1
|
Rehel S, Duivon M, Doidy F, Champetier P, Clochon P, Grellard JM, Segura-Djezzar C, Geffrelot J, Emile G, Allouache D, Levy C, Viader F, Eustache F, Joly F, Giffard B, Perrier J. Sleep oscillations related to memory consolidation during aromatases inhibitors for breast cancer. Sleep Med 2024; 121:210-218. [PMID: 39004011 DOI: 10.1016/j.sleep.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024]
Abstract
Aromatase inhibitors (AIs) are associated with sleep difficulties in breast cancer (BC) patients. Sleep is known to favor memory consolidation through the occurrence of specific oscillations, i.e., slow waves (SW) and sleep spindles, allowing a dialogue between prefrontal cortex and the hippocampus. Interestingly, neuroimaging studies in BC patients have consistently shown structural and functional modifications in these two brain regions. With the aim to evaluate sleep oscillations related to memory consolidation during AIs, we collected polysomnography data in BC patients treated (AI+, n = 17) or not (AI-, n = 17) with AIs compared to healthy controls (HC, n = 21). None of the patients had received chemotherapy and radiotherapy was finished since at least 6 months, that limit the confounding effects of other treatments than AIs. Fast and slow spindles were detected during sleep stage 2 at centro-parietal and frontal electrodes respectively. SW were detected at frontal electrodes during stage 3. Here, we show lower frontal SW densities in AI + patients compared to HC. These results concord with previous reports about frontal cortical alterations in cancer following AIs administration. Moreover, AI + patients tended to have lower spindle density at C4 electrode. Regression analyses showed that, in both patient groups, spindle density at C4 electrode explained a large variance of memory performances. Slow spindle characteristics did not differ between groups and sleep oscillations characteristics of AI- patients did not differ significantly from those of both AI + patients and HC. Overall, our results add to the compelling evidence of the systemic effects of AIs previously reported in animals, with deleterious effects on cortical activity during sleep and associated memory consolidation in the current study. There is thus a need to further investigate sleep modifications during AIs administration. Longitudinal studies are needed to confirm these findings and investigation in other cancers on this topic should be conducted.
Collapse
Affiliation(s)
- S Rehel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France.
| | - M Duivon
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - F Doidy
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - P Champetier
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - P Clochon
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - J M Grellard
- Clinical Research Department, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - C Segura-Djezzar
- Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - J Geffrelot
- Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - G Emile
- Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - D Allouache
- Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - C Levy
- Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France
| | - F Viader
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - F Eustache
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France
| | - F Joly
- Clinical Research Department, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France; Institut Normand Du Sein, Centre François Baclesse, Caen, France; Department of Medical Oncology, Centre François Baclesse, 3 Avenue Du Général Harris, Caen, France; INSERM, Normandie Univ, UNICAEN, U1086 ANTICIPE, Caen, France; Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14076, Caen, France
| | - B Giffard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France; Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14076, Caen, France
| | - J Perrier
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de La Mémoire Humaine, 14000, Caen, France.
| |
Collapse
|
2
|
Chou HL, Chen TC, Yao CT. Comparing the sensitivity of fatigue and sleep disturbance assessment tools in women with advanced cancer undergoing chemotherapy. Asia Pac J Oncol Nurs 2024; 11:100331. [PMID: 38283667 PMCID: PMC10821379 DOI: 10.1016/j.apjon.2023.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/28/2023] [Indexed: 01/30/2024] Open
Abstract
Objective This study aims to investigate the variations in fatigue and sleep disturbances among female patients with advanced lung cancer (ALC) and advanced breast cancer (ABC) during chemotherapy. Methods A total of 36 female patients with ALC and 36 with ABC, all of whom had completed their first cycle of chemotherapy, were included. Fatigue was assessed using the General Fatigue Scale (GFS), and sleep disturbances were evaluated using the Pittsburgh Sleep Quality Index (PSQI) at designated time points throughout the chemotherapy process. Results Linear regression analysis indicated that variables such as age, education level, employment status, cancer type, clinical stage, and symptom distress had no significant correlation with either fatigue or sleep disturbances. The GFS significantly discriminated fatigue among the ALC, ABC, and combined groups, while the PSQI demonstrated a significant distinction in sleep disturbance only within the ALC and combined groups. Conclusions In summary, when considering the findings of both assessments in this study, the GFS score exhibited greater sensitivity in detecting fatigue than the PSQI score did for identifying sleep disturbances in advanced cancer patients undergoing chemotherapy.
Collapse
Affiliation(s)
- Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tsan-Chi Chen
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chung-Tay Yao
- Department of Emergency, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| |
Collapse
|
3
|
Micha JP, Rettenmaier MA, Bohart RD, Goldstein BH. Prolonged endocrine therapy in the management of hormone receptor-positive early-stage breast cancer: What is the appropriate duration? J Obstet Gynaecol Res 2023; 49:1079-1082. [PMID: 36725670 DOI: 10.1111/jog.15553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/30/2022] [Indexed: 02/03/2023]
Abstract
AIM The clinical benefits associated with 5 years of endocrine therapy in the treatment of hormone receptor-positive, early-stage breast cancer (ESBC) have been well-substantiated. However, numerous studies have reported on the results of extended (i.e., >5 years) endocrine therapy to further effectuate a clinical benefit, with varying outcomes. Hence, the purpose of this study is to review these prolonged investigations and endeavor to clarify their corresponding treatment implications. METHODS We reviewed the study findings from several randomized controlled trials and meta-analyses, which incorporated clinical outcomes from pre-and postmenopausal, hormone receptor-positive, ESBC patients. RESULTS Hormone receptor-positive, ESBC patients treated with 5 years of endocrine therapy, who are node-negative with tumors <2 cm, will unlikely benefit from five additional years of treatment. Conversely, in women with larger tumors and node-positive disease, 7-8 total years of endocrine therapy may be indicated. Ultimately, clinicians should also consider the attendant side effects from endocrine therapy, namely bone fractures, namely cardiovascular symptoms, and vasomotor symptoms, when considering the appropriate treatment regimen. CONCLUSIONS While increased duration of endocrine therapy may selectively accord significant clinical benefits, prior to determining the patient's treatment interval, physicians should also assess the cumulative side effects from endocrine therapy when endeavoring to maintain treatment compliance and bolster quality of life.
