Chemotherapy-induced cognitive impairments: White matter pathologies
Cette étude passe en revue les effets indésirables des chimiothérapies sur les fonctions cognitives des patients et sur le développement de pathologies affectant la substance blanche cérébrale
Whilst chemotherapeutic agents show promising results in the amelioration of cancerous tumors, patients often experience cognitive disturbances associated with chemotherapy long after treatment has ceased. Research has suggested that the structural integrity of white matter fibers in the brain are susceptible to the harmful effects of chemotherapy. Post-chemotherapy, white matter tracts often display altered morphology with a reduction in glial cells such as oligodendrocytes. Demyelination, gliosis and leukoencephalopathy during or post chemotherapy is associated with changes in processing speed and IQ. Thus, understanding the relationship between chemotherapy, white matter damage and cognition is warranted. This review presents evidence for chemotherapy induced white matter damage highlighting the importance of implementing behavioral and pharmological strategies to prevent or reverse such acute toxicity in the brain. Highlights: •A review was composed to discuss the relationship between chemotherapy treatment, white matter pathologies and cognitive decline. •Chemotherapy treatment alone causes myelin pallor, edema, gliosis, swollen axons, necrosis and leukoencephalopathy. •White matter damage as the consequence of chemotherapy has led to cognitive decline in tests of IQ, processing speed, verbal reasoning, short term memory and attentional difficulties. •Potential mechanisms affected during chemotherapy include degeneration of oligodendrocyte precursor cells, accelerated ageing, altered rates of myelination, altered vascular permeability and inflammation. •Treatments that may target white matter denegation include anti-inflammatory drugs, exercise intervention, antidepressants and lithium.