In Rats, Transplanting Human Neural Stem Cells Restores Cognitive Function

This is an intriguing study out of UC Irvine with results reported in the February 15, 2015 issue of Cancer Research. I'm wondering if there's a window of opportunity. For example, were this to be valid for human trial, would transplantation reverse "chemo brain" in those still struggling years after cancer treatment?  I hope research continues with success...Idelle

See more below in this press release from the American Assoc. for the Advancement of Science (AAAS).  

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Irvine, Calif. -- Human neural stem cell treatments are showing promise for reversing learning and memory deficits after chemotherapy, according to UC Irvine researchers.

In preclinical studies using rodents, they found that stem cells transplanted one week after the completion of a series of chemotherapy sessions restored a range of cognitive functions, as measured one month later using a comprehensive platform of behavioral testing. In contrast, rats not treated with stem cells showed significant learning and memory impairment.

The frequent use of chemotherapy to combat multiple cancers can produce severe cognitive dysfunction, often referred to as "chemo brain," which can persist and manifest in many ways long after the end of treatments in as many as 75 percent of survivors - a problem of particular concern with pediatric patients.

"Our findings provide the first solid evidence that transplantation of human neural stem cells can be used to reverse chemotherapeutic-induced damage of healthy tissue in the brain," said Charles Limoli, a UCI professor of radiation oncology.

Many chemotherapeutic agents used to treat disparate cancer types trigger inflammation in the hippocampus, a cerebral region responsible for many cognitive abilities, such as learning and memory. This inflammation can destroy neurons and other cell types in the brain.

Additionally, these toxic compounds damage the connective structure of neurons, called dendrites and axons, and alter the integrity of synapses - the vital links that permit neurons to pass electrical and chemical signals throughout the brain. Limoli compares the process to a tree being pruned of its branches and leaves.

Consequently, the affected neurons are less able to transmit important neural messages that underpin learning and memory.

"In many instances, people experience severe cognitive impairment that's progressive and debilitating," Limoli said. "For pediatric cancer patients, the results can be particularly devastating, leading to reduced IQ, asocial behavior and diminished quality of life."

For the UCI study, adult neural stem cells were transplanted into the brains of rats after chemotherapy. They migrated throughout the hippocampus, where they survived and differentiated into multiple neural cell types. Additionally, these cells triggered the secretion of neurotrophic growth factors that helped rebuild wounded neurons.

Importantly, Limoli and his colleagues found that engrafted cells protected the host neurons, thereby preventing the loss or promoting the repair of damaged neurons and their finer structural elements, referred to as dendritic spines.

"This research suggests that stem cell therapies may one day be implemented in the clinic to provide relief to patients suffering from cognitive impairments incurred as a result of their cancer treatments," Limoli said. "While much work remains, a clinical trial analyzing the safety of such approaches may be possible within a few years."

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Munjal Acharya, Lori-Ann Christie, Vahan Martirosian, Nicole N. Chmielewski, Nevine Hanna, Katherine Tran, Alicia Liao and Vipan Parihar of UCI contributed to the study, which was funded by the National Institutes of Health (grant R01 NS074388581) and supported by UCI's Institute for Clinical & Translational Science.

doi: 10.1158/0008-5472.CAN-14-2237

"Brain Freeze," A Poem by Susan Rubin

I'd like you to know about my friend, Susan. She's smart and funny and one of my heroes. Susan does not let go. She pushes and prods the experts until they recognize her chemo-related disabilities and provide resources for her and others.  She sends them copies of our book so they'll see the research and understand that chemo brain is real. 

But Susan continues to struggle.  Here's her beautiful poem...

Can Sea Snails Fix Chemo Brain?

Aplysia Californica

It appears we have a few things in common with sea snails. In fact, neurobiolgists have long recognized the scientific possibilities of their nervous systems, using them in studies of Alzheimer’s and Parkinson’s. They are reflexive creatures, containing only about 20,000 neurons compared to the 100 billion in the typical adult brain. But the neurons are large and relay information much the same way as in humans. That simplicity helps scientists isolate how they—and we—learn.

