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Madden DJ, Merenstein JL. Quantitative susceptibility mapping of brain iron in healthy aging and cognition. Neuroimage 2023; 282:120401. [PMID: 37802405 PMCID: PMC10797559 DOI: 10.1016/j.neuroimage.2023.120401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/14/2023] [Accepted: 09/30/2023] [Indexed: 10/10/2023] Open
Abstract
Quantitative susceptibility mapping (QSM) is a magnetic resonance imaging (MRI) technique that can assess the magnetic properties of cerebral iron in vivo. Although brain iron is necessary for basic neurobiological functions, excess iron content disrupts homeostasis, leads to oxidative stress, and ultimately contributes to neurodegenerative disease. However, some degree of elevated brain iron is present even among healthy older adults. To better understand the topographical pattern of iron accumulation and its relation to cognitive aging, we conducted an integrative review of 47 QSM studies of healthy aging, with a focus on five distinct themes. The first two themes focused on age-related increases in iron accumulation in deep gray matter nuclei versus the cortex. The overall level of iron is higher in deep gray matter nuclei than in cortical regions. Deep gray matter nuclei vary with regard to age-related effects, which are most prominent in the putamen, and age-related deposition of iron is also observed in frontal, temporal, and parietal cortical regions during healthy aging. The third theme focused on the behavioral relevance of iron content and indicated that higher iron in both deep gray matter and cortical regions was related to decline in fluid (speed-dependent) cognition. A handful of multimodal studies, reviewed in the fourth theme, suggest that iron interacts with imaging measures of brain function, white matter degradation, and the accumulation of neuropathologies. The final theme concerning modifiers of brain iron pointed to potential roles of cardiovascular, dietary, and genetic factors. Although QSM is a relatively recent tool for assessing cerebral iron accumulation, it has significant promise for contributing new insights into healthy neurocognitive aging.
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Affiliation(s)
- David J Madden
- Brain Imaging and Analysis Center, Duke University Medical Center, Box 3918, Durham, NC 27710, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA; Center for Cognitive Neuroscience, Duke University, Durham, NC 27708, USA.
| | - Jenna L Merenstein
- Brain Imaging and Analysis Center, Duke University Medical Center, Box 3918, Durham, NC 27710, USA
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Franco-Rocha OY, Lewis KA, Longoria KD, De La Torre Schutz A, Wright ML, Kesler SR. Cancer-related cognitive impairment in racial and ethnic minority groups: a scoping review. J Cancer Res Clin Oncol 2023; 149:12561-12587. [PMID: 37432455 DOI: 10.1007/s00432-023-05088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Disparities in cognitive function among racial and ethnic groups have been reported in non-cancer conditions, but cancer-related cognitive impairment (CRCI) in racial and ethnic minority groups is poorly understood. We aimed to synthesize and characterize the available literature about CRCI in racial and ethnic minority populations. METHODS We conducted a scoping review in the PubMed, PsycInfo, and Cumulative Index to Nursing and Allied Health Literature databases. Articles were included if they were published in English or Spanish, reported cognitive functioning in adults diagnosed with cancer, and characterized the race or ethnicity of the participants. Literature reviews, commentaries, letters to the editor, and gray literature were excluded. RESULTS Seventy-four articles met the inclusion criteria, but only 33.8% differentiated the CRCI findings by racial or ethnic subgroups. There were associations between cognitive outcomes and the participants' race or ethnicity. Additionally, some studies found that Black and non-white individuals with cancer were more likely to experience CRCI than their white counterparts. Biological, sociocultural, and instrumentation factors were associated with CRCI differences between racial and ethnic groups. CONCLUSIONS Our findings indicate that racial and ethnic minoritized individuals may be disparately affected by CRCI. Future research should use standardized guidelines for measuring and reporting the self-identified racial and ethnic composition of the sample; differentiate CRCI findings by racial and ethnic subgroups; consider the influence of structural racism in health outcomes; and develop strategies to promote the participation of members of racial and ethnic minority groups.
