Barcelona Institute for Global Health (ISGlobal), Campus Mar, Barcelona Biomedical Research Park (PRBB), Dr Aiguader 88, 08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain.
Université de Paris and Université Paris-Saclay, Inserm, LRP/iRCM/IBFJ CEA, UMR Stabilité Génétique Cellules Souches et Radiations, F-92265 Fontenay-aux-Roses, France.
Environ Int. 2021 Feb;147:106295. doi: 10.1016/j.envint.2020.106295. Epub 2020 Dec 17.
The last decades have seen increased concern about the possible effects of low to moderate doses of ionizing radiation (IR) exposure on cognitive function. An interdisciplinary group of experts (biologists, epidemiologists, dosimetrists and clinicians) in this field gathered together in the framework of the European MELODI workshop on non-cancer effects of IR to summarise the state of knowledge on the topic and elaborate research recommendations for future studies in this area. Overall, there is evidence of cognitive effects from low IR doses both from biology and epidemiology, though a better characterization of effects and understanding of mechanisms is needed. There is a need to better describe the specific cognitive function or diseases that may be affected by radiation exposure. Such cognitive deficit characterization should consider the human life span, as effects might differ with age at exposure and at outcome assessment. Measurements of biomarkers, including imaging, will likely help our understanding on the mechanism of cognitive-related radiation induced deficit. The identification of loci of individual genetic susceptibility and the study of gene expression may help identify individuals at higher risk. The mechanisms behind the radiation induced cognitive effects are not clear and are likely to involve several biological pathways and different cell types. Well conducted research in large epidemiological cohorts and experimental studies in appropriate animal models are needed to improve the understanding of radiation-induced cognitive effects. Results may then be translated into recommendations for clinical radiation oncology and imaging decision making processes.
过去几十年，人们越来越关注低剂量至中剂量电离辐射 (IR) 暴露对认知功能可能产生的影响。该领域的一组跨学科专家（生物学家、流行病学家、剂量学家和临床医生）在欧洲 MELODI 关于 IR 的非癌症影响研讨会上聚集在一起，总结了该主题的现有知识，并为该领域的未来研究提出了研究建议。总体而言，生物学和流行病学都有证据表明低剂量 IR 会产生认知影响，但需要更好地描述效应并深入了解其作用机制。需要更好地描述可能受到辐射暴露影响的特定认知功能或疾病。这种认知缺陷的特征描述应考虑人类的寿命，因为效应可能因暴露时的年龄和结果评估时的年龄而有所不同。包括成像在内的生物标志物的测量可能有助于我们了解与认知相关的辐射诱导缺陷的机制。确定个体遗传易感性的位置和研究基因表达可能有助于确定风险较高的个体。辐射引起的认知效应的机制尚不清楚，可能涉及多个生物学途径和不同的细胞类型。需要在大型流行病学队列中进行良好的研究，并在适当的动物模型中进行实验研究，以增进对辐射引起的认知效应的理解。然后，可以将研究结果转化为临床放射肿瘤学和影像学决策制定过程的建议。
