A pilot study involving 22 breast cancer patients currently receiving chemotherapy (mean age 54), has found that those with higher levels of inflammatory biomarkers did significantly worse on tests for short-term visual memory. One particular biomarker — tumor necrosis factor-alpha (as reflected through its two soluble receptors, TNFRI and TNFRII) — was the strongest indicator of cognitive problems.
It’s long been known that eating oats can lower cholesterol levels, but the research focus has been on the effect on LDL cholesterol. However, there is growing evidence that two other markers provide an even more accurate assessment of cardiovascular risk:
This is especially true for people with metabolic syndrome and Type 2 diabetes, since they typically don't have elevated LDL cholesterol levels.
In light of this, it’s good to see a review and meta-analysis of 58 clinical trials has concluded that eating oat fibre can reduce all three markers.
The reason is thought to lie in beta-glucan, a viscous soluble fibre, for which oats are a rich source. Oat bran contains twice as much as oat meal.
The review found that overall, LDL cholesterol was reduced by 4.2%, non-HDL cholesterol by 4.8% and apoB by 2.3%.
https://www.eurekalert.org/pub_releases/2016-10/smh-rse100616.php
A study involving 33 overweight and obese adults who followed a whole grain diet for eight weeks and a refined grain diet during another eight week period, found that those on the whole grain diet saw a more than three-fold improvement in diastolic blood pressure compared to the refined grain diet.
This improvement equates to reducing the risk of death from heart disease by almost one-third, and the risk of death from a stroke by two-fifths.
Participants were under 50. Before age 50, an elevated diastolic blood pressure is associated with increased cardiovascular disease risk (diastolic is the bottom number, when you’re given a blood pressure reading).
Overall, there were substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol during both diet periods, but these differences were due to the people changing their normal dietary habits to carefully controlled diets. The order of diets was randomized, and there was a ten week period between them. The 33 participants included 6 men and 27 women.
The finding is supported by a meta-analysis of 45 different population studies that investigated whole grain intake in relation to risk of future illness or death due to specific causes. The review found that eating three more portions of whole grain foods a day was associated with a lower risk for all cardiovascular diseases and for dying of cancer, diabetes, and respiratory and infectious diseases. Three servings would be, say, two slices of whole-grain bread and one bowl of whole-grain cereal.
The benefits were dose-dependent, with the lowest risk found among those with the highest intake of whole-grain products: 7 to 7 ½ servings of whole grain products a day. This corresponds to 210-225 grams of whole grain products in fresh weight and about 70-75 grams of whole grains in dry weight.
https://www.eurekalert.org/pub_releases/2016-10/cc-ccs101816.php
http://www.eurekalert.org/pub_releases/2016-06/nuos-sso061516.php
Ho, H., Sievenpiper, J., Zurbau, A., Blanco Mejia, S., Jovanovski, E., Au-Yeung, F., . . . Vuksan, V. (2016). The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: A systematic review and meta-analysis of randomised-controlled trials. British Journal of Nutrition, 116(8), 1369-1382. doi:10.1017/S000711451600341X
Kirwan, J. P., Malin, S. K., Scelsi, A. R., Kullman, E. L., Navaneethan, S. D., Pagadala, M. R., … Ross, A. B. (2016). A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial. The Journal of Nutrition, 146(11), 2244–2251. https://doi.org/10.3945/jn.116.230508
Aune Dagfinn, Keum NaNa, Giovannucci Edward, Fadnes Lars T, Boffetta Paolo, Greenwood Darren C et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies BMJ 2016; 353 :i2716 http://www.bmj.com/content/353/bmj.i2716
A study involving 581 breast cancer patients and 364 healthy age-matched people (mean age 53) has found that women with breast cancer reported significantly greater cognitive difficulties for up to six months after chemotherapy. Cognitive difficulties were evaluated using FACT-Cog, an assessment that examines a person's own perceived impairment as well as cognitive impairment perceived by others.
A rat study has demonstrated that cytokines (immune system signaling molecules) impair communication among neurons in the hippocampus. The increased cytokine levels affected complex discrimination memory, that is, the ability to differentiate among generally similar experiences.
In the study, the rats were exposed to two similar environments, one of which was associated with a mild foot shock, making them reluctant to enter that environment. When some rats were then given a low dose of a bacterial agent to induce a neuroinflammatory response, leading to cytokine release in the brain, they became no longer able to distinguish between the two environments.
Analysis of changes in the activity patterns of hippocampal neurons suggested that cytokines impaired recall by disrupting the function of specific neuron circuits, taking the neural network that had learned the discrimination back to the state it had been before learning took place.
The finding may help explain "chemobrain", and suggests that an intervention aimed at reducing inflammation might be effective approach.
http://www.eurekalert.org/pub_releases/2014-09/uoc--bid091114.php
Czerniawski, J., & Guzowski, J. F. (2014). Acute Neuroinflammation Impairs Context Discrimination Memory and Disrupts Pattern Separation Processes in Hippocampus. The Journal of Neuroscience, 34(37), 12470–12480. http://doi.org/10.1523/JNEUROSCI.0542-14.2014
A six-week study involving 619 cancer patients has found that those who took part in a simple home-based exercise program significantly reduced their cognitive impairment ('chemo-brain'). The EXCAP (Exercise for Cancer Patients) was developed by the researchers some years ago, and this evaluation was a phase III randomized study for early-stage chemotherapy patients. Half the group were given standard care (no exercise during chemotherapy), while the others were given instruction to walk daily and carry out low-to-moderate resistance band training for 10 minutes, 5 days a week.
The issue of ‘chemo-brain’ — cognitive impairment following chemotherapy — has been a controversial one. While it is now (I hope) accepted by most that it is, indeed, a real issue, there is still an ongoing debate over whether the main cause is really the chemotherapy. A new study adds to the debate.
Cancer survivors who underwent chemotherapy often suffer long-term cognitive problems. Until now, most research has been occupied with establishing that this is in fact the case, and studies investigating how to help have been rare. I recently reported on studies suggesting that help with sleep problems and stress can be beneficial. It has also been suggested that exercise can help.
Women who received a once-standard type of chemotherapy regimen for breast cancer between 1976 and 1995 have been found to score worse on cognitive tests than women who never had cancer. Specifically, they tended to have lower scores on tests of immediate and delayed verbal memory, executive function, information processing speed, and psychomotor speed. The difference was comparable to some six years of age-related decline.
A mouse study has found that four commonly used chemotherapy drugs disrupt neurogenesis, and that the condition could be partially reversed with the growth hormone IGF-1. Surprising the researchers, both the drugs which cross the blood-brain barrier (cyclophosphamide and fluorouracil) and the two that don’t (paclitaxel and doxorubicin) reduced neurogenesis, with fluorouracil producing a 15.4% reduction, compared to 22.4% with doxorubicin, 30.5% with cyclophosphamide, 36% with paclitaxel. A second study of a single high dose of cyclophosphamide, a mainstay of breast cancer treatment, resulted in a 40.9% reduction. Administration of the experimental growth hormone IGF-1 helped in all cases, but was more effective with the high dose.
[ibib]448[/ibib]
http://www.eurekalert.org/pub_releases/2009-12/uorm-usr121709.php
A rat study has found that transplanted stem cells restored learning and memory to normal levels four months after radiotherapy. This compares with a greater than 50% decline in cognitive function in those rats that didn’t receive the therapy. Cranial irradiation is a common treatment for brain tumors.
[ibib]803[/ibib]
http://www.eurekalert.org/pub_releases/2009-11/uoc--scr110509.php
A mouse study has found that exercise can prevent a decline in memory after whole-brain radiation treatment. Mice that had radiation plus access to a running wheel did as well at remembering where an escape hole in maze was as normal mice that didn't exercise. Irradiated mice that had no access to an exercise wheel eventually showed no particular preference for the section of the maze with the escape hole. The irradiated mice who didn’t exercise also showed depressive-like behavior, while those who exercised did not.
Wong-Goodrich, S.J. et al. 2009. Exercise promotes recovery from cognitive dysfunction, depressive-like behavior, and loss of hippocampal neurogenesis following whole-brain irradiation in adult mice. Presented October 20 at the annual Society for Neuroscience meeting in Chicago.
http://www.eurekalert.org/pub_releases/2009-10/dumc-eca101309.php
A rat study has found that injections of the antioxidant N-acetyl cysteine (a modified form of the dietary amino acid cysteine), fully prevented the memory loss induced by the commonly used chemotherapy drugs adriamycin and cyclophosphamide. The findings suggest that the cause of impairment is oxidative stress. More research will be needed to determine the safety of NAC for chemotherapy patients.
[ibib]846[/ibib]
http://www.eurekalert.org/pub_releases/2008-09/s-prf090408.php
Trials have demonstrated that anastrozole is superior to tamoxifen in preventing breast cancer recurrence, and contralateral breast cancer in postmenopausal women, however other research has suggested that women receiving endocrine therapies show significantly poorer performance on verbal memory and processing tasks. In a substudy of the International Breast Intervention Study (IBIS II), which was specifically designed to investigate the clinical benefit of anastrozole, given daily for 5 years, as a primary chemopreventive treatment, cognitive function was assessed at baseline and at 6 and 24 months after the start of treatment. There were no significant differences between the anastrozole group and the placebo group in attention or memory, however, at 24 months significantly more women in the anastrozole group reported hot flushes. I note the recent study indicating the number of hot flushes in postmenopausal women is correlated with cognitive impairment.
[ibib]640[/ibib]
http://www.eurekalert.org/pub_releases/2008-09/l-adn082908.php
A trial involving 68 breast cancer survivors suffering from ‘chemo-brain’ has had positive results with modafinil (Provigil), a drug that promotes wakefulness. The women who took modafinil for eight weeks reported major improvements in memory, concentration and learning.
The findings were presented on June 3 at the American Society of Clinical Oncology meeting in Chicago.
http://www.eurekalert.org/pub_releases/2007-06/uorm-bpa052207.php
Hope for preventing the memory and learning problems that cancer patients often experience after whole-brain radiation treatments comes from a rat study. Rats receiving the diabetes drug piolitazone (Actos®) before, during and after radiation treatments did not experience cognitive impairment. The drug is thought to work by preventing inflammation.
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Full text available at http://tinyurl.com/37xglp
http://www.eurekalert.org/pub_releases/2007-01/wfub-dds011007.php
A common consequence of chemotherapy is memory problems, confusion and difficulty in concentrating ("chemobrain"). While nearly all breast and ovarian cancer patients receiving chemotherapy or radiation treatments seem to suffer chemobrain, 61% continue to experience memory problems long after their cancer treatment has stopped. A new study involving 154 cancer survivors suggests a possible new treatment using the drug dexmethyphenidate (d-MPH). The drug significantly reduced fatigue and improved memory.
Results of the study were presented to the annual meeting of the American Society of Clinical Oncology.
http://www.eurekalert.org/pub_releases/2005-06/uoc-ptf060705.php
A new study suggests that high doses of estrogen may improve long-term memory and decrease feelings of confusion in men whose testosterone levels have been lowered to treat advanced prostate cancer. The findings suggest that hormone deprivation, prostate cancer or a combination of the two significantly impair verbal memory, while estrogen therapy significantly improves verbal memory performance. Hormone deprivation appears to slow working memory performance, but did not affect accuracy. Supplementation with estrogen did not affect working memory.
Beer, T.M. & Janowsky, J. 2004. High dose estrogen may enhance memory in men with prostate cancer. Presented at the American Society for Clinical Oncology annual meeting in New Orleans, La. on June 6.
http://www.eurekalert.org/pub_releases/2004-06/ohs-ebm060604.php
A survey involving 785 CNS cancer survivors, 5,870 survivors of non-CNS cancers (such as leukemia, Hodgkin's disease, and bone tumors), and 379 siblings of CNS cancer survivors, sent at least 16 years after diagnosis, has found that CNS cancer survivors reported significantly greater neurocognitive dysfunction than their siblings and survivors of other types of cancer. Moreover, these problems were linked to lower achievement in education and in full-time employment and income, as well as less chance of being married. The worst problems were found in those who had tumors in the cortex, and those who had cranial radiation treatment.
Ellenberg, L. et al. 2009. Neurocognitive Status in Long-Term Survivors of Childhood CNS Malignancies: A Report From the Childhood Cancer Survivor Study. Neuropsychology, 23 (6), 705-717.
Full text available at http://www.apa.org/journals/releases/neu-23-6-705.pdf
http://www.eurekalert.org/pub_releases/2009-11/apa-bti102709.php
In a randomised controlled trial, 58 patients with one to three brain tumors were treated either with stereotactic radiosurgery (SRS) plus whole-brain radiotherapy (WBRT), or with SRS alone. Those who were randomly assigned to SRS plus WBRT were more likely to show a significant drop on a verbal learning & memory test at 4 months than patients randomly assigned to SRS alone (52% vs 24%, despite patients in the SRS alone group having a higher overall brain tumour recurrence rate. This finding persisted at 6-month follow-up. However, tumors didn’t recur in 73% of patients in the SRS plus WBRT group at 1 year, compared with 27% of patients who received SRS alone. Mortality rates were also higher in the SRS alone group. Despite this, the authors advise against WBRT because it causes more of decline in brain function — but point to the need for close clinical monitoring in that case (but see report below).