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Affiliation(s)
- Oscar Y Franco-Rocha
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA.
| | - Kimberly A Lewis
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Kayla D Longoria
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Alexa De La Torre Schutz
- Brain Health Neuroscience Lab, School of Nursing, The University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Michelle L Wright
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Shelli R Kesler
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
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Yao S, Zhang Q, Yao X, Zhang X, Pang L, Yu S, Cheng H. Advances of neuroimaging in chemotherapy related cognitive impairment (CRCI) of patients with breast cancer. Breast Cancer Res Treat 2023:10.1007/s10549-023-07005-y. [PMID: 37329458 DOI: 10.1007/s10549-023-07005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Chemotherapy related cognitive impairment (CRCI) has seriously affected the quality of life (QOL) of patients with breast cancer (BCs), thus the neurobiological mechanism of CRCI attracted widespread attention. Previous studies have found that chemotherapy causes CRCI through affecting brain structure, function, metabolism, and blood perfusion. FINDINGS A variety of neuroimaging techniques such as functional magnetic resonance imaging (fMRI), event-related potential (ERP), near-infrared spectroscopy (NIRS) have been widely applied to explore the neurobiological mechanism of CRCI. CONCLUSION This review summarized the progress of neuroimaging research in BCs with CRCI, which provides a theoretical basis for further exploration of CRCI mechanism, disease diagnosis and symptom intervention in the future. Multiple neuroimaging techniques for CRCI research.
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Affiliation(s)
- Senbang Yao
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Qianqian Zhang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Xinxin Yao
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xiuqing Zhang
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Lulian Pang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Sheng Yu
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China.
- Shenzhen Clinical Medical School, Southern Medical University, Shenzhen, Guangdong, China.
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Saita K, Amano S, Kaneko F, Okamura H. A scoping review of cognitive assessment tools and domains for chemotherapy-induced cognitive impairments in cancer survivors. Front Hum Neurosci 2023; 17:1063674. [PMID: 36891148 PMCID: PMC9987518 DOI: 10.3389/fnhum.2023.1063674] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Backgrounds Cancer survivors suffer from specific symptoms known as chemotherapy-induced cognitive impairments (CICIs). CICIs are difficult to capture with existing assessments such as the brief screening test for dementia. Although recommended neuropsychological tests (NPTs) exist, international consensus and shared cognitive domains of assessment tools are unknown. The aim of this scoping review was as follows: (1) to identify studies that assess CICIs in cancer survivors; (2) to identify shared cognitive assessment tools and domains by mapping the domains reported in studies using the International Classification of Functioning, Disability and Health (ICF) framework. Methods The study followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched the following three databases through October 2021: PubMed, CINAHL, and Web of Science. Prospective longitudinal or cross-sectional studies were selected to determine CICI-specific assessment tools for adult cancer survivors. Results Sixty-four prospective studies (36 longitudinal studies and 28 cross-sectional studies) were included after checking for eligibility. The NPTs were divided into seven main cognitive domains. The specific mental functions were often used in the order of memory, attention, higher-level cognitive functions, and psychomotor functions. Perceptual functions were used less frequently. In some ICF domains, shared NPTs were not clearly identified. In some different domains, the same NPTs were used, such as the trail making test and the verbal fluency test. When the association between the publishing year and the amount of NPT use was examined, it was found that the amount of tool use tended to decline over the publication years. The Functional Assessment of Cancer Therapy-Cognitive function (FACT-Cog) was a shared consensus tool among the patient-reported outcomes (PROs). Conclusion Chemotherapy-induced cognitive impairments are currently gaining interest. Shared ICF domains such as memory and attention were identified for NPTs. There was a gap between the publicly recommended tools and the tools actually used in the studies. For PROs, a clearly shared tool, FACT-Cog, was identified. Mapping the domains reported in studies using the ICF can help in the process of reviewing consensus on which NPTs may be used to target cognitive domains. Systematic review registration https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053710, identifier UMIN000047104.
