Thursday, November 29, 2012

Chemo Brain

Evidence of 'chemo brain' verified by researchers
By Loren Grush
Published November 27, 2012
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For many cancer patients undergoing chemotherapy, memory problems and a general mental haziness often plague them during and after treatment. The condition – known as‘chemo brain’ – has only been a reported phenomenon, without ever having been fully verified through scientific measures – until now.

Thanks to new research utilizing positron emission tomography combined with computed tomography (PET/CT), researchers have identified physiological evidence of chemo brain, proving it to be a very real medical condition.

According to the study’s lead researcher Rachel Lagos, all of the previous research that has been done on chemo brain has used magnetic resonance imaging (MRI) to examine changes in the brain during chemotherapy. However, this method only allows medical professionals to see changes in the brain’s appearance – which are usually very small.
By choosing to examine PET/CT brain imagining, Lagos said she was able to see how chemotherapy affects changes in brain function over time.

“With MR examination, we’re able to see structural change in the brain – areas that get broken down over time,” Lagos, a diagnostic radiology resident at the West University School of Medicine and West Virginia University Hospitals in Morgantown, W.Va., told “But with PET/CT imaging, we’re able to see how the brain is using energy. So you get an earlier glimpse of areas of the brain which are being affected by chemo, as they’re starting to use less energy, and then eventually you would see the structural changes in MR examination."

PET/CT scanning is a type of nuclear medical imaging, which allows doctors to diagnose and understand the aggressiveness of certain kinds of cancers. People who are diagnosed with cancer regularly get PET/CT scans so that doctors can better exam other areas of the body where the cancer may have spread. One such area that is observed through PET/CT imaging is the brain.

To gather their findings, Lagos and her colleagues analyzed PET/CT scans of 128 breast cancer patients who had undergone chemotherapy treatment under Lagos’ care. This helped her findings to come at a relatively cheaper price, because the PET/CT scans were already a part of her patients’ therapy; Lagos was simply reviewing the information from the scans to better understand changes in the brain’s metabolism.

The data from the imaging scans ultimately provided physiological proof to support chemo brain’s anecdotal history. Overall, key areas of the brain showed significant decreases in metabolism.

“We’re seeing changes of metabolism in areas of the brain that control problem solving, organizing daily events, sequencing, as well as long term memory,” Lagos said. “These seem to be the areas that chemo patients are complaining about. They have this haziness and can’t make plans or carry out simple tasks throughout their day. This corresponds to what we’re seeing in the research.”

While the data confirms chemo brain to be a real issue, the researchers also found the condition to be temporary – as the effected brain regions eventually regained their metabolism. Now armed with proof of chemo brain’s existence, Lagos hopes to expand her research to a national level, as well as prompt treatments to help those with the bizarre memory condition.

According to the Mayo Clinic, symptoms of chemo brain can include anything from difficulty multitasking and learning new skills to trouble with recalling conversations and even recalling words. Lagos suggested that group therapy and help from peers can resolve some of these issues.

“Members of [the patient’s] family or support groups can give these patients lists of things to do when they wake up in the morning, that way they have the plan for the day,” Lagos said of one treatment option. “They don’t have to make the plan themselves. They have no problem doing the tasks, it’s making the list – they can’t get past that step.”

Along with more therapeutic treatments, Lagos envisions a potential pharmaceutical medication that can be developed to help treat chemo brain. While that scenario is a way off, Lagos hopes in the meantime cancer patients feel more assured that the symptoms they are experiencing have a verified medical explanation.

“There’s a tremendous need for more research in this area,” Lagos said. “The people who are experiencing this are experiencing something real.”


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