Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.

BACKGROUND: Cognitive complaints are reported frequently after breast cancer treatments. Their association with neuropsychological (NP) test performance is not well-established. METHODS: Early-stage, posttreatment breast cancer patients were enrolled in a prospective, longitudinal, cohort study prior to starting endocrine therapy. Evaluation included an NP test battery and self-report questionnaires assessing symptoms, including cognitive complaints. Multivariable regression models assessed associations among cognitive complaints, mood, treatment exposures, and NP test performance. RESULTS: One hundred eighty-nine breast cancer patients, aged 21-65 years, completed the evaluation; 23.3% endorsed higher memory complaints and 19.0% reported higher executive function complaints (>1 SD above the mean for healthy control sample). Regression modeling demonstrated a statistically significant association of higher memory complaints with combined chemotherapy and radiation treatments (P = .01), poorer NP verbal memory performance (P = .02), and higher depressive symptoms (P < .001), controlling for age and IQ. For executive functioning complaints, multivariable modeling controlling for age, IQ, and other confounds demonstrated statistically significant associations with better NP visual memory performance (P = .03) and higher depressive symptoms (P < .001), whereas combined chemotherapy and radiation treatment (P = .05) approached statistical significance. CONCLUSIONS: About one in five post-adjuvant treatment breast cancer patients had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific NP test performances and depressive symptoms; combined chemotherapy and radiation treatment was also statistically significantly associated with memory complaints. These results and other emerging studies suggest that subjective cognitive complaints in part reflect objective NP performance, although their etiology and biology appear to be multifactorial, motivating further transdisciplinary research.

[Modern approaches to human cognitive activity enhancement].

Recent literature on human cognitive activity enhancement is reviewed and summarized. Two classes of pharmacological approaches are picked out, i.e. modern aspects of traditional substance utilization and application of specially developed drugs. Among non-pharmacological approaches a number of psychological, physiological, behavioral and biophysical methods to improve human cognition, memory and learning are analyzed. The most attention is paid to non-drug approaches that utilize bioelectric processes of the individual including characteristics of its brain electrical activity--electroencephalogram (EEG) to enhance different aspects of cognitive functioning. Some promising lines of these investigations are delineated.

[Comparative analysis of the effects of estrogens and tamoxifen on the brain higher functions].

At present, it is commonly accepted that estrogens modulate both cognitive and psycho-emotional status. Induced or natural hypoestrogeny is frequently accompanied by a complex of pathological states including suppressed state, anxiety, and weeping, sometimes with the development of depression. It is established that a substituting hormonal therapy in some cases favors restoration of the cognitive function and provides correction of affective disorders. Unfortunately, this therapy is accompanied by side effects and has some counterindications, which restricts its use in clinical practice. For this reason, it is of interest to try alternative agonists/antagonists of estrogen receptors possessing selective activity with respect to estrogen-sensitive tissues (including CNS), but these agents are still insufficiently studied. The given review describes the effect of estrogens on the brain functions, considers the mechanisms of action, and analyzes undesired side effects accompanying long-term administration. In particular, the results obtained in recent years concerning the effect of tamoxifen on the brain functions are summarized.

[State of the higher nervous activity and the immune system after vilozen adminstration].

Investigation of the condition of higher nervous activity and immune system after the vilosen immunostimulation was conducted. It was shown that vilosen caused increase of the monocytes and T-lymphocytes quantity at the expence of T-supressors subpopulation in the peripheral blood. Increase of the functional mobility of the nervous processes was also shown. Positive correlations between the functional mobility and quantity of the monocytes (r=0,7) and T- supressors (r=0,6) quantity in the perypheral blood were established.

[Antioxidant modification of ionizing irradiation and additional stress effects on higher nervous activity in rats].

The aim of this study was to investigate the oxidative effect of the low-level radiation upon the higher nervous activity. Behavioral (shuttle-box) and statistical methods were used. The effect of the ionizing radiation (0.05 Gy) upon the indices of rats behavioral reaction as well as ability of some antioxidants (alpha-tocopherol, ascorbic acid, beta-carotene) used separately and in complex to diminish exposure effects on the indices studied have been investigated Beta-carotene demonstrated the largest protective effect alone and as a component in complex compound. Alpha-tocopherol used in animal exposured to the dose of 0.05 Gy, could case decline of the rats behavior reactions indices; this suggest that use of antioxidant therapy demands certain cautiousness. The results obtained suggest dominant role of the oxidant stress during ionizing radiation at least in dose of 0.05 Gy.

[Effect of low intensity and very high frequency electromagnetic radiation on occupationally exposed personnel].

