Chemo Brain Syndrome
Chemo Brain Syndrome is described as a loss of mental “sharpness” and the inability to remember particular things, as well as difficulty completing activities, concentrating on something, or acquiring new abilities.
Michelle Monje was concerned about Covid-19’s ability to confound the chemo brain during the initial wave of the epidemic. Observing the virus’s huge inflammatory reaction and the early indications of what became known as Covid’s extended brain fog reminded her of “chemo brain,” the mind-numbing side effect that cancer patients experience when their treatment to burn away tumors also affects the brain.
Monje isn’t a virologist or epidemiologist by any stretch of the imagination. She is a Stanford neuro-oncologist who has spent the last 20 years researching the neurological foundations of cognitive impairment after cancer treatment.
However, over the last two years, she has concentrated her study, like that of experts all around the world, on the inclusion of Covid and its far-reaching effects throughout the body. When individuals can’t perform simple math, focus for more than a few moments, or find the correct words, it’s called brain fog.
She discovered that chemo brain and Covid induce neuroinflammation in the same manner, interacting with colleagues that included Yale virologist Akiko Iwasaki as well as the founder of Mount Sinai, David Putrino, the originator of the Covid clinic.
Their research, which was based on mice studies and autopsy findings, was recently released as a preprint on the bioRxiv platform and has since been submitted to a peer-reviewed journal (one that does not allow authors to expose the publication’s name until acceptance).
However, even with that proviso, Monje and her co-authors’ analysis provides fresh insight into a severe condition that affects up to a third of persons with lengthy Covid infection for months or years following infection. And the relationship raises optimism that one day a medication may be developed to put out the fires in the brain’s identical hot regions.
“Whereas the link isn’t immediately evident,” Beth Stevens, a correlate professor of neuroscience at Harvard Medical School as well as Boston Children’s Hospital, told STAT, “provided the positions neuroinflammation performs in ‘chemo brain’ neurology, it stands to reason that there’d be these resemblances to cognitive decline following an inflammatory problem like Covid,” Stevens revealed in 2012 that microglia, a kind of brain cell that had been overlooked since their discovery in the 1920s, were extremely potent immune cells. She was not a part of Monje’s study, but she is aware of it.
Long Covid tests patients on anything from medical gas relief to threatening messages
Stevens believes that understanding fundamental biology is the first step toward developing a successful treatment for both chemo brain and post-Covid brain fog. “Monje and his colleagues have been developing treatment strategies for cancer treatment cognitive impairment for a long time, and then they can now evaluate those possible therapies for extended Covid.” The next stages are obvious.”
Chemo brain medicines, Monje warned, are still a long way off, and so are treatments for long-term Covid’s brain fog, but these discoveries might pave the way.
There are no therapies available, according to Simone Bowles, an assisting special education teacher in Naperville, Illinois. She has been suffering from Covid and chemo brain fog for about two years and claims that medical treatment has been ineffective. A doctor advised taking Claritin to see whether the taste or odor would return, but it did not.
The fog has made ordinary activities more difficult: she once misplaced her debit card when refueling. “I also have my bank card with me at all times.” She told STAT, “Now I’m always checking, like, where is this?”
Her senses of taste and smell are still gone, and she suffers from exhaustion on a daily basis. She is devoted to her 9-year-old daughter and to the individuals she communicates with online in a Black long-haulers club, claiming that her faith in God keeps her going.
She explained, “I mean, I get up and go to work because I have to go to work.” “I had a trip planned mainly to force myself to do things again,” she explained. “I’m not interested in doing anything.”
Monje began her research on chemo brains and long-term Covid brain fog with a focus on neuroinflammation and the cognitive damage it produces. Microglia, which typically promote brain formation and subsequently maintain brain health, can be activated for a long time by cancer therapy. However, in sickness, these cells can go into overdrive, especially if the immunogen is Covid-19, which has been linked to cytokine release syndrome and other kinds of inflammatory dysregulation.
“I was afraid in the spring of 2020 that we would witness a cognitive syndrome defined by things like memory loss, executive functioning, attention, speed of information processing, and multitasking, similar to what we observe after cancer therapy,” Monje told STAT. “And then, you know, stories of exactly those types of concerns started showing up within months.”
It became obvious that excessive Covid may induce chemo brain damage, strokes, and, in rare situations, viral infection. But what she really wanted to know was how infections, as well as inflammation in other parts of the body, may influence the brain in the same way that cancer treatment targets tumors all over the body.
She was aware that the commonly used cancer treatment methotrexate activates particular microglia in the brain’s white matter, causing astrocytes to become neurotoxic. They cause cognitive impairment by disrupting the production of myelin, a covering surrounding neuron that speeds up messages from brain circuits. Experiments have demonstrated that removing hyperactive microglia can halt the progression of this disease.
Monje sought to know if a similar physiological process may be involved in long-term Covid brain fog and if it was reversible. To save cognition, the objective would be to restore the equilibrium between brain cells.
Even when people are sick, vaccination lessens the chance of long-term Covid, according to UK research.
Monje’s team utilized a model designed by Yale’s Iwasaki to infect mice with a weak variant of Covid-19 that was limited to the respiratory tract to test this theory. Brain samples from nine patients who died from Covid-19 were also investigated.
And Putrino had gathered serum samples from persons with long-term Covid illness, both with and without cognitive impairment, at Mount Sinai. The researchers discovered significant quantities of cytokines and chemokines — proteins that govern immune responses — in the white matter of the chemo brain, as well as signals of microglial activation, which are similar to what happens in people’s chemo brains after chemotherapy.
Persons with long Covid brain fog reported greater levels of a chemokine associated with cognitive impairment than people with long Covid without cognitive symptoms.
Monje was not shocked to see the likeness, but it did catch her attention. She said, “It wasn’t subtle.” She is grateful for the advances made in our knowledge of how neurons and glial cells cooperate to preserve neuronal health and plasticity. “Hopefully, following Covid, that basic work will guide cognitive function,” she added. “What’s interesting is that we’re not beginning from the beginning.”
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