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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.
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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.
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Melara RD, Root JC, Edelman JA, Estelle MC, Mohr I, Ahles TA. Effects of Breast Cancer Treatment on Neural Noise: a Longitudinal Design. Arch Clin Neuropsychol 2024:acae066. [PMID: 39197121 DOI: 10.1093/arclin/acae066] [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: 01/07/2024] [Revised: 07/08/2024] [Accepted: 08/09/2024] [Indexed: 08/30/2024] Open
Abstract
OBJECTIVE Cognitive dysfunction has been observed consistently in a subset of breast cancer survivors. Yet the precise neurophysiological origins of cancer-related cognitive decline remain unknown. The current study assessed neural noise (1/f activity in electroencephalogram [EEG]) in breast cancer survivors as a potential contributor to observed cognitive dysfunction from pre- to post-treatment. METHODS We measured EEG in a longitudinal design during performance of the paired-click task and the revised Attention Network Test (ANT-R) to investigate pre- versus post-treatment effects of neural noise in breast cancer patients (n = 20 in paired click; n = 19 in ANT-R) compared with healthy controls (n = 32 in paired click; n = 29 in ANT-R). RESULTS In both paradigms, one sensory (paired click) and one cognitive (ANT-R), we found that neural noise was significantly elevated after treatment in patients, remaining constant from pretest to posttest in controls. In the ANT-R, patients responded more slowly than controls on invalid cuing trials. Increased neural noise was associated with poorer alerting and poorer inhibitory control of attention (as measured by behavioral network scores), particularly for patients after treatment. CONCLUSIONS The current study is the first to show a deleterious effect of breast cancer and/or cancer treatment on neural noise, pointing to alterations in the relative balance of excitatory and inhibitory synaptic inputs, while also suggesting promising approaches for cognitive rehabilitation.
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Affiliation(s)
- Robert D Melara
- Department of Psychology, The City College, City University of New York, 160 Convent Avenue, NAC 7-120, New York, NY 10031, USA
| | - James C Root
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7th Floor, New York, New York 10022, USA
| | - Jay A Edelman
- Department of Biology, The City College, City University of New York, 160 Convent Avenue, MR 526, New York, NY 10031, USA
| | - Maria Camilla Estelle
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7th Floor, New York, New York 10022, USA
| | - Isabella Mohr
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7th Floor, New York, New York 10022, USA
| | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7th Floor, New York, New York 10022, USA
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Wang LY, Hu SL, Yao ZF, Xue M, Lu ZQ, Xiao-ju Z, Ding Y. Correlation between cancer-related cognitive impairment and resting cerebral glucose metabolism in patients with ovarian cancer. Heliyon 2024; 10:e34106. [PMID: 39113970 PMCID: PMC11305194 DOI: 10.1016/j.heliyon.2024.e34106] [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: 10/09/2023] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
Background An increasing number of research have applied neuroimaging techniques to explore the potential neurobiological mechanism of Cancer-related cognitive impairment (CRCI). Purpose To explore the correlation between resting brain glucose metabolism and CRCI using 18F-FDG PET/CT in ovarian cancer (OC) patients. Methods From December 2021 to March 2022, 38 patients with OC were selected as the study group, and 38 healthy women of the same age (±1 year) who underwent routine physical examination using PET/CT were selected as the control group. Patients received further assessment with the Montreal Cognitive Assessment Scale (MoCA) and Perceived Deficit Questionnaire (PDQ). Independent sample t-test and Spearman correlation were conducted for data analysis. Results The resting brain glucose metabolism in the OC group was significantly lower than in the healthy controls. 60.52 % patients had neuropsychological impairment and retrospective memory were the most serious perceived cognitive impairments. The resting brain glucose metabolism in OC patients did not significantly correlate with neuropsychological performance but had significant positive correlation with subjective cognitive evaluation. Discussion Resting glucose metabolism was low in OC patients and associated with subjective cognitive impairment but not objective neuropsychological test results. 18F-FDG PET/CT can be used to evaluate brain function in OC patients and provide reliable imaging indicators for early recognition of and intervention for changes in cognitive function.
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Affiliation(s)
- Li-ying Wang
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- School of Nursing, Fudan University, Shanghai, 200032, China
| | - Si-long Hu
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhi-feng Yao
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Mei Xue
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhen-qi Lu
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhang Xiao-ju
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yan Ding
- Department of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, 200090, China
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Jiménez Urrego ÁM, Santa V, Guerrero Gómez MJ, Guerrero Benitez AC, Romo-González T, Botero Carvajal A. Performance of the Wisconsin Card Sorting Test in Oncopediatric Patients in an Oncology Unit in Cali, Colombia: A Cross-Sectional Observational Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:850. [PMID: 39062299 PMCID: PMC11275006 DOI: 10.3390/children11070850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND In 2020, the prevalence of cancer rose to 844,778 cases among the population aged 0-19 years. Approximately 90% of individuals under 18 years of age reside in low- and middle-income countries, where cancer survivors report adverse outcomes that negatively impact their general health, emotional state, and external factors such as academic performance due to the effect of these outcomes on executive functions. The Wisconsin Cart Sorting Test (WCST) is the gold standard for evaluating executive functioning. Therefore, this article (1) reports the performance of the Wisconsin Card Sorting Test (WCST) in oncopediatric patients from Cali, Colombia; (2) indicates the reliability of the WCST; (3) describes the association between cancer type and executive functioning in patients; (4) describes the differences between patients with various executive deficits and their executive total scores; and (5) describes the association between cancer type and the presence of brain deficits based on the WCST. METHODS In this cross-sectional observational study, 24 oncopediatric patients were interviewed and evaluated via the WCST. RESULTS The mean age was 12.08 years (SD 3.98); 20.8% of the patients were women, 70.8% had a primary diagnosis of leukemia, 8% exhibited acquired brain deficits, and more than 75% displayed adequate functional indicators of executive functions. Robust statistics were employed to explore the differences between the types of diagnosis and performance in executive functions, and no statistically significant differences were found (p = 0.156). We found that the WCST has a reliable Cronbach's α of 0.804. Oncopediatric patients without brain deficits presented strong results in terms of executive functions (p = 0.002), with a moderate effect size (0.727). CONCLUSIONS The WCST is reliable for discriminating executive functioning among pediatric cancer patients. The evidence suggests that there were no differences in the executive functioning of the participants based on the types of cancer being evaluated.