Navigating Through 'Chemo Brain'*

By

Idelle Davidson

Does any of this sound familiar? You’re halfway through what will be six rounds of chemotherapy when you notice a dense fog rolling over your brain. You grow forgetful. The responsibility of making even small decisions overwhelms you. You find multitasking impossible; good luck completing any task at all. Driving shatters your nerves; you’re disoriented, no longer sure which direction is home.

Second-Hand Smoke and Memory Loss

In my July 5th column (Is Nicotine Good for Chemo Brain?), I wrote about the nicotine patch. Studies suggest the patch may help with memory loss.

UCLA Cognitive Rehabilitation Study Needs Participants

I've been asked to post information about UCLA's cognitive rehabilitation study for anyone in the Los Angeles area who might like to participate.

Michael Sieverts' Tips/Tricks to Recover Your Life

My friend, Michael Sieverts, is a 10-year brain cancer survivor, a highly respected patient advocate, and a qi gong instructor for the Cancer Support Community. He is exceptionally well-read on the topics of brain health and cancer-related cognitive decline. ID

Michael Sieverts

By Michael Sieverts

This is a handout for the “Chemobrain” panel I moderated on February 21st at the Cancer Support Community-Benjamin Center. From my introduction that evening:

This is an incredibly important moment in the history of cancer treatment, and we appear to be at an inflection point in terms of understanding the multitude of diseases we refer to collectively as cancer. A good deal of the excitement has to do with scientific

What’s Another Name for Chemo Brain?

We follow the New York Times style guidelines and spell it as two words: chemo brain. I’ve also seen it as one word: chemobrain, or chemo-brain.  Others call it, “chemonesia,” or “cancer brain fog.”

What the Vitamins in Your Blood Tell You About Your Brain

In an article just published in the journal Neurology (online version, 12-28-11), researchers identified three nutrient biomarker patterns (NBP) in blood that are linked to how well we think and reason.

Cancer Itself May Contribute to Brain Fog. Chemo Makes It Worse, Says a Stanford Study

And now we have more evidence that chemo brain is real.

In the latest study published this week in Archives of Neurology, researchers at Stanford University found that women with breast cancer (regardless of whether they had surgery and chemotherapy, or just surgery alone), experienced reduced activity in parts of the brain responsible for working memory, planning and attention.

Learning Ukulele Has Helped My Memory

By Lori Nakamura
Aiea, Hawaii

I was 39 years old when I was diagnosed with triple negative breast cancer. I went through 5 cycles of chemo, and still today endure the lingering effects of chemo brain.

Fortunately, I have a friend who told me about the Hands On Healing program. She explained that Roy Sakuma Ukulele Studios offers free lessons to cancer survivors. Adding to the joy of learning to play the ukulele, my two daughters were able to sign up for lessons as well. Next month makes two years since we've taken up ukulele, and it will be 5 years since my surgery and treatments.

Making the Cognitive Leap: Exercise is Good for 'Chemo Brain'

By Arash Asher, MD

Director, Cancer Survivorship and Rehabilitation

Samuel Oschin Comprehensive Cancer Institute

Cedars-Sinai Medical Center, Los Angeles, CA

Fortunately, the scientific community has come a long way over the last several years in better understanding chemo brain, its causes, and how it can really impact a cancer survivor's life.  Unfortunately, we have much more work to do in learning about effective treatments for this problem.  

Hodgkin's Lymphoma Survivor Says He is Wealthy Because of 'Chemo Brain' -- Think Pinball Wizard

By Patrick Harvill
Southern California
Guest Blogger

Hi Idelle,

I'm 9 1/2 years out from treatment for Hodgkin's lymphoma and I have chemo brain in spades.  My symptoms are mostly the usual -- short-term memory deficits, attention deficits meaning forgetting what I am talking about or doing, and the whole intending to do the action but it doesn't happen.  I have near-amnesia under stress.  Related chemo maladies are chronic fatigue and fibromyalgia. I can't recall them all. Those are the main ones that bedevil me.

Word Retrieval: How Chemotherapy Changes the Way You Think, Part 4

By

Idelle Davidson

It's right there on the tip of your tongue.  It's a word that has a "ka" sound in the beginning and a "tah" sound somewhere at the end.  And you can almost see it, but then darn, it's gone.  Perhaps later, when you're rushing to slap dinner on the table, that stupid word, so maddeningly elusive just hours before will pop right into your head, as if it were all just a silly misunderstanding between you and your brain.

