期刊名称：Revue de Neuropsychologie Neurosciences Cognitives et Cliniques
印刷版ISSN：2101-6739
电子版ISSN：2102-6025
出版年度：2010
卷号：2
期号：3
页码：250-254
DOI：10.1684/nrp.2010.0085
出版社：John Libbey Eurotext
摘要：Authors Nastassja Morel , Francis Eustache , Marie Lange , Florence Joly , Bénédicte Giffard Unité U923, Inserm – EPHE – Université de Caen/Basse-Normandie, Caen, Unité de recherche clinique, Centre François-Baclesse, Caen Key words: breast cancer, cognitive impairment, chemotherapy, brain imaging DOI : 10.1684/nrp.2010.0085 Page(s) : 250-4 Published in: 2010 Cognitive impairments in cancer represent a new field of interest that is directly linked to complaints reported by cancer survivors. Because of the increase in the treatments now available, including chemotherapy, radiotherapy, hormone-based therapy and, more recently, targeted therapies, mild but handicapping cognitive dysfunctions are frequently reported and can concern long periods of post-treatment. Although these deficits are reported in different cancer populations, the great majority of studies has been conducted in breast cancer after adjuvant chemotherapy. But the nature and mechanisms underlying these deficits are still poorly understood. This paper intends to review cognitive impairment after treatments for breast cancer. Studies on this topic generally report that chemotherapy induces memory loss, processing speed and attention and executive functions problems. Afterwards, we will show that other factors, little investigated for the moment, are also likely to cause cognitive dysfunctions: recent longitudinal studies, with a base measurement point before chemotherapy, demonstrated evidence of cognitive impairment prior to chemotherapy, suggesting that several parameters, including psychopathological and psychosocial factors (depression, anxiety, self disturbances) or biological factors (cytokine level), have clearly to be taken into account. Then, we will focus on studies investigating the situation in elderly cancer populations as these patients are highly likely to be confronted with cognitive deficits and with cancer, and the administration of chemotherapy treatment doesn't really take into account the age of the patients. Finally, recent neuroimaging studies began to better understand the neurobiological mechanisms underlying cognitive impairment in breast cancer. The patients demonstrated larger patterns of activation from control subjects, sometimes in spite of normal cognitive scores, suggesting mechanisms of compensation. Future studies should be developed and adopt a sensitive method with longitudinal design and the latest imaging techniques to explain cognitive impairment in cancer.
