Emotional impairments in patients with chemotherapy-induced polyneuropathy

Introduction. Cancer and its treatment with chemotherapy (CT) can induce or exacerbate emotional disturbances and cognitive impairment, significantly deteriorating patients’ quality of life and reducing treatment adherence. Approximately one-third of patients experience a high level of distress, including anxiety and depression, which often remains undiagnosed. Chemotherapy-induced peripheral neuropathy (CIPN) worsens the psychological state, increasing anxiety and depression, while emotional distress, in turn, heightens the perception of symptoms. These interrelated disorders necessitate a more attentive approach to their diagnosis and management.

Objective: to determine the relationship between neuropathic, emotional, and cognitive disorders in patients who have received neurotoxic chemotherapy.

Material and methods. The study included 71 patients with solid malignant tumors receiving platinum — or taxane — based polychemotherapy. CIPN was diagnosed in 73% of patients. Levels of asthenia (MFI-20), depression and anxiety (Hamilton Rating Scale), cognitive functions (Montreal Cognitive Assessment (MoCA)), and neuropathy severity (Neuropathy Disability Score (NDS)) were assessed before and after CT.

Results. Following CT, a statistically significant increase in asthenia was recorded (general fatigue: from 9 to 12 points (p = 0.017). The prevalence of depression increased from 28 to 49% while anxiety remained consistently high (in 79 — 81% of patients). Female patients demonstrated more pronounced asthenia, depression, and cognitive deficits. The most severe emotional disorders were dependent on the severity of CIPN.

Conclusion. CT exacerbates emotional and cognitive impairments, particularly in patients with neuropathy, underscoring the necessity for comprehensive monitoring and the integration of psychological support into the standard treatment process.

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