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Affiliation(s)
| | - Valeria Santa
- Department of Psychology, Universidad de San Buenaventura de Cali, Cali 760036, Colombia; (V.S.); (M.J.G.G.)
| | - Manuel José Guerrero Gómez
- Department of Psychology, Universidad de San Buenaventura de Cali, Cali 760036, Colombia; (V.S.); (M.J.G.G.)
| | | | - Tania Romo-González
- Institute of Biological Research, Universidad Veracruzana, Xalapa 91190, Mexico;
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Merceur M, Reilly KT, Bonan I, Holé J, Hummel E, Cogné M, Jacquin-Courtois S. A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times? Ann Phys Rehabil Med 2024; 67:101832. [PMID: 38537525 DOI: 10.1016/j.rehab.2024.101832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 12/04/2023] [Accepted: 02/10/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND "Cancer Related Cognitive Impairment" (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway. METHODS We conducted a systematic literature review following the PRISMA guidelines from 01 to 01-2019 to 16-07-2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome. RESULTS Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies). CONCLUSION CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation. DATABASE REGISTRATION The review was recorded on Prospero (01-03-2020), with the registration number 135,627.
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Affiliation(s)
- Marianne Merceur
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France.
| | - Karen T Reilly
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France
| | - Isabelle Bonan
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - Julie Holé
- Physical Medicine and Rehabilitation Department, Henry Gabrielle Hospital, Hospices Civils de Lyon, 20 route de Vourles, 69230 Saint Genis Laval, France
| | - Emilie Hummel
- Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
| | - Mélanie Cogné
- Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France
| | - Sophie Jacquin-Courtois
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France; Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
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Mulholland MM, Stuifbergen A, De La Torre Schutz A, Franco Rocha OY, Blayney DW, Kesler SR. Evidence of compensatory neural hyperactivity in a subgroup of chemotherapy-treated breast cancer survivors and its association with brain aging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.22.24306190. [PMID: 38712178 PMCID: PMC11071584 DOI: 10.1101/2024.04.22.24306190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Chemotherapy-related cognitive impairment (CRCI) remains poorly understood in terms of the mechanisms of cognitive decline. Neural hyperactivity has been reported on average in cancer survivors, but it is unclear which patients demonstrate this neurophenotype, limiting precision medicine in this population. We evaluated a retrospective sample of 80 breast cancer survivors and 80 non-cancer controls, age 35-73, for which we had previously identified and validated three data-driven, biological subgroups (biotypes) of CRCI. We measured neural activity using the z-normalized percent amplitude of fluctuation from resting state functional magnetic resonance imaging (MRI). We tested established, quantitative criteria to determine if hyperactivity can accurately be considered compensatory. We also calculated brain age gap by applying a previously validated algorithm to anatomic MRI. We found that neural activity differed across the three CRCI biotypes and controls (F = 13.5, p < 0.001), with Biotype 2 demonstrating significant hyperactivity compared to the other groups (p < 0.004, corrected), primarily in prefrontal regions. Alternatively, Biotypes 1 and 3 demonstrated significant hypoactivity (p < 0.02, corrected). Hyperactivity in Biotype 2 met several of the criteria to be considered compensatory. However, we also found a positive relationship between neural activity and brain age gap in these patients (r = 0.45, p = 0.042). Our results indicated that neural hyperactivity is specific to a subgroup of breast cancer survivors and, while it seems to support preserved cognitive function, it could also increase the risk of accelerated brain aging. These findings could inform future neuromodulatory interventions with respect to the risks and benefits of up or downregulation of neural activity.
