Download PDF
Onkologische Welt 2020; 11(05): 251-257
DOI: 10.1055/a-1213-5138
Originalartikel

„Chemobrain“? Beeinträchtigungen kognitiver Funktionen bei Mammakarzinompatientinnen

Kerstin Hermelink∗
1   Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe am LMU Klinikum
› Author Affiliations
› Further Information
    Permissions and Reprints

Viele Patientinnen mit einem Mammakarzinom klagen über Beeinträchtigungen des Gedächtnisses, der Aufmerksamkeit und anderer kognitiver Funktionen. Lange Zeit bestand weitgehend Konsens darüber, dass solche Probleme durch die Chemotherapie verursacht werden. Laborexperimente und Tiermodelle fanden Mechanismen, durch die Zytostatika das Gehirn schädigen könnten. Neuere klinische Studien allerdings lassen daran zweifeln, dass das sogenannte Chemobrain überhaupt existiert.

Ein Buch zu lesen oder einem Gespräch zu folgen macht Mühe, das richtige Wort oder ein Name lassen sich nicht aus dem Gedächtnis abrufen, die Organisation des Alltags ist eine Überforderung und alle intellektuellen Leistungen sind ungewohnt anstrengend – solche Klagen hören viele Ärzte von ihren onkologischen Patienten. Die Beeinträchtigungen kognitiver Funktionen erreichen zwar bei Weitem nicht das Ausmaß einer Demenz, sondern bleiben im Bereich von „slips and lapses“, die auch jedem Gesunden passieren können [1], aber einige der Betroffenen fühlen sich erheblich beeinträchtigt [2].