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Affiliation(s)
- Kazuya Saita
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoru Amano
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Fumiko Kaneko
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Petr J, Hogeboom L, Nikulin P, Wiegers E, Schroyen G, Kallehauge J, Chmelík M, Clement P, Nechifor RE, Fodor LA, De Witt Hamer PC, Barkhof F, Pernet C, Lequin M, Deprez S, Jančálek R, Mutsaerts HJMM, Pizzini FB, Emblem KE, Keil VC. A systematic review on the use of quantitative imaging to detect cancer therapy adverse effects in normal-appearing brain tissue. MAGMA (NEW YORK, N.Y.) 2022; 35:163-186. [PMID: 34919195 PMCID: PMC8901489 DOI: 10.1007/s10334-021-00985-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/17/2022]
Abstract
Cancer therapy for both central nervous system (CNS) and non-CNS tumors has been previously associated with transient and long-term cognitive deterioration, commonly referred to as 'chemo fog'. This therapy-related damage to otherwise normal-appearing brain tissue is reported using post-mortem neuropathological analysis. Although the literature on monitoring therapy effects on structural magnetic resonance imaging (MRI) is well established, such macroscopic structural changes appear relatively late and irreversible. Early quantitative MRI biomarkers of therapy-induced damage would potentially permit taking these treatment side effects into account, paving the way towards a more personalized treatment planning.This systematic review (PROSPERO number 224196) provides an overview of quantitative tomographic imaging methods, potentially identifying the adverse side effects of cancer therapy in normal-appearing brain tissue. Seventy studies were obtained from the MEDLINE and Web of Science databases. Studies reporting changes in normal-appearing brain tissue using MRI, PET, or SPECT quantitative biomarkers, related to radio-, chemo-, immuno-, or hormone therapy for any kind of solid, cystic, or liquid tumor were included. The main findings of the reviewed studies were summarized, providing also the risk of bias of each study assessed using a modified QUADAS-2 tool. For each imaging method, this review provides the methodological background, and the benefits and shortcomings of each method from the imaging perspective. Finally, a set of recommendations is proposed to support future research.
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Affiliation(s)
- Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Louise Hogeboom
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Pavel Nikulin
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Evita Wiegers
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gwen Schroyen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Jesper Kallehauge
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marek Chmelík
- Department of Technical Disciplines in Medicine, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - Patricia Clement
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Ruben E Nechifor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Liviu-Andrei Fodor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Philip C De Witt Hamer
- Department of Neurosurgery, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Cyril Pernet
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Maarten Lequin
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Radim Jančálek
- St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Francesca B Pizzini
- Radiology, Deptartment of Diagnostic and Public Health, Verona University, Verona, Italy
| | - Kyrre E Emblem
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Vera C Keil
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Schroyen G, Vissers J, Smeets A, Gillebert CR, Lemiere J, Sunaert S, Deprez S, Sleurs C. Blood and neuroimaging biomarkers of cognitive sequelae in breast cancer patients throughout chemotherapy: A systematic review. Transl Oncol 2021; 16:101297. [PMID: 34896851 PMCID: PMC8681023 DOI: 10.1016/j.tranon.2021.101297] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/27/2022] Open
Abstract
Breast cancer treatment can induce alterations in blood- and neuroimaging-based markers. However, an overview of the predictive value of these markers for cognition is lacking for breast cancer survivors. This systematic review summarized studies of the last decade, using the PubMed database, evaluating blood markers, and the association between blood- or structural neuroimaging markers and cognition across the chemotherapy trajectory for primary breast cancer, following PRISMA guidelines. Forty-four studies were included. Differences were observed in all blood marker categories, from on-therapy until years post-chemotherapy. Associations were found between cognitive functioning and (1) blood markers (mainly inflammation-related) during, shortly-, or years post-chemotherapy and (2) white and gray matter metrics in frontal, temporal and parietal brain regions months up until years post-chemotherapy. Preliminary evidence exists for epigenetic and metabolic changes being associated with cognition, only after chemotherapy. This review demonstrated time-dependent associations between specific blood-based and structural neuroimaging markers with cognitive impairment in patients with breast cancer. Future studies are encouraged to include both neuroimaging- and blood markers (e.g. of neuronal integrity, epigenetics and metabolism) to predict long-term cognitive effects of chemotherapy.