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Affiliation(s)
- Michele M Mulholland
- Department of Comparative Medicine, The University of Texas MD Anderson Cancer Center, Bastrop, TX, USA
| | - Alexa Stuifbergen
- Division of Adult Health, School of Nursing, University of Texas at Austin, Austin, TX, USA
| | | | - Oscar Y Franco Rocha
- Division of Adult Health, School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Douglas W Blayney
- Department of Medical Oncology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Shelli R Kesler
- Division of Adult Health, School of Nursing, University of Texas at Austin, Austin, TX, USA
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Gaynor AM, Ahsan A, Jung D, Schofield E, Li Y, Ryan E, Ahles TA, Root JC. Novel computerized neurocognitive test battery is sensitive to cancer-related cognitive deficits in survivors. J Cancer Surviv 2024; 18:466-478. [PMID: 35939254 PMCID: PMC11274167 DOI: 10.1007/s11764-022-01232-w] [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: 03/23/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE There is increasing interest in developing new methods to improve sensitivity in detecting subtle cognitive deficits associated with cancer and its treatments. The current study aimed to evaluate the ability of a novel computerized battery of cognitive neuroscience-based tests to discriminate between cognitive performance in breast cancer survivors and controls. METHODS Breast cancer survivors (N = 174) and age-matched non-cancer controls (N = 183) completed the Enformia Cogsuite Battery of cognitive assessments, comprised of 7 computerized tests of multiple cognitive domains. Primary outcome measures included accuracy, reaction times (RT), and coefficients of variation (CV) for each task, as well as global scores of accuracy, RT, and CV aggregated across tests. RESULTS Linear regressions adjusting for age, education, and remote vs. in-office administration showed that compared to non-cancer controls, survivors had significantly lower performance on measures of attention, executive function, working memory, verbal ability, visuospatial ability, and motor function. Survivors had significantly greater CV on measures of attention, working memory, and processing speed, and significantly slower RT on measures of verbal fluency. CONCLUSIONS The Cogsuite battery demonstrates sensitivity to cancer-related cognitive dysfunction across multiple domains, and is capable of identifying specific cognitive processes that may be affected in survivors. IMPLICATIONS FOR CANCER SURVIVORS The sensitivity of these tasks to subtle cognitive deficits has advantages for initial diagnosis of cancer-related cognitive dysfunction, as well as detecting changes in survivors' cognitive function over time. The remote delivery of the battery may help overcome barriers associated with in-office administration and increase access to neurocognitive evaluation.
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Affiliation(s)
- Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA.
- Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA.
| | - Anam Ahsan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | | | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
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Tometich DB, Welniak T, Gudenkauf L, Maconi ML, Fulton HJ, Martinez Tyson D, Zambrano K, Hasan S, Rodriguez Y, Bryant C, Li X, Reed DR, Oswald LB, Galligan A, Small BJ, Jim HSL. "I couldn't connect the wires in my brain." Young adult cancer survivors' experience with cognitive functioning. Psychooncology 2024; 33:e6309. [PMID: 38420860 PMCID: PMC11249037 DOI: 10.1002/pon.6309] [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: 10/17/2023] [Revised: 01/20/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE There is a dearth of literature describing young adult (YA) cancer survivors' experiences with cancer-related cognitive impairment (CRCI). We aimed to elucidate CRCI among YA cancer survivors and identify potentially modifiable risk factors. METHODS We conducted individual qualitative interviews with YA cancer survivors aged 18-30 years at study enrollment and used applied thematic analysis to identify themes across three topics (i.e., affected cognitive abilities, risk and protective factors influencing the impact of CRCI, and strategies for coping with CRCI). RESULTS YA cancer survivors (N = 20) were, on average, 23 years old at diagnosis and 26 years old when interviewed. Diverse cancer types and treatments were represented; most participants (85%) had completed cancer treatment. Participants described experiences across three qualitative topics: (1) affected cognitive abilities (i.e., concentration and attention, prospective memory, and long-term memory), (2) Risk factors (i.e., fatigue, sleep problems, mood, stress/distractions, and social isolation) and protective factors (i.e., social support), and (3) coping strategies, including practical strategies that helped build self-efficacy (e.g., writing things down, reducing distractions), beneficial emotion-focused coping strategies (e.g., focus on health, faith/religion), strategies with mixed effects (i.e., apps/games, medications/supplements, and yoga), and "powering through" strategies that exacerbated stress. CONCLUSIONS YA cancer survivors experience enduring cognitive difficulties after treatment. Specific concerns highlight the importance of attention and executive functioning impairments, long-term memory recall, and sensitivity to distractions. Future work is needed to improve assessment and treatment of CRCI among YA cancer survivors.
