235:genetics; D020022:Genetic Predisposition to Disease; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D012307:Risk Factors
D000970:Antineoplastic Agents