The psychological consequences of (perceived) ionizing radiation exposure: a review on its role in radiation-induced cognitive dysfunction

Abstract

Purpose

Exposure to ionizing radiation following environmental contamination (e.g., the Chernobyl and Fukushima nuclear accidents), radiotherapy and diagnostics, occupational roles and space travel has been identified as a possible risk-factor for cognitive dysfunction. The deleterious effects of high doses (≥1.0 Gy) on cognitive functioning are fairly well-understood, while the consequences of low (≤0.1 Gy) and moderate doses (0.1–1.0 Gy) have been receiving more research interest over the past decade. In addition to any impact of actual exposure on cognitive functioning, the persistent psychological stress arising from perceived exposure, particularly following nuclear accidents, may itself impact cognitive functioning. In this review we offer a novel interdisciplinary stance on the cognitive impact of radiation exposure, considering psychological and epidemiological observations of different exposure scenarios such as atomic bombings, nuclear accidents, occupational and medical exposures while accounting for differences in dose, rate of exposure and exposure type. The purpose is to address the question that perceived radiation exposure - even where the actual absorbed dose is 0.0 Gy above background dose - can result in psychological stress, which could in turn lead to cognitive dysfunction. In addition, we highlight the interplay between the mechanisms of perceived exposure (i.e., stress) and actual exposure (i.e., radiation-induced cellular damage), in the generation of radiation-induced cognitive dysfunction. In all, we offer a comprehensive and objective review addressing the potential for cognitive defects in the context of low- and moderate-dose IR exposures.

Conclusions

Overall the evidence shows prenatal exposure to low and moderate doses to be detrimental to brain development and subsequent cognitive functioning, however the evidence for adolescent and adult low- and moderate-dose exposure remains uncertain. The persistent psychological stress following accidental exposure to low-doses in adulthood may pose a greater threat to our cognitive functioning. Indeed, the psychological implications for instructed cohorts (e.g., astronauts and radiotherapy patients) is less clear and warrants further investigation. Nonetheless, the psychosocial consequences of low- and moderate-dose exposure must be carefully considered when evaluating radiation effects on cognitive functioning, and to avoid unnecessary harm when planning public health response strategies.

Keywords:

• Radiation exposure
• cognitive function
• psychological stress
• inflammation
• radiation accidents

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was, in part, supported by the Nuclear Community Charity Fund (NCCF) through funds received by The Armed Forces Covenant Fund Trust under the Aged Veterans Fund Grant AVF16 and Brunel University London under Grant 10790100.

Notes on contributors

George Collett

George Collett, MSc, is a doctoral research student at the Center for Health Effects of Radiological and Chemical Agents within the Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom.

Kai Craenen

Kai Craenen, PhD, was a postdoctoral research fellow at the Center for Health Effects of Radiological and Chemical Agents within the Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom.

William Young

William Young, PhD, CPsychol, is a Senior Lecturer in Rehabilitation Psychology in the School of Sport and Health Sciences at The University of Exeter, Devon, United Kingdom.

Mary Gilhooly

Mary Gilhooly, M.Ed, MPhil, PhD, retired in May 2019. She was Professor of Gerontology and Health Studies, Founding Fellow and Past President of the British Society of Gerontology, and is a member of the Center for Health Effects of Radiological and Chemical Agents within the Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom.

Rhona M. Anderson

Rhona M. Anderson, PhD, is a Reader in Radiation Biology and Director of the Center for Health Effects of Radiological and Chemical Agents within the Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom.