After treatment with CAR-T cells - immune cells engineered to attack cancer - patients sometimes tell their doctors they feel like they have "brain fog," or forgetfulness and difficulty concentrating.
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A recent study published in Cell by Stanford Medicine researchers reveals that CAR-T cell therapy, while transformative for cancer treatment, may lead to mild cognitive impairments, commonly referred to as "brain fog." This condition encompasses symptoms like forgetfulness and difficulty concentrating and appears to occur independently of other treatments such as chemotherapy. The study, conducted primarily in mice, identified mechanisms similar to those observed in cognitive impairments following chemotherapy and infections like COVID-19. Once activated by the immune response, brain’s immune cells, called microglia, release inflammatory molecules that damage oligodendrocytes (responsible for myelin production), thereby impairing neural signal transmission. Importantly, the researchers discovered potential strategies to reverse these effects using compounds akin to existing medications, suggesting that treatments could be developed relatively quickly. These findings underscore the importance of monitoring cognitive health in patients undergoing CAR-T therapy and developing interventions to mitigate such side effects and enhance quality of life.