Mechanisms of radiotherapy-associated cognitive disability in patients with brain tumours

Intracranial radiotherapy leads to permanent and substantial cognitive disability in 50–90% of patientsThe pathophysiology of radiotherapy-associated cognitive disability remains poorly understood and there are no effective preventive measures or long-term treatmentsHistorically, most research has addressed markers of damage and the cognitive decline that appears 6 months to 1 year or more after irradiationMore-sensitive imaging techniques have revealed subtle evidence of CNS damage much sooner than 6 months after radiationThese early forms of CNS damage can persist and synergize over time to cause long-term, irreversible deficits in neurons and supporting cell lineages that are vital to cognitionConsideration of early forms of radiation-induced CNS damage could help to identify early treatments that can reverse degenerative processes before they cause permanent disability