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Affiliation(s)
- Danielle B Tometich
- Moffitt Cancer Center, Tampa, Florida, USA
- University of South Florida, Tampa, Florida, USA
| | | | | | | | | | | | | | - Syed Hasan
- Moffitt Cancer Center, Tampa, Florida, USA
| | | | | | - Xiaoyin Li
- Moffitt Cancer Center, Tampa, Florida, USA
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Chen VCH, Chuang W, Tsai YH, McIntyre RS, Weng JC. Longitudinal assessment of chemotherapy-induced brain connectivity changes in cerebral white matter and its correlation with cognitive functioning using the GQI. Front Neurol 2024; 15:1332984. [PMID: 38385045 PMCID: PMC10879440 DOI: 10.3389/fneur.2024.1332984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Objective Breast cancer was the most prevalent type of cancer and had the highest incidence rate among women worldwide. The wide use of adjuvant chemotherapy might have a detrimental effect on the human brain and result in chemotherapy-related cognitive impairment (CICI) among breast cancer patients. Furthermore, prior to chemotherapy, patients reported cancer-related cognitive impairment (CRCI), which might be due to physiological factors or mood symptoms. The present longitudinal study aimed to investigate microstructural and macroscale white matter alterations by generalized q-sampling imaging (GQI). Methods The participants were categorized into a pre-chemotherapy group (BB) if they were diagnosed with primary breast cancer and an age-matched noncancer control group (HC). Some participants returned for follow-up assessment. In the present follow up study, 28 matched pairs of BB/BBF (follow up after chemotherapy) individuals and 28 matched pairs of HC/HCF (follow up) individuals were included. We then used GQI and graph theoretical analysis (GTA) to detect microstructural alterations in the whole brain. In addition, we evaluated the relationship between longitudinal changes in GQI indices and neuropsychological tests as well as psychiatric comorbidity. Findings The results showed that disruption of white matter integrity occurred in the default mode network (DMN) of patients after chemotherapy, such as in the corpus callosum (CC) and middle frontal gyrus (MFG). Furthermore, weaker connections between brain regions and lower segregation ability were observed in the post-chemotherapy group. Significant correlations were observed between neuropsychological tests and white matter tracts of the CC, MFG, posterior limb of the internal capsule (PLIC) and superior longitudinal fasciculus (SLF). Conclusion The results provided evidence of white matter alterations in breast cancer patients, and they may serve as potential imaging markers of cognitive changes. In the future, the study may be beneficial to create and evaluate strategies designed to maintain or improve cognitive function in breast cancer patients undergoing chemotherapy.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wei Chuang
- Department of Medical Imaging and Radiological Sciences, and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Roger S. McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Medical Imaging and Radiological Sciences, and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
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10
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Amani O, Mazaheri MA, Moghani MM, Zarani F, Choolabi RH. Chemotherapy-induced cognitive impairment in breast cancer survivors: A systematic review of studies from 2000 to 2021. Cancer Rep (Hoboken) 2024; 7:e1989. [PMID: 38351543 PMCID: PMC10864736 DOI: 10.1002/cnr2.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/27/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Studies have indicated that apart from enhancing patient survival, chemotherapy has adverse side effects on the psychological, social, and cognitive functions of breast cancer survivors. AIMS This study was conducted to understand chemotherapy's impact on breast cancer survivors' cognitive functions. METHODS AND RESULTS Our study is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched English databases, including PubMed/MEDLINE, PsycINFO, and Web of Science, and Persian databases, such as Irandoc and Elmnet, using Persian keywords of cancer, breast cancer, chemotherapy, cognitive functions, executive functions, and neuropsychological functions. Two reviewers independently evaluated the full text of the articles according to predefined criteria. Among the 937 available studies, 26 were selected based on the inclusion and exclusion criteria, of which 17 (65%) were longitudinal and 9 (35%) were cross-sectional. The findings indicated a significant relationship between the use of chemotherapy and cognitive impairments, most notably attention, working and short-term memory, and executive functions. However, the studies differed in their findings regarding the long-term persistence of cancer-related cognitive impairment (CRCI), which could be due to the wide range of tools used, different methods to measure cognitive functions, and the difference in the sample size of the studies. CONCLUSION Chemotherapy, affecting cortical and subcortical brain structures, causes a set of cognitive impairments that can lead to impairments in social responsibility acceptance, daily functioning, and quality of life of women. Therefore, rigorous and extensive research design is required to understand the causes and consequences of CRCI using standardized and sensitive measures of cognitive functions. Specifically, studies comparing the effects of different chemotherapy regimens on cognition and potential mechanisms and/or moderators of CRCI would be instrumental in designing more effective therapy regimens and evaluating the efficacy and cost-effectiveness of cognitive rehabilitation and supportive care programs.
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Affiliation(s)
- Omid Amani
- Department of PsychologyShahid Beheshti UniversityTehranIran
| | | | | | - Fariba Zarani
- Department of PsychologyShahid Beheshti UniversityTehranIran
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11
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Daniel E, Deng F, Patel SK, Sedrak MS, Kim H, Razavi M, Sun C, Root JC, Ahles TA, Dale W, Chen BT. Brain white matter microstructural changes in chemotherapy-treated older long-term breast cancer survivors. Cancer Med 2024; 13:e6881. [PMID: 38152038 PMCID: PMC10807556 DOI: 10.1002/cam4.6881] [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: 07/06/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023] Open
Abstract
PURPOSE To assess white matter microstructural changes in older long-term breast cancer survivors 5-15 years post-chemotherapy treatment. METHODS Breast cancer survivors aged 65 years or older who underwent chemotherapy (C+) and who did not undergo chemotherapy (C-) and age- and sex-matched healthy controls (HC) were enrolled at time point 1 (TP1) and followed for 2 years for time point 2 (TP2). All participants underwent brain MRI with diffusion tensor images and neuropsychological (NP) testing with the NIH Toolbox Cognition Battery. Tract-based spatial statistics (TBSS) analysis was performed on the diffusion tensor images to assess white matter microstructural changes with the fractional anisotropy (FA) parameter. RESULTS There were significant longitudinal alterations in FA within the C+ group over time. The C+ group showed diminished FA in the body and genu of corpus callosum, anterior corona radiate, and external capsule on both the whole brain and region of interest (ROI) based analyses after p < 0.05 family-wise error (FWE) correction. However, there were no significant group differences between the groups at TP1. Additionally, at TP1, a positive correlation (R = 0.58, p = 0.04) was observed between the FA value of the anterior corona radiata and the crystallized composite score in the C+ group. CONCLUSIONS Brain white matter microstructural alterations may be the underlying neural correlates of cognitive changes in older breast cancer survivors who had chemotherapy treatment years ago.
