Chemo Brain

This project aims to understand how platinum-based chemotherapy affects hearing function in cancer patients from different socioeconomic backgrounds in the North West of England. Platinum-based chemotherapy drugs, such as cisplatin, are ototoxic, meaning that they cause permanent damage to the hair cells of the ear, resulting in hearing loss. Patients from more deprived backgrounds face additional risk factors to their hearing health, including limited healthcare access, greater occupational noise exposure, and poorer overall health, making them more vulnerable to hearing loss. This is especially concerning as hearing loss can make communication more challenging, which creates a greater reliance on cognitive processes such as thinking and memory to navigate social interactions. This challenge is exacerbated when individuals experience cognitive dysfunction related to chemotherapy, commonly referred to as 'chemo brain'. Addressing these communication difficulties is crucial for promoting healthy ageing and maintaining social engagement. It is expected that cancer patients from the most deprived backgrounds would experience greater hearing loss following chemotherapy than those from less deprived backgrounds. As a secondary aim, this study will also investigate how hearing loss may affect cognitive function. Specifically, it will assess whether differences in speech-in-noise performance from pre- to post-treatment predict cognitive performance post-treatment, to understand if changes in hearing over time are associated with changes in cognition. The study will also explore how socioeconomic deprivation, cumulative chemotherapy dose, and treatment duration influence these relationships. By identifying disparities in hearing loss and possible associations with cognition, this research will help guide future hearing screening and intervention strategies for cancer patients.

This research study evaluates the effect of chemotherapy on cognition (thinking) and the brain in people with breast cancer.

Chemotherapy-induced cognitive impairment (CICI), also known as "chemobrain," is a range of neurocognitive deficits experienced during and after cancer chemotherapy. It is also one of the significant factors affecting the quality of life of cancer patients. Due to patients' subjective feelings, the definition of cognitive impairment, the variety of testing scales, and the lack of pre-chemotherapy cognitive function measurements, it is difficult to determine its incidence rate. Consequently, the diagnosis and treatment of this condition are delayed. Existing studies report a high incidence of CICI, affecting 17% to 78% of survivors, and it may persist for years after chemotherapy cessation, leading to more severe progressive manifestations. Its main clinical presentations include deficits in attention, memory, reasoning, multi-tasking ability, decision-making ability, as well as learning and language impairments. These significantly affect patients' functional independence, imposing a heavy burden on families and society. Numerous studies have proposed several potential mechanisms and etiologies for CICI, including direct neurotoxicity of chemotherapeutic drugs, blood-brain barrier disruption, reduced hippocampal neurogenesis, white matter abnormalities, secondary neuroinflammatory responses, and increased oxidative stress. However, the exact underlying mechanisms remain unclear. Currently, there is no clear and effective diagnosis or treatment method for CICI. How to effectively diagnose and treat cognitive impairment caused by chemobrain remains a key focus and challenge in current research. Previous studies indicate that in the treatment of ischemic stroke, Edaravone exerts its effects by scavenging oxygen free radicals, reducing inflammatory responses, mitigating neuronal and endothelial cell damage, and inhibiting excitatory neurotoxicity. It also inhibits neuronal lipid peroxidation and alleviates brain tissue damage and cerebral edema caused by cerebral ischemia and hypoxia. Dexborneol, as a bicyclic monoterpenoid compound, can also inhibit inflammatory responses, protect blood-brain barrier permeability, and reduce cell apoptosis. The combination of these two active ingredients can exert multiple mechanisms of action, including free radical scavenging, anti-inflammation, and blood-brain barrier protection, significantly reducing neuronal damage caused by acute ischemic stroke and exerting neuroprotective effects. Clinically, it effectively reduces infarct volume and improves neurological function. The aforementioned pathogenesis of CICI precisely involves increased neuroinflammation and oxidative stress, as well as damage to the blood-brain barrier. Furthermore, the sublingual tablet dosage form offers advantages in convenience compared to injections. Based on this, we hypothesize that Edaravone Borneol sublingual tablets may also have considerable efficacy in treating chemotherapy-related cognitive impairment. This study addresses a clinical cross-disciplinary event in neurology and oncology. It aims to evaluate the efficacy of Edaravone Dexborneol sublingual tablets for CICI and conduct preliminary exploration of early diagnostic biomarkers for CICI by collecting clinical patient imaging data, blood samples, and neuropsychological scale results. This will ultimately help optimize chemotherapy regimens to the greatest extent.

Cancer-related cognitive impairment (CRCI), also known as "chemobrain," is the cognitive decline that negatively impacts the majority of cancer patients undergoing chemotherapy, radiation, and/or hormonal treatments. This application focuses on evaluating if using a cognitive mobile training application can decrease the impact of CRCI in gynecologic oncology patients through a multidisciplinary approach with patients undergoing assessments by our neurocognitive team.

The purpose of this research study is to see how the brain changes in patients receiving chemotherapy (cytotoxic drug) treatment for colon or rectal cancer at Parkview Cancer Institute. This information will be used to identify helpful tests to diagnose individuals at risk for developing difficulties with thinking and memory due to their cancer treatments.

The MyBrain study investigates the brain function of children, adolescents and young adults during and after chemo treatment for cancer. The tests include 1) cognitive skills such as memory and attention; 2) the brain's electrical activity; 3) and biological markers related to brain function. The aim of the study is to better understand the trajectories of cognitive functioning and measures that have been associated with cognitive impairment in patients treated with chemotherapy.

To explore the cognitive impairment caused by chemotherapy and endocrine therapy in premenopausal breast cancer patients and to find biomarkers with early predictive effect on this cognitive impairment by using multimodal integrated PET/MRI technology combined with psychobehavioral technology.