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[化疗脑]

[Chemobrain].

作者信息

Szentmartoni Gyongyver, Makkos Zoltan, Dank Magdolna

机构信息

Semmelweis Egyetem Onkológiai Központ, Budapest, Hungary.

出版信息

Neuropsychopharmacol Hung. 2018 Sep;20(3):112-116.

Abstract

Over the past ten years, in oncology there is an increased interest in understanding the cognitive dysfunction caused by chemotherapy also known as chemobrain or chemofog. As a result of oncological therapies the number of survivors of malignant diseases has increased considerably, but the side effects also appear to be more prevalent and severe including persistent cognitive symptoms. Symptoms of chemobrain include memory impairment, loss of concentration, speech and psychomotor deceleration, attention and learning coordination problems, and disturbance of executive functions. The symptoms may be transient but are often long-lasting, the latter negatively affecting functionality and quality of life. Structural and functional imaging studies (MRI, fMRI, PET) and neuropsychological tests are not consistent in the diagnosis of chemobrain. Several factors are suspected leading to the appearance of symptoms, but the specific patomechanism is not yet known. Nutrition status, age, anemia, inflammatory cytokines, stress, and depression can all affect the quality of life and may be related to cognitive symptoms. Currently, there is no treatment strategy for preventing or alleviating cognitive impairement related to chemobrain, and several pharmacotherapies are under investigation. Results imply that understanding the patomechanism of chemobrain can also yield a deeper understanding of cognitive dysfunction associated with depression.

摘要

在过去十年中,肿瘤学领域对理解由化疗引起的认知功能障碍(也称为化疗脑或化疗迷雾)的兴趣日益增加。由于肿瘤治疗,恶性疾病幸存者的数量大幅增加,但副作用似乎也更为普遍和严重,包括持续的认知症状。化疗脑的症状包括记忆障碍、注意力不集中、言语和精神运动迟缓、注意力和学习协调问题以及执行功能障碍。这些症状可能是短暂的,但通常会持续很长时间,后者会对功能和生活质量产生负面影响。结构和功能成像研究(MRI、fMRI、PET)以及神经心理学测试在化疗脑的诊断中并不一致。有几个因素被怀疑导致症状出现,但具体的发病机制尚不清楚。营养状况、年龄、贫血、炎性细胞因子、压力和抑郁都会影响生活质量,并且可能与认知症状有关。目前,尚无预防或减轻与化疗脑相关的认知障碍的治疗策略,几种药物疗法正在研究中。结果表明,了解化疗脑的发病机制也可以更深入地理解与抑郁症相关的认知功能障碍。

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