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Affiliation(s)
- Gwen Schroyen
- Leuven Brain Institute, KU Leuven, Leuven, Belgium; Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
| | - Julie Vissers
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Ann Smeets
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Céline R Gillebert
- Leuven Brain Institute, KU Leuven, Leuven, Belgium; Department of Brain and Cognition, KU Leuven, Leuven 3000, Belgium
| | - Jurgen Lemiere
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Stefan Sunaert
- Leuven Brain Institute, KU Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; Radiology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Sabine Deprez
- Leuven Brain Institute, KU Leuven, Leuven, Belgium; Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- Leuven Brain Institute, KU Leuven, Leuven, Belgium; Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
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Spence H, McNeil CJ, Waiter GD. The impact of brain iron accumulation on cognition: A systematic review. PLoS One 2020; 15:e0240697. [PMID: 33057378 PMCID: PMC7561208 DOI: 10.1371/journal.pone.0240697] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/01/2020] [Indexed: 12/31/2022] Open
Abstract
Iron is involved in many processes in the brain including, myelin generation, mitochondrial function, synthesis of ATP and DNA and the cycling of neurotransmitters. Disruption of normal iron homeostasis can result in iron accumulation in the brain, which in turn can partake in interactions which amplify oxidative damage. The development of MRI techniques for quantifying brain iron has allowed for the characterisation of the impact that brain iron has on cognition and neurodegeneration. This review uses a systematic approach to collate and evaluate the current literature which explores the relationship between brain iron and cognition. The following databases were searched in keeping with a predetermined inclusion criterion: Embase Ovid, PubMed and PsychInfo (from inception to 31st March 2020). The included studies were assessed for study characteristics and quality and their results were extracted and summarised. This review identified 41 human studies of varying design, which statistically assessed the relationship between brain iron and cognition. The most consistently reported interactions were in the Caudate nuclei, where increasing iron correlated poorer memory and general cognitive performance in adulthood. There were also consistent reports of a correlation between increased Hippocampal and Thalamic iron and poorer memory performance, as well as, between iron in the Putamen and Globus Pallidus and general cognition. We conclude that there is consistent evidence that brain iron is detrimental to cognitive health, however, more longitudinal studies will be required to fully understand this relationship and to determine whether iron occurs as a primary cause or secondary effect of cognitive decline.
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Affiliation(s)
- Holly Spence
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
- * E-mail:
| | - Chris J. McNeil
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
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Systematic review of cognitive sequelae of non-central nervous system cancer and cancer therapy. J Cancer Surviv 2020; 14:464-482. [PMID: 32146576 DOI: 10.1007/s11764-020-00870-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this review is to provide an updated overview of chemotherapy-related cognitive impairment (CRCI) in patients with cancer outside central nervous system (CNS), its incidence and prevalence, the cognitive pattern in neuropsychological studies, neuroimaging findings, and the relationship between chemobrain and aging. Methodological limitations of studies are also discussed. METHODS This review was guided by the PRISMA statement. The MEDLINE and Scopus databases were employed to search articles about CRCI in non-CNS cancer patients published from January 2004 to September 2019. Two types of research were reviewed: prospective studies addressing the effects of chemotherapy on cognition and systematic reviews about factors related with CRCI, also as neuroimaging findings and current available treatments. RESULTS Fifty-nine studies meeting the criteria were analyzed: 47 were longitudinal studies on cancer and cognition and 12 were reviews on risk factors, neuroimaging, and treatment. The majority of studies find cognitive impairment in patients with cancer treated with chemotherapy. The body of the literature on breast cancer is the most abundant, but there are also studies on colorectal, testicular, and lung cancer. Neuroimaging studies show changes in structure and activation in patients undergoing chemotherapy. Non-pharmacological treatment is effective for improving cognition and quality of life. CONCLUSIONS The occurrence of CRCI during the course of treatment in people with different types of cancer is frequent. Some risk factors have been identified, but CRCI is a complex phenomenon, with mediating factors related to cancer and treatment and moderating factors related with lifestyle and health. IMPLICATIONS FOR CANCER SURVIVORS This review highlights the importance of recognizing that this cognitive dysfunction is frequent, mild to moderate in nature but with great impact on quality of life.
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Chen BT, Ye N, Wong CW, Patel SK, Jin T, Sun CL, Rockne RC, Kim H, Root JC, Saykin AJ, Ahles TA, Holodny AI, Prakash N, Mortimer J, Sedrak MS, Waisman J, Yuan Y, Li D, Vazquez J, Katheria V, Dale W. Effects of chemotherapy on aging white matter microstructure: A longitudinal diffusion tensor imaging study. J Geriatr Oncol 2019; 11:290-296. [PMID: 31685415 DOI: 10.1016/j.jgo.2019.09.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/20/2019] [Accepted: 09/25/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We aimed to use diffusion tensor imaging (DTI) to detect alterations in white matter microstructure in older patients with breast cancer receiving chemotherapy. METHODS We recruited women age ≥60 years with stage I-III breast cancer (chemotherapy [CT] group; n = 19) to undergo two study assessments: at baseline and within one month after chemotherapy. Each assessment consisted of a brain magnetic resonance imaging scan with DTI and neuropsychological (NP) testing using the National Institutes of Health (NIH) Toolbox Cognition Battery. An age- and sex-matched group of healthy controls (HC, n = 14) underwent the same assessments at matched intervals. Four DTI parameters (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], and radial diffusivity [RD]) were calculated and correlated with NP testing scores. RESULTS For CT group but not HCs, we detected statistically significant increases in MD and RD in the genu of the corpus callosum from time point 1 to time point 2 at p < 0.01, effect size:0.3655 and 0.3173, and 95% confidence interval: from 0.1490 to 0.5821, and from 0.1554 to 0.4792, for MD and RD respectively. AD values increased for the CT group and decreased for the HC group over time, resulting in significant between-group differences (p = 0.0056, effect size:1.0215, 95% confidence interval: from 0.2773 to 1.7657). There were no significant correlations between DTI parameters and NP scores (p > 0.05). CONCLUSIONS We identified alterations in white matter microstructures in older women with breast cancer undergoing chemotherapy. These findings may potentially serve as neuroimaging biomarkers for identifying cognitive impairment in older adults with cancer.