Publication History

Article published online:
04 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Shilling V, Jenkins V. Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer. Eur J Oncol Nurs 2007; 11: 6-15
    CrossrefPubMedGoogle Scholar
  • 2 Von Ah D, Habermann B, Carpenter JS. et al Impact of perceived cognitive impairment in breast cancer survivors. Eur J Oncol Nurs 2013; 17: 236-241 doi:10.1016/j. ejon.2012.06.002
    CrossrefPubMedGoogle Scholar
  • 3 Wieneke MH, Dienst ER. Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. Psycho-Oncology 1995; 4: 61-66
    CrossrefGoogle Scholar
  • 4 Shilling V, Jenkins V, Trapala IS. The (mis)-classification of chemo-fog – methodological inconsistencies in the investigation of cognitive impairment after chemotherapy. Breast Cancer Res Treat 2006; 95: 125-129
    CrossrefPubMedGoogle Scholar
  • 5 Pomykala KL, de Ruiter MB, Deprez S. et al Integrating imaging findings in evaluating the post-chemotherapy brain. Brain Imaging Behav 2013; 7: 436-452 doi:10.1007/s11682-013-9239-y
    CrossrefPubMedGoogle Scholar
  • 6 Seigers R, Schagen SB, Van Tellingen O. et al Chemotherapy-related cognitive dysfunction: current animal studies and future directions. Brain Imaging Behav 2013; 7: 453-459 doi:10.1007/s11682-013-9250-3
    CrossrefPubMedGoogle Scholar
  • 7 Chung NC, Walker AK, Dhillon HM. et al Mechanisms and Treatment for Cancer- and Chemotherapy-Related Cognitive Impairment in Survivors of Non-CNS Malignancies. Oncology (Williston Park) 2018; 32: 591-598
    Google Scholar
  • 8 Ahles TA, Saykin AJ, McDonald BC. et al Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat 2008; 110: 143-152
    CrossrefPubMedGoogle Scholar
  • 9 Hermelink K, Voigt V, Kaste J. et al Elucidating pretreatment cognitive impairment in breast cancer patients: the impact of cancer-related post-traumatic stress. J Natl Cancer Inst 2015; 107: djv099 doi:10.1093/jnci/djv099
    CrossrefPubMedGoogle Scholar
  • 10 Wefel JS, Lenzi R, Theriault R. et al ‘Chemobrain’ in breast carcinoma?: a prologue. Cancer 2004; 101: 466-475
    CrossrefPubMedGoogle Scholar
  • 11 Hermelink K, Untch M, Lux MP. et al Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study. Cancer 2007; 109: 1905-1913
    CrossrefPubMedGoogle Scholar
  • 12 Cimprich B, Reuter-Lorenz P, Nelson J. et al Prechemotherapy alterations in brain function in women with breast cancer. J Clin Exp Neuropsychol 2010; 32: 324-331 doi:10.1080/13803390903032537
    CrossrefPubMedGoogle Scholar
  • 13 Scherling C, Collins B, Mackenzie J. et al Prechemotherapy differences in response inhibition in breast cancer patients compared to controls: a functional magnetic resonance imaging study. J Clin Exp Neuropsychol 2012; 34: 543-560 doi:10.1080/13803395.2012.666227
    CrossrefPubMedGoogle Scholar
  • 14 Lopez Zunini RA, Scherling C, Wallis N. et al Differences in verbal memory retrieval in breast cancer chemotherapy patients compared to healthy controls: a prospective fMRI study. Brain Imaging Behav 2013; 7: 460-477 doi:10.1007/s11682-012-9213-0
    CrossrefPubMedGoogle Scholar
  • 15 McDonald BC, Conroy SK, Ahles TA. et al Alterations in brain activation during working memory processing associated with breast cancer and treatment: a prospective functional magnetic resonance imaging study. J Clin Oncol 2012; 30: 2500-2508 doi:10.1200/JCO.2011.38.5674
    CrossrefPubMedGoogle Scholar
  • 16 Bernstein LJ, McCreath GA, Komeylian Z. et al Cognitive impairment in breast cancer survivors treated with chemotherapy depends on control group type and cognitive domains assessed: A multilevel meta-analysis. Neurosci Biobehav Rev 2017; 83: 417-428 doi:10.1016/j.neubiorev.2017.10.028
    CrossrefPubMedGoogle Scholar
  • 17 Ono M, Ogilvie JM, Wilson JS. et al A metaanalysis of cognitive impairment and decline associated with adjuvant chemotherapy in women with breast cancer. Front Oncol 2015; 5: 59 doi:10.3389/fonc.2015.00059
    CrossrefPubMedGoogle Scholar
  • 18 Vearncombe KJ, Rolfe M, Andrew B. et al Cognitive effects of chemotherapy-induced menopause in breast cancer. Clin Neuropsychol 2011; 25: 1295-1313 doi:10.1080/13854046.2011.631586
    CrossrefPubMedGoogle Scholar
  • 19 Hermelink K, Henschel V, Untch M. et al Short-term effects of treatment-induced hormonal changes on cognitive function in breast cancer patients: results of a multicenter, prospective, longitudinal study. Cancer 2008; 113: 2431-2439
    CrossrefPubMedGoogle Scholar
  • 20 Phillips KA, Regan MM, Ribi K. et al Adjuvant ovarian function suppression and cognitive function in women with breast cancer. Br J Cancer 2016; 114: 956-964 doi:10.1038/bjc.2016.71
    CrossrefPubMedGoogle Scholar
  • 21 Van Dyk K, Crespi CM, Bower JE. et al The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment. Cancer 2019; 125: 681-689 doi:10.1002/cncr.31858
    CrossrefPubMedGoogle Scholar
  • 22 Underwood EA, Rochon PA, Moineddin R. et al Cognitive sequelae of endocrine therapy in women treated for breast cancer: a metaanalysis. Breast Cancer Res Treat 2018; 168: 299-310 doi:10.1007/s10549-017-4627-4
    CrossrefPubMedGoogle Scholar
  • 23 Ahles TA, Hurria A. New Challenges in Psycho-Oncology Research IV: Cognition and cancer: Conceptual and methodological issues and future directions. Psycho-Oncology 2018; 27: 3-9 doi:10.1002/pon.4564
    CrossrefPubMedGoogle Scholar
  • 24 Andreotti C, Root JC, Ahles TA. et al Cancer, coping, and cognition: a model for the role of stress reactivity in cancer-related cognitive decline. Psycho-Oncology 2015; 24: 617-623 doi:10.1002/pon.3683
    CrossrefPubMedGoogle Scholar
  • 25 Bremner JD. Traumatic stress: effects on the brain. Dialogues Clin Neurosci 2006; 8: 445-461
    CrossrefPubMedGoogle Scholar
  • 26 Yang Y, Hendrix CC. Cancer-Related Cognitive Impairment in Breast Cancer Patients: Influences of Psychological Variables. Asia Pac J Oncol Nurs 2018; 5: 296-306 doi:10.4103/apjon.apjon_16_18
    CrossrefPubMedGoogle Scholar
  • 27 Hermelink K, Buhner M, Sckopke P. et al Chemotherapy and Post-traumatic Stress in the Causation of Cognitive Dysfunction in Breast Cancer Patients. J Natl Cancer Inst 2017; 109: djx057 doi:10.1093/jnci/djx057
    CrossrefPubMedGoogle Scholar
  • 28 Bray VJ, Dhillon HM, Vardy JL. Systematic review of self-reported cognitive function in cancer patients following chemotherapy treatment. J Cancer Surviv 2018; 12: 537-559 doi:10.1007/s11764-018-0692-x
    CrossrefPubMedGoogle Scholar
  • 29 Schagen SB, Das E, Vermeulen I. Information about chemotherapy-associated cognitive problems contributes to cognitive problems in cancer patients. Psycho-Oncology 2012; 21: 1132-1135 doi:10.1002/pon.2011
    CrossrefPubMedGoogle Scholar