Researchers Identify Physiological Evidence of ‘Chemo Brain’

Chemotherapy can induce changes in the brain that may affect concentration and memory, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA). Using positron emission tomography combined with computed tomography (PET/CT), researchers were able to detect physiological evidence of chemo brain, a common side effect in patients undergoing chemotherapy for cancer treatment.

"The chemo brain phenomenon is described as ‘mental fog’ and ‘loss of coping skills’ by patients who receive chemotherapy," said Rachel A. Lagos, D.O., diagnostic radiology resident at the West Virginia University School of Medicine and West Virginia University Hospitals in Morgantown, W.V. "Because this is such a common patient complaint, healthcare providers have generically referred to its occurrence as ‘chemo brain’ for more than two decades."

While the complaint may be common, the cause of chemo brain phenomenon has been difficult to pinpoint. Some prior studies using magnetic resonance imaging (MRI) have found small changes in brain volume after chemotherapy, but no definitive link has been found.

Instead of studying chemotherapy’s effect on the brain’s appearance, Dr. Lagos and colleagues set out to identify its effect on brain function. By using PET/CT, they were able to assess changes to the brain’s metabolism after chemotherapy.

"When we looked at the results, we were surprised at how obvious the changes were," Dr. Lagos said. "Chemo brain phenomenon is more than a feeling. It is not depression. It is a change in brain function observable on PET/CT brain imaging."

PET/CT results demonstrated statistically significant decreases in regional brain metabolism that were closely associated with symptoms of chemo brain phenomenon.

"The study shows that there are specific areas of the brain that use less energy following chemotherapy," Dr. Lagos said. "These brain areas are the ones known to be responsible for planning and prioritizing."

Dr. Lagos believes that PET/CT could be used to help facilitate clinical diagnosis and allow for earlier intervention.