Scholars recently characterized plasma levels of the biomarker dehydroepiandrosterone (DHEA) and its sulfated form (DHEAS) – jointly referred to as DHEA(S) – to be biological determinants of chemobrain, difficulties related to memory and attention in cancer patients even months after completing their treatment.

DHEA(S) are neurosteroids that help to regulate brain development, but it was previously unknown whether their levels correlate with cognitive function or are associated with the onset of chemobrain.

The study showed that early-stage breast cancer patients with higher plasma DHEAS levels prior to chemotherapy were found to have a lower risk of developing chemobrain in the specific domains of verbal fluency and mental acuity.

The researchers recruited 81 early-stage breast cancer patients who had no prior exposure to chemotherapy or radiotherapy and were scheduled to receive chemotherapy treatment with curative intent. This was a multi-center, prospective cohort study conducted in the National Cancer Centre Singapore and KK Women’s and Children’s Hospital between 2011 and 2016.

To assess the extent of chemobrain, patients completed assessments for self-perceived and objective cognitive function before, during, and after chemotherapy. The validated questionnaire assessed patients on individual subdomains of mental acuity, concentration, memory, verbal fluency, functional interference and multitasking. Conversely, the computerized neuropsychological test performed was used to assess for processing speed, response time, memory and attention of each patient. In addition, patients also completed a series of questionnaires to assess their fatigue symptoms, anxiety symptoms and health-related quality of life.

Plasma samples collected prior to chemotherapy were quantified for DHEA(S) levels. Mr Toh Yi Long, a doctoral student working with Assoc Prof Chan, and the first author of the study, said, “Our findings suggest that patients with higher prechemotherapy DHEAS levels had lower odds of developing self-perceived cognitive impairment. However, future studies are required to further investigate the effect of DHEA(S) on specific cognitive domains and to validate our findings in independent cohorts.”

Citation: YL Toh; JS Mujtaba; S Bansal; A Yeo; M Shwe; AJ Lau; A Chan*, "Prechemotherapy Levels of Plasma Dehydroepiandrosterone and Its Sulfated Form as Predictors of Cancer‐Related Cognitive Impairment in Patients with Breast Cancer Receiving Chemotherapy", PHARMACOTHERAPY DOI: 10.1002/phar.2259 Published: 2019.