INFORMATION PROCESSING: How Chemotherapy Changes the Way You Think, Part 3

by

Idelle Davidson

In the introduction of Your Brain After Chemo, I tell the story of one of my friends, "Linda," who was in a support group with me at the Wellness Community.  Earlier in the week she had tried to get to the market only to find herself tangled in frustration.
  

Hear My Interview on Empower Radio

by

Idelle Davidson

You can download my interview with Mel Majoros of Empower Radio, here.  I've been interviewed several times about Your Brain After Chemo, but this was probably the most fun conversation of all.  Mel has a great sense of humor and she is a very warm and inviting radio host.

Check out Mel's blog as well at http://www.thecancerwarrior.blogspot.com/

EXECUTIVE FUNCTIONING: How Chemotherapy Changes the Way You Think, Part 2

by

Idelle Davidson

Many people who have been through chemotherapy report problems with EXECUTIVE FUNCTIONING.  Of course they don't call it that, they just say their brains have turned to sludge.

Executive functioning is high-level thought found in a part of the brain called the frontal cortex (just behind the forehead).

INTRODUCTION: How Chemotherapy Changes the Way You Think, Part 1

by

Idelle Davidson

Have you heard of "cognitive domains?" That's a term mental health experts use to explain which areas of the brain do what. People who have gone through chemotherapy often take a hit in these areas.  Look at the domain categories below. Do any describe what you may be calling chemo brain or post-chemo brain or brain fog?  What you may be suffering is actually a deficit in your executive functioning.  A mouthful, I know.  Okay, let's go back to chemo brain...

After Chemo, Changes in Personality and Mood [From Ellen K.]

Dear Dr. Silverman and Ms. Davidson,

I just read with great enthusiasm your book which I hope is the first step toward an understanding of "Chemo Brain."  I am nearly 5-years out from surviving surgery/dose-dense ACT (Adriamycin, Cytoxan and Taxol) chemo/radiation for stage 3 breast cancer.  I was 39 at diagnosis,

Questions About Memory Loss From a Hodgkin's Lymphoma Patient

My story is a brief one, but I sense a need to spell out what is not told to patients by many oncologists.

I was diagnosed with Hodgkin's lymphoma a little over a year ago after I had experienced symptoms about 18 months ago with primarily weight loss.  I was in great physical shape and doing  a lot of hiking.

The treatments of ABVD (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine) began in August 2009, and it was shortly after that my brain began changing.  I had a history of retaining names, ideas, concepts, book titles and past experiences, but began to forget many things I once experienced.  By the time I finished my chemotherapy sessions in February 2010, I was definitely different because of what I had forgotten, and what I consistently knew before and could no longer remember.

Your Brain After Chemo is absolutely a vital resource in providing ideas for recovering some of my memory that has simply disappeared, as if I had entered a twilight zone during chemo sessions. My memory was so affected by chemotherapy drugs, that even though much long-term memory is still there, many memories of names of people whom I met and titles of books I have read during the past few years suddenly were forgotten.  My brain could simply not retrieve them when I got into conversations with friends and wanted to speak of a person or a book, even though I remembered some content and experiences. 

I am retrieving short-term memory slowly and with practice and re-reading, but I always wonder: What is considered normal memory loss after certain specific chemotherapies?  

Second question might be: Why is it that many patients are not told of this potential memory loss BEFORE they enter chemotherapy?  Why is it not normal protocol for oncologists to mention cognitive and brain functions are affected?

I still do much physical activity, I once even hiked 4 miles in between chemo treatments, but my normal astute brain functions seem to recover slowly at times, and some times rapidly, depending on the day, on sleep patterns, on reading habits, on memory exercises and on dietary intake.

Thank you for writing the book and for this opportunity to share an experience on the mental side effect of my Chemotherapy.

Lorenzo C

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A RESPONSE FROM

DR. DAN SILVERMAN

Thanks for sharing your experience, Lorenzo, as well as for your feedback on Your Brain After Chemo.   

Regarding your questions, first, there really is no "normal memory loss" which we can cite... the experiences of patients even with a given