OBJECTIVE: To investigate the effect of low intensity and very high frequency (VHF) electromagnetic radiation (170 MHz) on nervous system function and serum enzymes and immune function in human subjects with occupational exposure to VHF. METHODS: To measure the intensity of VHF and other environmental factors on the spot, to hold the questionnaire about chief complaints, to examine the rheoencephalography and the neurobehavior function, to analyze ALT, AST, ALP and LDH, and IgA, IgM and IgG in experimental group and control group. RESULTS: The intensity of VHF (direction of antenna: 0 degrees, 10 m and 135 degrees, 20 m) was higher than that of national standard on-the-spot. The incidences of symptoms such as headache, insomnia and amnesia etc. was significantly higher in experimental group (P < 0.01). Rheoencephalography indicated that the raising time of both left [(0.155 3 +/- 0.057 9) s] and right [(0.154 1 +/- 0.059 2) s] in the experimental group after exposure were significantly longer than before exposure [(0.104 4 +/- 0.030 2) s, (0.103 2 +/- 0.030 4) s respectively] or in the control [(0.118 5 +/- 0.056 8) s, (0.117 7 +/- 0.057 5) s respectively, (P < 0.01)]. Neurobehavior function test showed that digital symbol, digital span and pursuit aiming test were decreased after exposure in the experimental group (P < 0.01). Serum enzyme analysis showed that AST, ALP and LDH were significantly increased after exposure in the experimental group (P < 0.01). No marked change was found in IgA level, while the levels of IgM and IgG after exposure in the experimental group especially the latter were significantly increased (P < 0.01). CONCLUSIONS: Low-intensity VHF radiation can decrease the nervous system function in occupationally exposed personnel and induce increase in some kinds of enzymes and immunoglobulins.

[Psychophysiological aspects of the problem of narcotic dependency]. / Nekotorye psikhofiziologicheskie aspekty problemy narkoticheskoi zavisimosti.

An attempt has been made at analyzing mechanisms of formation of addiction to narcotics from the standpoint of a systemic approach to a functional organization of psychic activity. A model is proposed of the pathological functional system as the basis of narcodependence, which combines processes of two adjoining levels--those of psychic activity and of higher nervous activity. It is suggested that pathological hyperactivity of the functional structure maintaining the need for a change in the emotional state might be the basis of addiction to narcotic drugs.

The effects of vasopressin on memory processes in Java monkeys.

The roles of vasopressin (arginine-vasopressin) in controlling conditioned operant food-procuring reflexes and various types of memory were studied in monkeys. Types of memory were: conditioned reflex, image (Hunter-Kerr test), short-term, and long-term. The effects of vasopressin were assessed in terms of objective measures of higher nervous activity: movement and autonomous functions. These studies showed that administration of vasopressin to monkeys had different effects on simple operant food-procuring responses and memory processes. Vasopressin had greater effects on memory processes and the restoration of memory after functional derangements of higher nervous activity. The question of the formation of the two types of effect of vasopressin on higher nervous activity is discussed in relation to the evolution of mammals.

[The effect of medikhronal on the psychophysiological and metabolic processes in alcoholism]. / Vplyv medykhronalu na psykhofiziolohichni ta metabolichni protsesy pry alkoholizmi.

Pathopsychological examination, biochemical analysis of blood and urine as well as electroencephalogram (REG) were made in patients of the second (II) stage of alcoholism. The state of higher nervous activity (HNA) before and after treatment with antialcoholic drug medichronal was also analyzed. It has been shown that the course of treatment with medichronal applied to patients with alcoholism results in the removal of the inclination to alcohol, to improvement of functional state of the central nervous system, as well as ethanol (E), acetaldehyde (AcA) and catecholamines (CA) exchange, the disturbances in their metabolism (and first of all AcA) apparently being the basis of pathogenetic mechanisms of alcoholism.

[The effect of vasopressin on memory processes in Macaca fascicularis]. / Vliianie vazopressina na protsessy pamiati u iavanskikh obez'ian.

The role of vasopressin (arginin-vasopressin) in the regulation of conditioned instrumental food-procuring reactions and different kinds of memory such as delayed reflexes, image, short-, and long-time memory was studied in monkeys. Motor and autonomic effects of vasopressin were assessed. It was found that in monkeys, vasopressin administration differently affected the simple conditioned food-procuring reactions and memory. During functional disorders of the higher nervous activity, vasopressin was more efficient in its action on memory and its restoration. Formation of two types of vasopressin effects on the higher nervous activity in evolution of mammals is discussed.

[The neurotropic effect of aplegin (carnitine) in cerebral hypoxia]. / Neirotroficheskoe vliianie aplegina (karnitina) pri gipoksii golovnogo mozga.

Intravenously injected aplegin (carnitine) competitively displacing glucose, includes metabolic shunt of fatty acids, the activity for which was determined by the presence of free carnitine and was not limited by oxygen unlike the aerobic glycolysis. This effect may have paramount importance in acute hypoxia of the brain, and in some other critical conditions. Carnitine has a potent neurotrophic activity. Thus, it inhibits development of apoptosis, limits the area of damage and restores structure of nervous tissue.

[New approaches in correcting disorders of higher integrative brain functions in the pharmacotherapy of arterial hypertension with propranolol]. / Novye podkhody k korrektsii narushenii vysshikh integrativnykh funktsii mozga pri farmakoterapii arterial'noi gipertenzii propranololom.

In experiments on rats it is found that propranolol in a dose of 2 mg/kg has a negative effect on higher integrative functions of the brain. Nootropics--pyracetam (200 mg/kg), AKF-94 (20 mg/kg), PIR-87-6-O (50 mg/kg) and actoprotector bemityl (40 mg/kg)--normalized orientative-trying behavior, memory, and emotionality of the animals. A possible mechanism of the drug action and prospects of their clinical application are discussed.

[Experience in the study of the effects of lead on the health status of children in Belovo]. / Opyt izucheniia vozdeistviia svintsa na sostoianie zdorov'ia detei g. Belovo.

Lead releases in Belovo town containing metallurgy enterprise had reached 120 tons/year earlier, but in recent years have decreased to 9 tons/year. Reduction of the production induced decrease of lead levels in the ambient air from 0.7-2.3 mg/m3 in 1994 to 0.001-0.24 mg/m3. Lead concentration in the soil ranges from 30 to 3000 mg/kg. Lead levels were measured in serum of 91 children, in hair of 67 ones and in teeth of 15 children. Serum lead levels in children aged 7-8 years varied from 0.5 to 39 mg/dl, with an average of 9.9 mg/dl (SD is 5.2 mg/dl), geometric mean is 8.5 mg/dl and error of geometric mean is 3.3. 46% of the children had serum lead levels exceeding the normal one (10 mg/dl). Average lead level in the hair equaled 4.5 mg/g (SD is 4.9 mg/g). The children living in towns with higher environmental lead levels demonstrated more frequent anxiety and changes in higher psychic functions. The major points influencing the serum lead level are proximity to highway, dietary load of goods grown near the residence, mother's smoking. Biokinetic model describing lead transfer into the blood helped to evaluate various modes of the enterprise functioning and efficiency of some environmental protection measures. The most efficient are measures aimed to lower dietary intake of lead, less efficiency is associated with measures reducing lead levels in air, dust and soil.

[Nootropil in the treatment of disorders of the higher mental functions in patients with an ischemic stroke]. / Nootropil v lechenii narushenii vysshikh psikhicheskikh funktsii u bol'nykh s ishemicheskim insul'tom.

47 patients with acute ischemic stroke were treated with nootropil (pyracetam, UCB, Belgium) from the first day of the disease (12 g, intravenously, by drops during 2 weeks, then 4.8 g, per os) on the background of basic therapy. There was revealed increase of spontaneous activity, expressive and impulsive speech, audio- and speaking memory (especially delayed memory), tactile, acoustic and visual gnosis, space praxis. There was observed more pronounced positive dynamics of functions of damaged hemisphere in patients with localisation of ischemic focus in left hemisphere. Meanwhile restoration was slower when ischemic focus was localized in right hemisphere. Restoration of high mental functions occurred to be faster during nootropil treatment as compared with basic therapy only. The conclusion was made that nootropil can be prescribed for the patients with hemispheric ischemic stroke and especially for the patients with alterations of cerebral circulation in system of internal carotid artery including such disturbances on the background of insufficiency of circulation in vertebrobasilar system.

[The comparative physiological characteristics of the regulating effect of vasopressin on higher nervous activity in mammals in an ascending order]. / Sravnitel'no-fiziologicheskie osobennosti reguliruiushchego vliianiia vazopressina na vysshuiu nervnuiu deiatel'nost' v voskhodiashchem riadu mlekopitaiushchikh.

Small doses of vasopressin in hedgehogs facilitated positive conditioning as well as formation of extinguishing inhibition. In rabbits [correction of rodents], vasopressin enhanced the trace conditioning however shortly. In monkeys, vasopressin exerts a complicated effect upon simpler conditioning and memory processes, the conditioned memory being obviously enhanced.

[The role of opioid neuropeptides and adrenocorticotropic hormone in the mechanisms compensating for disordered central nervous system functions during stimulation and after destruction of the limbic structures in the brain of the hedgehog Erinaceus auritus]. / Rol' opioidnykh neiropeptidov i adrenokortikotropnogo gormona v mekhanizmakh kompensatsii narushennykh funktsii tsentral'noi nervnoi sistemy pri stimuliatsii i posle razrusheniia limbicheskikh struktur mozga u ezha Erinaceus aurinatus.

On the model of food behaviour of hedgehogs possibilities of disrupted acquired and congenital forms of nervous activity have been studied using opioid neuropeptides, beta-endorphin, met-enkephalin and adrenocorticotropin (ACTH). It was established that preliminary introduction of opioid neuropeptides removed inhibitory effects of stimulation of limbic cortex on conditioned-reflex brain activity. The influence of different neuropeptides on higher nervous activity and behaviour revealed strict tendency to specialization. In particular, at met-enkephalin introduction latent periods of conditioned food-procuring reactions were essentially shortened, fading inhibition was not developed and intersignal, motor and food excitement were increased. At beta-endorphin introduction formation of fading inhibition did ton differ from the one in norm. On the background of ACTH introduction incomplete removing of inhibitory effects of limbic cortex irritation was revealed. Met-enkephalin introduction to animals with broken limbic cortex and basolateral part of amygdala was accompanied by restoration of food-procuring, orientation-research and motor activity. Restoration of acquired forms of nervous activity was uncomplete and transitory. The problem of possibility of neurochemical compensation of disrupted functions in mammalian brain is discussed.