Radiation-Induced Cognitive Impairment in Postmenopausal Female Nonhuman Primates

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Impairment in Postmenopausal
Impairment
in
Postmenopausal
Female Nonhuman Primates
Mary Lou Voytko1, Rhonda Murray1, Dan Bourland3,4, Mark Cline2,
Mike Robbins
34
Mike
Robbins
3
,
4
Departments of Neurobiology & Anatomy1, Pathology2, and Radiation
Oncology
3
Brain Tumor Center of Excellence
4
Comprehensive Cancer
Oncology
,
Brain
Tumor
Center
of
Excellence
,
Comprehensive
Cancer
Center, Wake Forest School of Medicine, Winston-Salem, NC 27157,
USA
ICCTF International Cognition and Cancer ICCTF International Cognition and Cancer TaskTask Force Force ConferenceConference March 15March 15--17 17 thth 2012 2012 ––PARIS PARIS --FRANCEFRANCE

Radiation-induced Brain Injury
~ 30% of the ~1,600,000 new cancer patients diagnosed in
2011 in the US will develop brain metastases
Brain metastases represent the most common neurological
manifestation of cancer
Annual incidence of brain metastases is increasing due to:
i. an aging population
ii
idihif idi
ii
.
i
mprove
d
ant
i
cancer t
h
erap
i
es
f
or system
i
c
di
sease
iii. improved imaging techniques that detect smaller metastases
ICCTF International Cognition and Cancer ICCTF International Cognition and Cancer TaskTask Force Force ConferenceConference March 15March 15--17 17 thth 2012 2012 ––PARIS PARIS --FRANCEFRANCE

Radiation-induced Brain Injury
Currently ~ 200,000 patients/year receive fractionated partial
or whole brain irradiation (fWBI)
Cognitive impairment is observed in >50% of adult and 100%
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n tumor pat
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ents w
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ong-term surv
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vors
after brain irradiation
Includes deficits in short-term memory (hippocampus, medial
temporal lobe) and in executive and attention function
(prefrontal cortex)
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S
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ort-term
i
ntervent
i
ons
h
ave s
h
own temporary e
ffi
cacy,
b
ut
there are no proven long-term treatments for radiation-induced
cognitive impairment
ICCTF International Cognition and Cancer ICCTF International Cognition and Cancer TaskTask Force Force ConferenceConference March 15March 15--17 17 thth 2012 2012 ––PARIS PARIS --FRANCEFRANCE
cognitive
impairment

Radiation
induced Brain Injury
Radiation
-
induced
Brain
Injury
days years
months
weeks
ACUTE EARLY DELAYED LATE
Vascular abnormalities
Demyelination; Gliosis
Edema
Headache
Di
Transient demyelination
Somnolence White matter necrosis
Cognitive impairment
D
rows
i
ness
Neuro. worsening Attention deficits
Short-term memory loss
Dementia
Death
ICCTF International Cognition and Cancer ICCTF International Cognition and Cancer TaskTask Force Force ConferenceConference March 15March 15--17 17 thth 2012 2012 ––PARIS PARIS --FRANCEFRANCE