Cognitive and Neuroimaging Effects of Chemotherapy: Evidence Across Cancer Types and Treatment Regimens

Over the past 40 years, increasing evidence has been found of cognitive effects of treatments for non–central nervous system (CNS) cancers and of effects prior to systemic treatment suggestive of contributions of host or disease factors. The most consistent finding has been cognitive sequelae of systemic chemotherapy. A growing neuroimaging literature has sought to elucidate the neural basis of these changes, largely focusing on breast cancer patients. Findings have included decreased gray matter density and volume, decreased white matter integrity, and altered structural and functional connectivity, which have been shown to correlate with objective neuropsychological performance and subjective cognitive complaints (1–5). Similar effects have recently been found in lung (6) and ovarian (7) cancers. The paper by Amidi et al. (8) in this issue of the Journal adds to this growing literature.

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