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The following is a summary of “Chemotherapy-Related Cognitive Impairment and Changes in Neural Network Dynamics: A Systematic Review,” published in the December 2024 issue of Neurology by Leskinen et al.
Chemotherapy-related cognitive impairment (CRCI) is linked to functional and structural brain alterations in individuals diagnosed with noncentral nervous system (non-CNS) cancers, affecting memory, attention, and processing speed.
Researchers conducted a retrospective study examining how chemotherapy (CTX) affects brain connectivity and cognition in patients with non-CNS cancer.
They searched PubMed/MEDLINE, Web of Science, and Embase databases, following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Data on study design, participant demographics, cancer type, CTX agents, neuroimaging techniques, brain connectivity changes, and cognitive assessments were extracted. Study quality was assessed using an adapted Newcastle-Ottawa Scale (NOS) for observational studies.
The results showed 63 studies, 11,335 records, and 3,642 individuals, including 24 prospective, 1 retrospective, 36 cross-sectional, and 2 longitudinal studies. Individuals with breast cancer accounted for 75% of the studies. Neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), revealed post-CTX alterations in the default mode, central executive, and dorsal attention networks. Cognitive deficits were reported in learning and memory (64%), processing speed (56%), and attention/working memory (70%). Among studies examining connectivity and cognition, 72% identified significant correlations, though 45% of high-evidence studies found no such associations.
They concluded that CTX may affect brain connectivity and cognition. Still, inconsistent findings emphasize the need for a robust, standardized study to address potential cognitive impairments in individuals undergoing systemic treatment.
Source: neurology.org/doi/10.1212/WNL.0000000000210130
