Mechanisms of chemotherapy-related cognitive impairment

Aleksandra Janota; Katarzyna Kołodziejczyk; Paulina Piechowicz; Piotr Dunaj; Tomasz Dzierżanowski

doi:10.5114/pm.2022.125856

eISSN: 2081-2833
ISSN: 2081-0016

Medycyna Paliatywna/Palliative Medicine

Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures

Editorial System

Submit your Manuscript

3/2022
vol. 14

Send email

Copy url:

abstract:

Review paper

Mechanisms of chemotherapy-related cognitive impairment

Aleksandra Janota

¹

,

Katarzyna Kołodziejczyk

¹

,

Paulina Piechowicz

¹

,

Piotr Dunaj

¹

,

Tomasz Dzierżanowski

¹

Pracownia Medycyny Paliatywnej, Zakład Medycyny Społecznej i Zdrowia Publicznego, Warszawski Uniwersytet Medyczny, Warszawa, Polska

Medycyna Paliatywna 2022; 14(3): 132–141

DOI: https://doi.org/10.5114/pm.2022.125856

Online publish date: 2023/03/20

View full text Get citation

PlumX metrics:

Chemotherapy, an effective means in the fight against cancer, damages healthy tissues. More and more attention is being paid to chemobrain, which describes broadly defined cognitive disorders that manifest after anticancer treatment, with a particular focus on chemotherapy. There are numerous potential mechanisms of damage to the central nervous system, varying between distinct groups of chemotherapeutics. During treatment, there is an increased release of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, both locally, mediated by activated microglia cells, and those peripherally produced that penetrate the blood-brain barrier. It leads to a local inflammatory response that disrupts neurogenesis and neuroplasticity within the hippocampus. Pro-inflammatory cytokines also increase oxidative stress in cells, inducing the production of free radicals that damage the mitochondrial membrane, causing mitochondrial dysfunction. This further enhances oxidative stress, considered one of the most important causal factors of chemobrain. The proapoptotic cascade is also activated, resulting in a picture of reduced hippocampal volume. For some drugs, mechanisms of direct neurotoxicity or disruption of cell division have also been postulated. In this article, we present the state of knowledge on the toxic effects on the central nervous system of representatives of each of the most commonly used groups of chemotherapeutics in clinical practice.

keywords:

Mechanisms of chemotherapy-related cognitive impairment

Aleksandra Janota 1 , Katarzyna Kołodziejczyk 1 , Paulina Piechowicz 1 , Piotr Dunaj 1 , Tomasz Dzierżanowski 1

chemobrain, chemotherapy, cognitive impairment, chemotherapy-related cognitive impairment, CRCI

Aleksandra Janota

¹

,

Katarzyna Kołodziejczyk

¹

,

Paulina Piechowicz

¹

,

Piotr Dunaj

¹

,

Tomasz Dzierżanowski

¹