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Affiliation(s)
- Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA 91010, United States; Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Ningrong Ye
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Chi Wah Wong
- Center for Informatics, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Sunita K Patel
- Department of Population Science, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Taihao Jin
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Can-Lan Sun
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Russell C Rockne
- Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Heeyoung Kim
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - James C Root
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
| | - Andrew J Saykin
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Tim A Ahles
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States.
| | - Neal Prakash
- Division of Neurology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Joanne Mortimer
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Mina S Sedrak
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - James Waisman
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Yuan Yuan
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Daneng Li
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Jessica Vazquez
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - Vani Katheria
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States.
| | - William Dale
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA 91010, United States; Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA 91010, United States.
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Chen BT, Jin T, Patel SK, Ye N, Ma H, Wong CW, Rockne RC, Root JC, Saykin AJ, Ahles TA, Holodny AI, Prakash N, Mortimer J, Waisman J, Yuan Y, Li D, Sedrak MS, Vazquez J, Katheria V, Dale W. Intrinsic brain activity changes associated with adjuvant chemotherapy in older women with breast cancer: a pilot longitudinal study. Breast Cancer Res Treat 2019; 176:181-189. [PMID: 30989462 DOI: 10.1007/s10549-019-05230-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/09/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE Older cancer patients are at increased risk of cancer-related cognitive impairment. The purpose of this study was to assess the alterations in intrinsic brain activity associated with adjuvant chemotherapy in older women with breast cancer. METHODS Chemotherapy treatment (CT) group included sixteen women aged ≥ 60 years (range 60-82 years) with stage I-III breast cancers, who underwent both resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological testing with NIH Toolbox for Cognition before adjuvant chemotherapy, at time point 1 (TP1), and again within 1 month after completing chemotherapy, at time point 2 (TP2). Fourteen age- and sex-matched healthy controls (HC) underwent the same assessments at matched intervals. Three voxel-wise rs-fMRI parameters: amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity, were computed at each time point. The changes in rs-fMRI parameters from TP1 to TP2 for each group, the group differences in changes (the CT group vs. the HC group), and the group difference in the baseline rs-fMRI parameters were assessed. In addition, correlative analysis between the rs-fMRI parameters and neuropsychological testing scores was also performed. RESULTS In the CT group, one brain region, which included parts of the bilateral subcallosal gyri and right anterior cingulate gyrus, displayed increased ALFF from TP1 to TP2 (cluster p-corrected = 0.024); another brain region in the left precuneus displayed decreased fALFF from TP1 to TP2 (cluster level p-corrected = 0.025). No significant changes in the rs-fMRI parameters from TP1 to TP2 were observed in the HC group. Although ALFF and fALFF alterations were observed only in the CT group, none of the between-group differences in rs-fMRI parameter changes reached statistical significance. CONCLUSIONS Our study results of ALFF and fALFF alterations in the chemotherapy-treated women suggest that adjuvant chemotherapy may affect intrinsic brain activity in older women with breast cancer.
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Affiliation(s)
- Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA.
| | - Taihao Jin
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Sunita K Patel
- Department of Population Science, City of Hope National Medical Center, Duarte, CA, USA
| | - Ningrong Ye
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Huiyan Ma
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA
| | - Chi Wah Wong
- Center for Informatics, City of Hope National Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - James C Root
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Saykin
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tim A Ahles
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Neal Prakash
- Division of Neurology, City of Hope National Medical Center, Duarte, CA, USA
| | - Joanne Mortimer
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - James Waisman
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Yuan Yuan
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Daneng Li
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Mina S Sedrak
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Jessica Vazquez
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA
| | - Vani Katheria
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA
| | - William Dale
- Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA
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