Effects of ionizing radiation on the mammalian brain.

Epidemiological studies on the atomic-bomb survivors, cancer survivors and occupational cohorts provide strong evidence for multifaceted damage to brain after ionizing radiation. Radiation-induced late effects may manifest as brain tumors or cognitive impairment. Decreased neurogenesis and differentiation, alteration in neural structure and synaptic plasticity as well as increased oxidative stress and inflammation are suggested to contribute to adverse effects in the brain. In addition to neural stems cells, several brain-specific mature cell types including endothelial and glial cells are negatively affected by ionizing radiation. Radiation-induced enhancement of endothelial cell apoptosis results in disruption of the vascular system and the blood brain barrier. Activated microglia create inflammatory environment that negatively affects neuronal structures and results in decreased synaptic plasticity. Although the molecular mechanisms involved in radiation-induced brain injury remain elusive, first strategies for prevention and amelioration are being developed. Drug-based prevention and treatment focus mainly on the inhibition of oxidative stress and inflammation. Cell replacement therapy holds great promise as first animal studies using transplantation of neural stem cells to irradiated brain have been successful in restoring memory and cognition deficits. This review summarizes the epidemiological and biological data on radiation-induced brain damage and describes prevention and therapy methods to avoid and ameliorate these adverse effects, respectively.