Chemo Brain Linked to Long-Term Changes in Brain

Posted on May 8th, 2012 by

Chemo brain appears to correlate with long-term changes in the brain’s white matter, according to the results of a study published in the Journal of Clinical Oncology.

Patients undergoing chemotherapy have long complained of a phenomenon referred to as “chemo brain”. Chemo brain refers to changes in cognitive function, such as loss of memory and inability to think clearly or perform some daily functions. Thus far, researchers have not been able to pinpoint the cause of chemo brain, but studies are ongoing to evaluate brain structure and function in order to better understand the effects of chemotherapy on the brain.

Researchers performed a controlled observational cohort study in order to evaluate cerebral white matter integrity before and after chemotherapy. The small study included 34 younger premenopausal women with early stage breast cancer who were exposed to chemotherapy, 16 patients who were not exposed to chemotherapy, and 19 age-matched healthy controls.

The women exposed to chemotherapy underwent cognitive testing and magnetic resonance diffusion tensor imaging (DTI) prior to beginning chemotherapy and again 3 to 4 months after treatment. The women in the other two groups underwent the same assessment at matched intervals.

Compared to both control groups, the women in the chemotherapy-treated group performed significantly worse on attention tests, psychomotor speed, and memory during the second round of assessment (3 to 4 months after chemotherapy). In addition, the chemotherapy group had significantly increased self-reported cognitive complaints. Furthermore, the DTI detected decreased white matter integrity in the brain areas involved with cognition in the women treated with chemotherapy—but no changes in the two control groups. The researchers speculated that there might be a causal relationship between chemotherapy exposure, cognitive complaints, neuropsychological test abnormalities, and white matter changes.

The researchers concluded that they found longitudinal changes in cognitive functioning and cerebral white matter integrity after chemotherapy—and an association between the two characteristics. This was a small study and research is ongoing to study chemo brain. This study adds to the mounting evidence that chemotherapy may have long-term neurological effects.


Deprez S, Amant F, Smeets A, et al: Longitudinal assessment of chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning. Journal of Clinical Oncology. 2012; 30:274-281

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