Rübe Claudia E, Raid Silvia, Palm Jan, Rübe Christian
Department of Radiation Oncology, Saarland University Medical Center, Kirrbergerstrasse Building 6.5, 66421 Homburg, Germany.
Cancers (Basel). 2023 May 31;15(11):2999. doi: 10.3390/cancers15112999.
Cranial radiotherapy is a known risk factor for neurocognitive impairment in cancer survivors. Although radiation-induced cognitive dysfunction is observed in patients of all ages, children seem to be more vulnerable than adults to suffering age-related deficits in neurocognitive skills. So far, the underlying mechanisms by which IR negatively influences brain functions as well as the reasons for the profound age dependency are still insufficiently known. We performed a comprehensive Pubmed-based literature search to identify original research articles that reported on age dependency of neurocognitive dysfunction following cranial IR exposure. Numerous clinical trials in childhood cancer survivors indicate that the severity of radiation-induced cognitive dysfunction is clearly dependent on age at IR exposure. These clinical findings were related to the current state of experimental research providing important insights into the age dependency of radiation-induced brain injury and the development of neurocognitive impairment. Research in pre-clinical rodent models demonstrates age-dependent effects of IR exposure on hippocampal neurogenesis, radiation-induced neurovascular damage and neuroinflammation.
颅脑放疗是癌症幸存者发生神经认知障碍的已知风险因素。尽管在各个年龄段的患者中均观察到辐射诱发的认知功能障碍，但儿童似乎比成年人更容易出现与年龄相关的神经认知技能缺陷。到目前为止，电离辐射对脑功能产生负面影响的潜在机制以及年龄依赖性的深层原因仍知之甚少。我们基于PubMed进行了全面的文献检索，以识别报告颅脑电离辐射暴露后神经认知功能障碍年龄依赖性的原创研究文章。众多针对儿童癌症幸存者的临床试验表明，辐射诱发的认知功能障碍的严重程度明显取决于电离辐射暴露时的年龄。这些临床发现与当前的实验研究状况相关，为辐射诱发脑损伤的年龄依赖性和神经认知障碍的发展提供了重要见解。临床前啮齿动物模型的研究表明，电离辐射暴露对海马神经发生、辐射诱发的神经血管损伤和神经炎症具有年龄依赖性影响。
