|
1
|
Ng DQ, Cheng I, Wang C, Tan CJ, Toh YL, Koh YQ, Ke Y, Foo KM, Chan RJ, Ho HK, Chew L, Bin Harunal Rashid MF, Chan A. Brain-derived neurotrophic factor as a biomarker in cancer-related cognitive impairment among adolescent and young adult cancer patients. Sci Rep 2023; 13:16298. [PMID: 37770565 PMCID: PMC10539508 DOI: 10.1038/s41598-023-43581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/26/2023] [Indexed: 09/30/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) improves cognitive function by stimulating neurogenesis and neuroplasticity. We hypothesize that higher plasma BDNF levels are protective against cognitive toxicity among adolescent and young adult cancer patients (15-39 years old). In a prospective, longitudinal study, we recruited 74 newly diagnosed cancer and 118 age-matched non-cancer controls who completed the Cambridge Neuropsychological Test Automated Battery (CANTAB), Functional Assessment of Cancer Therapy-Cognitive Function questionnaire (FACT-Cog) and blood draws. Plasma BDNF was quantified using an enzyme-linked immunosorbent assay. Genomic DNA from buffy coat was genotyped for BDNF Val66Met. Most cancer participants were diagnosed with breast (24%) and head/neck (22%) cancers. After adjusting for sociodemographic variables (age, gender, race, marital status, education years), cancer participants had lower BDNF levels (ng/mL) at baseline (median: 10.7 vs 21.6, p < 0.001) and 6-months post-baseline (median: 8.2 vs 15.3, p = 0.001) compared to non-cancer controls. Through linear mixed modelling adjusted for sociodemographic variables, baseline cognition, fatigue, psychological distress, and time, we observed that among cancer participants, lower baseline BDNF levels were associated with worse attention (p = 0.029), memory (p = 0.018) and self-perceived cognitive abilities (p = 0.020) during cancer treatment. Met/Met was associated with enhanced executive function compared to Val/Val (p = 0.012). Plasma BDNF may serve as a predictive biomarker of cancer-related cognitive impairment.
Collapse
Affiliation(s)
- Ding Quan Ng
- Department of Clinical Pharmacy Practice, University of California Irvine, 802 W Peltason Dr, Irvine, CA, 92697-4625, USA
| | - Ivy Cheng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Claire Wang
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Chia Jie Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Yi Long Toh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Yong Qin Koh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Yu Ke
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Koon Mian Foo
- Department of Pharmacy, KK Women and Children's Hospital, Singapore, Singapore
| | - Raymond J Chan
- Caring Futures Institutes, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Han Kiat Ho
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Lita Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California Irvine, 802 W Peltason Dr, Irvine, CA, 92697-4625, USA.
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore.
| |
Collapse
|
|
2
|
Correa DD, Vachha BA, Baser RE, Koch A, Wong P, Gohel S, Giralt S, Root JC. Neuroimaging and Neurocognitive Outcomes in Older Patients with Multiple Myeloma Treated with Chemotherapy and Autologous Stem Cell Transplantation. Cancers (Basel) 2023; 15:4484. [PMID: 37760454 PMCID: PMC10526394 DOI: 10.3390/cancers15184484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
There is a paucity of research on treatment-related neurotoxicity in older adults with multiple myeloma (MM) treated with high-dose chemotherapy (HDC) and autologous SCT (HDC/ASCT), despite the increasing use of this regimen. We examined resting state functional connectivity (RSFC), gray matter (GM) volume, neurocognitive function (NF), and proinflammatory cytokines (PCy) in older patients with MM pre- and post-HDC/ASCT. Eighteen patients underwent MRI, NF tests, and serum PCy measurements prior to HDC/ASCT, and fifteen patients completed a follow up five-months post-HDC/ASCT. There were significant decreases in RSFC post-HDC/ASCT in (1) the central executive network (CEN) involving the left dorsolateral prefrontal cortex and right posterior parietal cortex (p = 0.022) and (2) the CEN involving the right posterior parietal cortex and the salience network involving the right dorsal anterior cingulate cortex (p = 0.029). There were no significant changes in GM or NF, except for improvements in attention (Digit Span Backward, p = 0.03). There were significant increases in several PCy post-HDC/ASCT (p ≤ 0.05). In conclusion, RSFC decreased in frontal, parietal, and cingulate cortices post-HDC/ASCT, NF was relatively stable, and several PCy increased. These findings are congruent with other studies in cancer patients and provide supporting evidence for the vulnerability of frontoparietal regions to chemotherapy's adverse effects.
