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Vanderbilt Psychiatrist Studying Fog Associated with Chemotherapy

Jun. 17, 2003, 10:01 AM

Nashville, Tenn. – Laurel Brown, PhD, assistant professor of psychiatry, is the principal investigator of a pilot study currently underway in The Vanderbilt Ingram Cancer Center, in conjunction with the Departments of Psychiatry and Psychology to uncover the cause of cognitive deficits many breast cancer patients experience after being treated with chemotherapy, often referred to as "chemo brain" or "chemo fog."

Patients who are affected by "chemo brain" typically report memory problems and problems with mental clarity and focus. Some patients report only mild problems, while others feel significantly impaired. Brown says previous studies indicate that roughly 30% of patients who undergo chemotherapy report cognitive deficits. She theorizes that the problems may be related to damage to a specific region in the brain during treatment.

"We know that the hippocampus is vital for declarative memory and the hippocampus is especially vulnerable to damage from sources experienced by breast cancer patients — such as dexamethasone, chemotherapeutic agents, or simply high levels of endogenous glucocorticoids that are common during stressful situations," Brown said.

Breast cancer patients are commonly treated with the steroid dexamethasone or decadron to curb some of the side effects of chemotherapy. But in theory, Brown says it might be contributing to the problems known as "chemo brain."

Brown’s study will enroll women after they have been diagnosed with breast cancer, but before they have been treated to see what, if any problems can be directly related to treatment. She plans to measure deficits in declarative memory using The Randt Memory Test and The Benton Visual Retention Test, hippocampal volume loss and hippocampal functioning will be tested using structural and functional MRI, and changes in the daily fluctuation of cortisol levels will be noted. All three will be measured before and after treatment for breast cancer. Brown hopes to gather evidence in support of her theory that the problems known as "chemo brain" are related to damage in the hippocampus.

She hopes that eventually we will be able to understand the phenomenon well enough to be able to predict which patients might develop these problems during chemotherapy.

"If we could learn how to predict which patients might be at an increased risk for cognitive changes, then perhaps their treatment could be tailored to try to avoid the development of memory problems," said Brown.

The pilot study of "chemo brain" at VICC is currently enrolling breast cancer patients who have recently been diagnosed with breast cancer and are scheduled to receive chemotherapy, but have not yet started their treatment. For more information about the study, call Dr. Brown at: 615-343-2131, or Barbee Smith at: 322-0387.

Media contact: Heather Hall, (615) 322-3894 heather.l.hall@vanderbilt.edu

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