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Affiliation(s)
- Ebenezer Daniel
- Department of Diagnostic RadiologyCity of Hope National Medical CenterDuarteCAUSA
| | - Frank Deng
- Department of Diagnostic RadiologyCity of Hope National Medical CenterDuarteCAUSA
| | - Sunita K. Patel
- Department of Population ScienceCity of Hope National Medical CenterDuarteCAUSA
| | - Mina S. Sedrak
- Department of Medical OncologyCity of Hope National Medical CenterDuarteCAUSA
| | - Heeyoung Kim
- Center for Cancer and AgingCity of Hope National Medical CenterDuarteCAUSA
| | - Marianne Razavi
- Department of Supportive Care MedicineCity of Hope National Medical CenterDuarteCAUSA
| | - Can‐Lan Sun
- Center for Cancer and AgingCity of Hope National Medical CenterDuarteCAUSA
| | - James C. Root
- Neurocognitive Research LabMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - Tim A. Ahles
- Neurocognitive Research LabMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - William Dale
- Center for Cancer and AgingCity of Hope National Medical CenterDuarteCAUSA
- Department of Supportive Care MedicineCity of Hope National Medical CenterDuarteCAUSA
| | - Bihong T. Chen
- Department of Diagnostic RadiologyCity of Hope National Medical CenterDuarteCAUSA
- Center for Cancer and AgingCity of Hope National Medical CenterDuarteCAUSA
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12
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Hu Y, Yu H, Lai Y, Liu J, Tan Y, Lei W, Zhang J, Zhou X, Cao Y, Tang Y, Liu D, Zhang J. Longitudinal trajectory of amplitude of low-frequency fluctuation changes in breast cancer patients during neoadjuvant chemotherapy-A preliminary prospective study. Brain Res Bull 2024; 206:110845. [PMID: 38101650 DOI: 10.1016/j.brainresbull.2023.110845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
There is growing evidence that the amplitude of low-frequency fluctuation (ALFF) changes in breast cancer patients after chemotherapy. However, longitudinal changes in ALFF during chemotherapy are unclear. To assess the trajectory of ALFF changes during chemotherapy, 36 breast cancer patients underwent both resting-state functional magnetic resonance imaging and neuropsychological testing at three time points, including before neoadjuvant chemotherapy (NAC) (time point 0, TP0), after one cycle of NAC (before the second cycle of NAC, TP1), and upon completion of NAC (pre-operation, TP2). Healthy controls (HC) received the same assessments at matching time points. We compared the longitudinal changes of ALFF in the NAC and two HC groups. In the NAC group, compared with TP0, ALFF values in the right orbital part of the inferior frontal gyrus, left medial orbital part of the superior frontal gyrus, right insula, left medial part of the superior frontal gyrus, and right middle frontal gyrus declined significantly at TP1 and TP2. Compared with TP1, there were no significant changes in ALFF values at TP2. In the two HC groups, there were no significant changes in ALFF at corresponding intervals. We concluded that for breast cancer patients receiving NAC, ALFF values declined significantly in some brain regions after one cycle of NAC and then remained stable until the completion of NAC, and most of the brain regions with ALFF changes were located in the frontal lobe.
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Affiliation(s)
- Yixin Hu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Hong Yu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yong Lai
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiang Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Weiwei Lei
- Department of Intensive Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jing Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaoyu Zhou
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Ying Cao
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yu Tang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China.
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China.
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13
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Chen D, Mackenzie L, Hossain SZ, Wang JX, Jiang PL, Wang Y, Qin L, Zhen J, Jia J. Cognitive impairment experienced by Chinese breast cancer survivors. Sci Rep 2023; 13:22245. [PMID: 38097726 PMCID: PMC10721869 DOI: 10.1038/s41598-023-49524-0] [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: 03/01/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
To identify cognitive function in Chinese breast cancer survivors. Research questions were: is cognitive function was associated with breast cancer and/or chemotherapy treatment and/or psychological functioning:? and did women with breast cancer experience more cognitive and psychological issues than age-matched women without cancer? Breast cancer survivors with chemotherapy (n = 106, mean age = 50.2 ± 9.5), breast cancer survivors without chemotherapy (n = 100, mean age = 50.5 ± 10.0) and matched healthy controls (n = 96, mean age = 47.9 ± 9.1) completed a battery of cognitive and psychosocial functioning. Demographic characteristics were also collected. The Perceived Cognitive Impairment score for cancer groups was significantly higher than for the healthy group (p = 0.04), but not between the cancer groups. Processing speed was significantly slower in the cancer groups than in the healthy group (both p < 0.001), but not between the cancer groups. Age, living status and education were significantly associated with the FACT-Cog (all p < 0.05). The correlations between the FACT-Cog score and BSI score were strong (r = 0.60 p < 0.01), and between the HADS anxiety and depression scales were strong (r = 0.53 and 0.50, p < 0.01) but correlations were weaker between performance based cognitive tests and measures of psychological functioning. Breast cancer groups indicated more cognitive impairment and reduced psychological functioning compared to the healthy group. However, there was no differences between the breast cancer groups. Chinese breast cancer survivors experienced excess cognitive impairment not associated with usual ageing. Assessment and intervention to address cognitive impairment should be made available to breast cancer survivors.
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Affiliation(s)
- Dan Chen
- Department of Rehabilitation Medicine, Jing'an District Central Hospital of Shanghai, Shanghai, China
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Syeda Zakia Hossain
- Discipline of Behavioural Sciences, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Jing-Xin Wang
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ping-Lan Jiang
- Department of Breast Surgery, Xiangya Hospital of Central South University, Changsha, China
| | - Yuanxiao Wang
- Department of Breast Surgery, Yunnan Cancer Hospital, Yunnan, China
| | - Lanhui Qin
- Department of Rehabilitation, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jun Zhen
- Department of Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Jing'an District Central Hospital of Shanghai, Shanghai, China
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China
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14
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Rodrigues PFS, Bártolo A, Albuquerque PB. Memory Impairments and Wellbeing in Breast Cancer Patients: A Systematic Review. J Clin Med 2023; 12:6968. [PMID: 38002583 PMCID: PMC10672522 DOI: 10.3390/jcm12226968] [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: 09/04/2023] [Revised: 09/30/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer is one of the most diagnosed cancers among women. Its effects on the cognitive and wellbeing domains have been widely reported in the literature, although with inconsistent results. The central goal of this review was to identify, in women with breast cancer, the main memory impairments, as measured by objective and subjective tools and their relationship with wellbeing outcomes. The systematic literature search was conducted in the PubMed, Scopus, and ProQuest databases. The selected studies included 9 longitudinal and 10 cross-sectional studies. Although some studies included participants undergoing multimodal cancer therapies, most focused on chemotherapy's effects (57.89%; n = 11). The pattern of results was mixed. However, studies suggested more consistently working memory deficits in breast cancer patients undergoing chemotherapy. In addition, some associations have been identified between objective memory outcomes (verbal memory) and wellbeing indicators, particularly depression and anxiety. The inconsistencies in the results could be justified by the heterogeneity of the research designs, objective and subjective measures, and sample characteristics. This review confirms that more empirical evidence is needed to understand memory impairments in women with breast cancer. An effort to increase the homogeneity of study methods should be made in future studies.
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Affiliation(s)
- Pedro F. S. Rodrigues
- I2P—Portucalense Institute for Psychology, Portucalense University, 4200-072 Porto, Portugal;
| | - Ana Bártolo
- I2P—Portucalense Institute for Psychology, Portucalense University, 4200-072 Porto, Portugal;
| | - Pedro B. Albuquerque
- CIPsi—Psychology Research Centre, School of Psychology, University of Minho, 4710-057 Braga, Portugal;
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15
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Torre M, Bukhari H, Nithianandam V, Zanella CA, Mata DA, Feany MB. A Drosophila model relevant to chemotherapy-related cognitive impairment. Sci Rep 2023; 13:19290. [PMID: 37935827 PMCID: PMC10630312 DOI: 10.1038/s41598-023-46616-9] [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: 06/23/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023] Open
Abstract
Chemotherapy-related cognitive impairment (CRCI) is a common adverse effect of treatment and is characterized by deficits involving multiple cognitive domains including memory. Despite the significant morbidity of CRCI and the expected increase in cancer survivors over the coming decades, the pathophysiology of CRCI remains incompletely understood, highlighting the need for new model systems to study CRCI. Given the powerful array of genetic approaches and facile high throughput screening ability in Drosophila, our goal was to validate a Drosophila model relevant to CRCI. We administered the chemotherapeutic agents cisplatin, cyclophosphamide, and doxorubicin to adult Drosophila. Neurologic deficits were observed with all tested chemotherapies, with doxorubicin and in particular cisplatin also resulting in memory deficits. We then performed histologic and immunohistochemical analysis of cisplatin-treated Drosophila tissue, demonstrating neuropathologic evidence of increased neurodegeneration, DNA damage, and oxidative stress. Thus, our Drosophila model relevant to CRCI recapitulates clinical, radiologic, and histologic alterations reported in chemotherapy patients. Our new Drosophila model can be used for mechanistic dissection of pathways contributing to CRCI (and chemotherapy-induced neurotoxicity more generally) and pharmacologic screens to identify disease-modifying therapies.
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Affiliation(s)
- Matthew Torre
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Hassan Bukhari
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Vanitha Nithianandam
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Camila A Zanella
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | | | - Mel B Feany
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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16
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Melis M, Blommaert J, Van der Gucht K, Smeets A, McDonald BC, Sunaert S, Smith A, Deprez S. The impact of mindfulness on working memory-related brain activation in breast cancer survivors with cognitive complaints. J Cancer Surviv 2023:10.1007/s11764-023-01484-0. [PMID: 37922071 DOI: 10.1007/s11764-023-01484-0] [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: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) has been associated with altered brain activation after chemotherapy in areas related to working memory. Hence, improving working memory capacity and associated brain activation might aid in the recovery of CRCI. In this study, we investigated the potential of a mindfulness-based intervention (MBI) to impact working memory-related brain activation. METHODS Female breast cancer survivors reporting cognitive complaints (N=117) were randomized into a mindfulness (n=43; MBI), physical training (n=36; PT), or waitlist control condition (n=38; WL). Participants completed MRI scans before the intervention, immediately after, and three months post-intervention. Task-based functional MRI was used to measure differences between groups over time in working memory-related brain activation while performing a visual-verbal n-back task. RESULTS Data of 83 participants (32/26/25 MBI/PT/WL) was included. Compared to the waitlist group, MBI participants showed reduced task-related activation in the right middle frontal and angular gyrus and increased activation in the right dorsal posterior cingulate cortex over time. Compared to the physical training group, MBI participants showed reduced brain activation in the bilateral superior parietal lobule and right dorsal anterior cingulate cortex over time. No differences between physical training and no intervention were identified. CONCLUSION This study showed that an 8-week mindfulness-based intervention can significantly alter brain activation across brain regions involved in working memory, attentional control, and emotion processing during performance of a working memory task. This might aid in the recovery of CRCI. IMPLICATIONS FOR CANCER SURVIVORS Mindfulness might alter brain activation patterns while performing a working memory task, which might ultimately aid in restoring higher order cognitive functions.
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Affiliation(s)
- Michelle Melis
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium.
- Research Foundation Flanders (FWO), Flanders, Belgium.
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute, KU Leuven, Leuven, Belgium.
| | - Jeroen Blommaert
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Katleen Van der Gucht
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Neuromodulation Laboratory, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ann Smeets
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Multidisciplinary Breast Center, Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Stefan Sunaert
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Andra Smith
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Sabine Deprez
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
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17
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Vance DE, Collette C, Frank JS, Billings R, Deaver J, Del Bene VA, Fazeli PL, Bail JR, Li W, Triebel K, Von Ah D, Wang HL. Cognitive intra-individual variability in breast cancer survivors: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-15. [PMID: 37878814 DOI: 10.1080/23279095.2023.2270097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Subjective and objective cognitive impairments in Breast Cancer Survivors (BCS) often do not correlate. One important contribution to the reported disparities may be the reliance on mean-based cognitive performance. Cognitive intra-individual variability (IIV) may provide important insights into these reported disparities. Cognitive IIV refers to the fluctuation in performance for an individual on either one cognitive task across a trial or dispersed across tasks within a neuropsychological test battery. The purpose of this systematic review was to search for and examine the literature on cognitive IIV in BCS. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to search for all articles related to cognitive IIV in BCS. MEDLINE (via PubMed), Embase, and Scopus databases were searched using detailed search terms and strategies. Initially, 164 articles were retrieved but only 4 articles met the criteria for this systematic review. BCS differed from healthy controls in similar ways across the four studies, generally demonstrating similar performance but showing increased cognitive IIV for the more difficult tasks. Differences were enhanced later during chemotherapy. The four studies provide support for cognitive IIV as a useful measure to detect the subtle objective cognitive change often reported by BCS but frequently not detected by standard normed-based cognitive testing. Unexpectedly, measures of cognitive IIV were not consistently associated with self-reported measures of cognition.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christopher Collette
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Rebecca Billings
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jill Deaver
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor A Del Bene
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer R Bail
- College of Nursing, The University of Alabama in Huntsville, Huntsville, AL, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Diane Von Ah
- College of Nursing, Ohio State University, Columbus, OH, USA
| | - Hsiao-Lan Wang
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Yu J, Cao X, Zhou R, Chen Q, Wang Y. Abnormal brain glucose metabolism patterns in patients with advanced non-small-cell lung cancer after chemotherapy:A retrospective PET study. Brain Res Bull 2023; 202:110751. [PMID: 37625525 DOI: 10.1016/j.brainresbull.2023.110751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE This study was designed to investigate the acute or chronic post-chemotherapy effect and different chemotherapy cycles effect on brain glucose metabolism. METHODS A total of seventy-three patients who received chemotherapy after being diagnosed with advanced non-small-cell lung cancer (NSCLC) and underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan at Nuclear Medicine Department of the Fifth Hospital of Sun Yat-sen University between September 2017 and August 2022 were included. Seventy-two healthy control patients who underwent whole-body 18F-FDG PET/CT scans at our department, without any evidence of malignancy and confirmed by follow-up visits, were included. Advanced NSCLC patients were classified into six arms: short-to-long course (chemotherapy cycles under 4, between 5 and 8 and more than 8) in acute chemotherapy effect (AC) group (scanned 18F-FDG PET/CT within 6 months post-chemotherapy) or chronic chemotherapy effect (CC) group (the interval between scanning and the last chemotherapy session more than six months). Statistical Parametric Mapping (SPM) analysis between patients' groups and healthy controls' brain 18F-FDG PET was performed (uncorrected p ˂ 0.001 with cluster size above 20 contiguous voxels). RESULTS There were no significant differences between patients' groups and healthy controls in age, gender and body mass index (BMI). SPM PET analyses revealed anomalous brain metabolic activity in different groups (p ˂ 0.001). Short-course + AC group exhibited hypermetabolism in the cerebellum and widespread hypometabolism in bilateral frontal lobe predominantly. Only hypometabolic brain regions were observed in middle-course + AC patients. Long-course + AC group displayed a greater number of abnormalities. Notably, these metabolic abnormalities tended to decrease in CC groups versus AC groups across all courses. CONCLUSION Our study revealed that patients with advanced NSCLC who underwent chemotherapy exhibited persistent abnormal brain metabolism patterns during continuous chemotherapy and these abnormalities tended to recover after completion of chemotherapy over time, but without correlation to an increasing number of chemotherapy cycles. 18F-FDG PET/CT may serve as a possible modality for evaluating brain function and guiding appropriate treatment timing.