Collapse
Affiliation(s)
- Denise D. Correa
- Department of Neurology, MSKCC—Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY 10065, USA
| | - Behroze A. Vachha
- Department of Radiology, UMass Chan Medical School, Worcester, MA 01665, USA
| | - Raymond E. Baser
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Adrian Koch
- Department of Neurology, MSKCC—Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Phillip Wong
- Department of Immune Monitoring Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Suril Gohel
- Department of Heath Informatics, Rutgers University School of Health Professions, Newark, NJ 08854, USA
| | - Sergio Giralt
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - James C. Root
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Departments of Psychiatry, Weill Cornell Medical College, New York, NY 10065, USA
| |
Collapse
|
|
3
|
Usmani MT, Krattli RP, El-Khatib SM, Le ACD, Smith SM, Baulch JE, Ng DQ, Acharya MM, Chan A. BDNF Augmentation Using Riluzole Reverses Doxorubicin-Induced Decline in Cognitive Function and Neurogenesis. Neurotherapeutics 2023; 20:838-852. [PMID: 36720792 PMCID: PMC10275819 DOI: 10.1007/s13311-022-01339-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/02/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) considerably affects the quality of life of millions of cancer survivors. Brain-derived neurotrophic factor (BDNF) has been shown to promote survival, differentiation, and maintenance of in vivo dentate neurogenesis, and chemotherapy induces a plethora of physiological and cellular alterations, including a decline in neurogenesis and increased neuroinflammation linked with cognitive impairments. In our clinical studies, breast cancer patients treated with doxorubicin (Adriamycin®, ADR) experienced a significant reduction in the blood levels of BDNF that was associated with a higher risk of CRCI. Our past rodent studies in CRCI have also shown a significant reduction in dentate neurogenesis accompanied by cognitive impairment. In this study, using a female mouse model of ADR-induced cognitive decline, we tested the impact of riluzole (RZ), an orally active BDNF-enhancing medication that is FDA-approved for amyotrophic lateral sclerosis. ADR-treated mice receiving RZ in the drinking water for 1 month showed significant improvements in hippocampal-dependent learning and memory function (spatial recognition), fear extinction memory consolidation, and reduced anxiety-like behavior. RZ prevented chemotherapy-induced reductions of BDNF levels in the hippocampus. Importantly, RZ mitigated chemotherapy-induced loss of newly born, immature neurons, dentate neurogenesis, and neuroinflammation. In conclusion, this data provides pre-clinical evidence for a translationally feasible approach to enhance the neuroprotective effects of RZ treatment to prevent CRCI.
Collapse
Affiliation(s)
- Manal T Usmani
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA
| | - Robert P Krattli
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA
| | - Sanad M El-Khatib
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA
| | - Anh C D Le
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA
| | - Sarah M Smith
- Department of Radiation Oncology, School of Medicine, University of California, Irvine, CA, USA
| | - Janet E Baulch
- Department of Radiation Oncology, School of Medicine, University of California, Irvine, CA, USA
| | - Ding Quan Ng
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, CA, USA
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA
| | - Munjal M Acharya
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA.
- Department of Radiation Oncology, School of Medicine, University of California, Irvine, CA, USA.
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, CA, USA.
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA.
| |
Collapse
|
|
4
|
Ng DQ, Chan D, Agrawal P, Zhao W, Xu X, Acharya M, Chan A. EVIDENCE OF BRAIN-DERIVED NEUROTROPHIC FACTOR IN AMELIORATING CANCER-RELATED COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW OF HUMAN STUDIES. Crit Rev Oncol Hematol 2022; 176:103748. [PMID: 35718064 DOI: 10.1016/j.critrevonc.2022.103748] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 12/27/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) plays an essential role in neurogenesis and neuroplasticity and may be a key protein in cancer-related cognitive impairment (CRCI). This systematic review assessed the relationship between BDNF biomarkers and neurocognitive outcomes in cancer patients and survivors. A search in PubMed, Scopus, and PsycINFO yielded 638 articles, of which 26 were eligible. Fourteen (54%)studied BDNF protein levels while 15 (58%) analyzed BDNF rs6265 polymorphism. Of the nine observational studies reporting BDNF plasma/serum levels, five (56%) exhibited a positive association between BDNF and cognitive function. One study reported intra-tumoral BDNF levels that were negatively associated with memory. For rs6265, three (20%) of 15 studies reported an association with cognitive function with inconsistent directions. Among seven neuroimaging studies, three (43%) demonstrated an effect of BDNF on brain function and structure. These results suggest that BDNF is a potential monitoring biomarker and druggable target for CRCI.
Collapse
Affiliation(s)
- Ding Quan Ng
- Department of Clinical Pharmacy Practice, University of California, Irvine, Irvine, California, United States of America; Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Daniella Chan
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Parisa Agrawal
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Weian Zhao
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, California, United States of America; Department of Biological Chemistry, University of California, Irvine, Irvine, California, USA; Department of Biomedical Engineering, The Henry Samueli School of Engineering, University of California, Irvine, Irvine, California, USA; Institute for Immunology, University of California, Irvine, Irvine, California, USA; Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, California, USA; Edwards Life Sciences Center for Advanced Cardiovascular Technology, University of California, Irvine, Irvine, California, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, California, USA
| | - Xiangmin Xu
- Department of Anatomy and Neurobiology, University of California, Irvine, Irvine, California, USA; The Center for Neural Circuit Mapping, University of California Irvine, Irvine, California, USA
| | - Munjal Acharya
- Department of Anatomy and Neurobiology, University of California, Irvine, Irvine, California, USA; Department of Radiation Oncology, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California, Irvine, Irvine, California, United States of America; Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, California, United States of America; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, California, USA.
| |
Collapse
|