Collapse
Affiliation(s)
- John P Micha
- Women's Cancer Research Foundation, Laguna Beach, California, USA
| | | | | | - Bram H Goldstein
- Women's Cancer Research Foundation, Laguna Beach, California, USA
| |
Collapse
|
4
|
Giskeødegård GF, Madssen TS, Sangermani M, Lundgren S, Wethal T, Andreassen T, Reidunsdatter RJ, Bathen TF. Longitudinal Changes in Circulating Metabolites and Lipoproteins After Breast Cancer Treatment. Front Oncol 2022; 12:919522. [PMID: 35785197 PMCID: PMC9245384 DOI: 10.3389/fonc.2022.919522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/05/2022] [Indexed: 02/06/2023] Open
Abstract
The multimodal treatment of breast cancer may induce long term effects on the metabolic profile and increase the risk of future cardiovascular disease. In this study, we characterized longitudinal changes in serum lipoprotein subfractions and metabolites after breast cancer treatment, aiming to determine the long-term effect of different treatment modalities. Further, we investigated the prognostic value of treatment-induced changes in breast cancer-specific and overall 10-year survival. In this study, serum samples from breast cancer patients (n = 250) were collected repeatedly before and after radiotherapy, and serum metabolites and lipoprotein subfractions were quantified by NMR spectroscopy. Longitudinal changes were assessed by univariate and multivariate data analysis methods applicable for repeated measures. Distinct changes were detectable in levels of lipoprotein subfractions and circulating metabolites during the first year, with similar changes despite large differences in treatment regimens. We detect increased free cholesterol and decreased esterified cholesterol levels of HDL subfractions, a switch towards larger LDL particles and higher total LDL-cholesterol, in addition to a switch in the glutamine-glutamate ratio. Non-survivors had different lipid profiles from survivors already at baseline. To conclude, our results show development towards an atherogenic lipid profile in breast cancer patients with different treatment regimens.
Collapse
Affiliation(s)
- Guro F. Giskeødegård
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Torfinn S. Madssen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Matteo Sangermani
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Lundgren
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Torgeir Wethal
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medicine, Stroke Unit, St. Olavs University Hospital, Trondheim, Norway
| | - Trygve Andreassen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Randi J. Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tone F. Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
5
|
Martin T, Duivon M, Bessot N, Grellard JM, Emile G, Polvent S, Raoul L, Viader F, Eustache F, Joly F, Giffard B, Perrier J. Rest activity rhythms characteristics of breast cancer women following endocrine therapy. Sleep 2021; 45:6384813. [PMID: 34624895 DOI: 10.1093/sleep/zsab248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/22/2021] [Indexed: 01/20/2023] Open
Abstract
Rest-activity rhythm (RAR) disruptions are frequently associated with chemotherapy in breast cancer (BC), but they are less known in BC with endocrine therapy. The aim of this ancillary study was to characterize the RAR and estimated sleep characteristics from actigraphy in BC patients either treated (ET+) or untreated with endocrine therapy (ET-), compared to healthy controls (HC) and using a cross-sectional design. Eighteen ET+, 18 ET- and 16 HC completed questionnaires and wore wrist actigraphs at home for 2 weeks. Parametric and non-parametric RAR, sleep parameters, and quality of life were compared between groups (p<0.05). BC groups presented lower daytime activity than HC according to RAR analysis (mesor and M10 parameters). Compared to HC, ET- had lower inter-daily stability and ET+ had greater sleep complaints. Compared to ET-, ET+ had lower sleep efficiency, more time awake and higher activity levels at night, as assessed with actigraphy. Our results suggest an effect of cancer independent of treatment on RAR in BC, highlighting the need for further investigation of this topic. In contrast, sleep as assessed with actigraphy seems modified only during ET which matches with patients' sleep complaints. Further longitudinal studies would aid in confirming the latter hypothesis.
Collapse
Affiliation(s)
- T Martin
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, Faculty of Sciences and Technologies, Avenue Olivier Messiaen, Le Mans, France
| | - M Duivon
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - N Bessot
- UNICAEN, INSERM, COMETE, GIP CYCERON, Normandie University , Caen, France
| | - J M Grellard
- Departments of Clinical Research Unit and Medical Oncology, Caen, France.,Institut Normand du Sein, Centre François Baclesse, Caen, France
| | - G Emile
- Departments of Clinical Research Unit and Medical Oncology, Caen, France.,Institut Normand du Sein, Centre François Baclesse, Caen, France
| | - S Polvent
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - L Raoul
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - F Viader
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - F Eustache
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - F Joly
- Departments of Clinical Research Unit and Medical Oncology, Caen, France.,Institut Normand du Sein, Centre François Baclesse, Caen, France.,CHU Côte de Nacre, Caen, France.,INSERM, Normandie Univ, UNICAEN, U1086 ANTICIPE, Caen, France.,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14076, Caen, France
| | - B Giffard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14076, Caen, France
| | - J Perrier
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| |
Collapse
|