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Full Article at: http://press.thelancet.com/tlowbrt.pdf
http://www.eurekalert.org/pub_releases/2009-10/l-aow100109.php
http://www.eurekalert.org/pub_releases/2009-10/uotm-srp100509.php
A six-year study of 58 cancer patients with tumors that have spread to the brain has found that those who had whole brain radiation as well as stereotactic radiosurgery (SRS) had more than double the risk of developing learning and memory problems compared to those who only had stereotactic radiosurgery. The trial was halted when interim results showed that patients who received both had a 49% decline in learning and memory functioning at four months, while those who underwent stereotactic radiosurgery alone experienced only a 23% decline in neurocognitive functioning. Nearly half of the patients who had both treatments lost the ability to recall five words from the same list over three attempts.
The study was presented September 22, 2008, at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.
http://www.eurekalert.org/pub_releases/2008-09/asft-cpe091508.php
A study that tested 30 women with breast cancer repeatedly before each cycle of chemotherapy and one month after the final cycle, comparing them to healthy controls, found the women with breast cancer had slight problems in attention and learning skills before chemotherapy started. Only three women (10%) developed cognitive problems during chemotherapy, and interestingly, these were not the women who reported that they had problems.
Another study compared 40 women with breast cancer not yet treated, 27 women who had recently had a breast biopsy that was not cancerous, and 20 breast cancer survivors who had completed treatment at least one year before. On tests of working memory and spatial learning, the women recently diagnosed with breast cancer performed about the same as the women with the recent benign biopsy, but both groups were slower and less accurate than the breast cancer survivors. The results suggest the cognitive difficulties may be related to stress as a result of the diagnosis and other quality-of-life factors.
The studies were presented at the American Academy of Neurology Annual Meeting in Chicago, April 12–19.
http://www.eurekalert.org/pub_releases/2008-04/aaon-cmn040208.php
On the other hand, studies have shown that upwards of 82% of breast cancer patients report that they suffer from some form of cognitive impairment, and that a significant proportion of these (reports range from 15-20% to 50%) have lingering cognitive problems a year or more after treatment. And following their demonstration that three common chemotherapy drugs used to treat a wide range of cancers are more toxic to healthy brain cells than the cancer cells they were intended to treat, researchers have now found in cell and mouse studies that the widely used chemotherapy drug 5-fluorouracil (5-FU) is associated with a progressing collapse of support cells that are responsible for producing myelin. The next step will be to find out why some patients are vulnerable to this, and others not.
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Full text available at http://jbiol.com/content/7/4/12
http://www.eurekalert.org/pub_releases/2008-04/uorm-rdc041708.php
A survey of 471 cancer patients has found that the cognitive impairment experienced by 14 to 45% of cancer patients can be long-lasting and severely affect their personal and professional lives. Patients report that the lack of concentration, short-term memory loss, difficulty with word recall and the inability to organize or multi-task have led to significant problems at home and in the workplace. 42% described their doctors as dismissive or indifferent when it came to addressing their concerns.
To view the executive summary, visit www.hurricanevoices.org/today/cognition.
http://www.eurekalert.org/pub_releases/2007-10/hvbc-cdl100107.php
Whole-brain radiation is widely used to treat recurrent brain tumors as well as to prevent other cancers from spreading to the brain. About a half of patients later develop progressive memory problems. A new study has now identified changes in brain chemistry that may be responsible. Using middle-aged rats, researchers found changes in brain receptors for the neurotransmitter glutamate. The changes may impair synaptic communication.
The research was reported at the annual meeting of the Radiation Research Society in Philadelphia.
http://www.eurekalert.org/pub_releases/2006-11/wfub-ssp103006.php
A new study may explain ‘chemo-brain’ (cognitive dysfunction following chemotherapy). The study reveals that common drugs used to treat cancer are far more toxic to healthy brain cells than cancer cells — typical exposure levels killed 70-100% of brain cells but just 40-80% of the cancer cells. Moreover, the healthy cells continued to die for at least six weeks after treatment. Now the task is to find out how to protect healthy cells from the drugs.
The full article is available at: http://jbiol.com/content/5/7/22
[ibib]568[/ibib]
http://www.eurekalert.org/pub_releases/2006-11/uorm-cct112806.php
A new study has found that although significant regions of the brain associated with cognitive function were significantly smaller in breast cancer patients within 12 months of receiving adjuvant chemotherapy, after three years, there were no differences in these regions between those who had received chemotherapy and those who had not.
[ibib]418[/ibib]
http://www.eurekalert.org/pub_releases/2006-11/jws-cta112006.php
A study involving female mice confirms the existence of "chemobrain", finding mild to moderate learning and memory deficits in mice receiving methotrexate and 5-fluorouracil (5FU), two drugs widely used in women to prevent recurrence of breast cancer. The deficits extended only to those types of memory that involve the hippocampus or the frontal lobes (spatial memory and working memory, in this instance). The study only looked at short-term effects (2—4 weeks).
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http://www.eurekalert.org/pub_releases/2006-10/b-cdf102706.php
A PET study of 21 women who had undergone surgery to remove breast tumors five to 10 years earlier found that the 16 who had been treated with chemotherapy regimens near the time of their surgeries to reduce the risk of cancer recurrence had specific alterations in activity of frontal cortex, cerebellum, and basal ganglia compared to 5 breast cancer patients who underwent surgery only, and 13 control subjects who did not have breast cancer or chemotherapy. The alterations suggested the chemotherapy patients’ brains were working harder to recall the same information.
[ibib]542[/ibib]
http://www.eurekalert.org/pub_releases/2006-10/uoc--bn092906.php
A study involving 702 cancer survivors and their cancer-free twins has found that cancer survivors are twice as likely to develop cognitive problems as individuals who have never been treated for cancer. About 15% of the cancer survivors showed cognitive dysfunction. The study did not involve patients who had tumors involving the central nervous system. A follow-up study is planned, to compare those who received different treatments for their cancer.
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http://www.eurekalert.org/pub_releases/2005-05/uosc-csm052705.php
A study of 142 patients who had blood disorders and who underwent hematopoietic cell transplant (preceded by high-dose chemotherapy) found that, at three months after transplant, patients experienced a significant decline in all cognitive and motor functions tested. By one year, however, the neuromotor functions for most patients had come back to the level experienced before the transplant, with the exception of two capabilities: grip strength and motor dexterity. Patients who had no chemotherapy or chemotherapy with only hydroxyurea prior to the transplant and those who did not receive certain immune suppressants were better off.
Syrjala, K.L., Dikmen, S., Langer, S.L., Roth-Roemer, S. & Abrams, J.R. 2004. Neuropsychologic changes from before transplantation to 1 year in patients receiving myeloablative allogeneic hematopoietic cell transplant. Blood, 104, 3386-3392.
http://www.eurekalert.org/pub_releases/2004-11/asoh-inf110804.php
The second phase of a clinical trial for ependymoma (a malignant brain tumor that occurs predominately in children) suggests a radiation therapy technique called conformal radiation therapy (CRT) allows young patients to enjoy normal development of their cognitive functions. About 75% of the 88 children treated for ependymoma with CRT did not experience progression of their cancer after three years, and their cognitive development was not significantly impaired by radiation therapy. Although radiation treatment is more effective than chemotherapy for brain tumors, physicians have been reluctant to use it because of fears of impairing cognitive development in young children.
[ibib]637[/ibib]
http://www.eurekalert.org/pub_releases/2004-08/sjcr-3io080504.php
The first study to evaluate cognitive skills prior to chemotherapy has found significant deficits in neuropsychological function in breast cancer patients before undergoing chemotherapy, and suggests the incidence of "chemobrain," a widely reported side effect in women undergoing treatment for breast cancer, may be overestimated. The study found 35% of the women demonstrated baseline cognitive impairment with significant deficits in verbal learning and memory prior to chemotherapy. Psychomotor processing speed and attention, non-verbal memory, naming, complex visual tasks and hand fine motor dexterity also trended toward significant impairment compared to the controls.
[ibib]544 [/ibib]
http://www.eurekalert.org/pub_releases/2004-06/jws-scw061604.php
A recent study of cancer survivors has found that many survivors still suffer moderate to severe problems with pain, fatigue, sleep, memory and concentration three to five years after treatment has ended.