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Neurocognitive decline following radiotherapy: Mechanisms and therapeutic implications

TitleNeurocognitive decline following radiotherapy: Mechanisms and therapeutic implications
Publication TypeArticolo su Rivista peer-reviewed
Year of Publication2020
AuthorsPazzaglia, Simonetta, Briganti Giovanni, Mancuso Mariateresa, and Saran Anna
Keywords7, 8 dihydroxyflavone, brain radiation, cell damage, clinical effectiveness, cognitive defect, disorders of higher cerebral function, donepezil, executive function, external beam radiotherapy, human, intensity modulated radiation therapy, Ionizing radiation, memantine, mild cognitive impairment, minocycline, nervous system development, neural stem cell, neuroprotection, non small cell lung cancer, nonhuman, Radiation exposure, radiation response, review, small cell lung cancer, stem cell transplantation, stereotactic radiosurgery, volumetric modulated arc therapy, whole brain radiotherapy

The brain undergoes ionizing radiation (IR) exposure in many clinical situations, particularly during radiotherapy for malignant brain tumors. Cranial radiation therapy is related with the hazard of long-term neurocognitive decline. The detrimental ionizing radiation effects on the brain closely correlate with age at treatment, and younger age associates with harsher deficiencies. Radiation has been shown to induce damage in several cell populations of the mouse brain. Indeed, brain exposure causes a dysfunction of the neurogenic niche due to alterations in the neuronal and supporting cell progenitor signaling environment, particularly in the hippocampus—a region of the brain critical to memory and cognition. Consequent deficiencies in rates of generation of new neurons, neural differentiation and apoptotic cell death, lead to neuronal deterioration and lasting repercussions on neurocognitive functions. Besides neural stem cells, mature neural cells and glial cells are recognized IR targets. We will review the current knowledge about radiation-induced damage in stem cells of the brain and discuss potential treatment interventions and therapy methods to prevent and mitigate radiation related cognitive decline. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.


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Citation KeyPazzaglia2020