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Affiliation(s)
- Jie Yu
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Xiaoling Cao
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Renwei Zhou
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Qingling Chen
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ying Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China.
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19
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Kuo PH, Chen AYC, Rodriguez RJ, Stuehm C, Chalasani P, Chen NK, Chou YH. Transcranial Magnetic Stimulation for the Treatment of Chemo Brain. SENSORS (BASEL, SWITZERLAND) 2023; 23:8017. [PMID: 37836847 PMCID: PMC10575384 DOI: 10.3390/s23198017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/04/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023]
Abstract
This pilot feasibility study aimed to evaluate the effects of transcranial magnetic stimulation (TMS) on chemotherapy-related cognitive impairment (CRCI), and we report here on the first patient. BACKGROUND Deleterious cognitive changes due to chemotherapy or CRCI are commonly referred to as "chemo brain". With the increasing survival of cancer patients, this poorly understood and inadequately treated condition will likewise have an increasing toll on individuals and society. Since there is no approved treatment for chemo brain, we have initiated a therapeutic trial using transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique approved in many countries for the treatment of neurologic and psychiatric conditions like migraine and depression. CASE PRESENTATION A 58-year-old woman, diagnosed 7 years prior with left breast cancer, underwent partial mastectomy with sentinel lymph node biopsy. She then received four cycles of adjuvant chemotherapy followed by radiation therapy. Afterwards, she was on tamoxifen for 4 years and then switched to aromatase inhibitors. The patient's CRCI started during chemotherapy and severely impaired her quality of life for an additional two years. In the third year after chemotherapy, the CRCI partially cleared to stabilize to the level at the time of presentation for this trial. The patient continues to have memory difficulties and decreased concentration, which makes multi-tasking very difficult to impossible. She is reliant on memory aids at work and at home. The participant underwent 10 consecutive sessions of TMS during weekdays for 2 weeks. Stimulation was directed to the left dorsolateral prefrontal cortex. After TMS, the participant significantly improved in memory function on neuropsychological testing. While she reported no subjective differences in concentration or memory, she did report an improvement in her sleep. Functional magnetic resonance imaging of the brain before and after TMS showed increased resting-state functional connectivity between the stimulation site and several brain regions. Remarkably, after 6 years of chemo brain and remaining in the same position at work due to her inability to concentrate and multi-task, she applied for and received a promotion 5-6 months after her TMS treatments. CONCLUSIONS This first patient in the phase 1 clinical trial testing of TMS for the treatment of "chemo brain" provided important lessons for feasibility and insights into mechanisms of potential benefit.
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Affiliation(s)
- Phillip H. Kuo
- Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ 85721, USA
| | - Allison Yu-Chin Chen
- Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, AZ 85721, USA;
| | | | - Carol Stuehm
- Department of Medical Imaging, University of Arizona, Tucson, AZ 85721, USA;
| | - Pavani Chalasani
- Division of Hematology-Oncology, George Washington Cancer Center, Washington, DC 20037, USA;
| | - Nan-Kuei Chen
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85721, USA;
| | - Ying-Hui Chou
- Brain Imaging and TMS Laboratory, Department of Psychology, Evelyn F McKnight Brain Institute, Arizona Center on Aging, BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA;
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20
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Correa DD, Vachha BA, Baser RE, Koch A, Wong P, Gohel S, Giralt S, Root JC. Neuroimaging and Neurocognitive Outcomes in Older Patients with Multiple Myeloma Treated with Chemotherapy and Autologous Stem Cell Transplantation. Cancers (Basel) 2023; 15:4484. [PMID: 37760454 PMCID: PMC10526394 DOI: 10.3390/cancers15184484] [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: 07/19/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
There is a paucity of research on treatment-related neurotoxicity in older adults with multiple myeloma (MM) treated with high-dose chemotherapy (HDC) and autologous SCT (HDC/ASCT), despite the increasing use of this regimen. We examined resting state functional connectivity (RSFC), gray matter (GM) volume, neurocognitive function (NF), and proinflammatory cytokines (PCy) in older patients with MM pre- and post-HDC/ASCT. Eighteen patients underwent MRI, NF tests, and serum PCy measurements prior to HDC/ASCT, and fifteen patients completed a follow up five-months post-HDC/ASCT. There were significant decreases in RSFC post-HDC/ASCT in (1) the central executive network (CEN) involving the left dorsolateral prefrontal cortex and right posterior parietal cortex (p = 0.022) and (2) the CEN involving the right posterior parietal cortex and the salience network involving the right dorsal anterior cingulate cortex (p = 0.029). There were no significant changes in GM or NF, except for improvements in attention (Digit Span Backward, p = 0.03). There were significant increases in several PCy post-HDC/ASCT (p ≤ 0.05). In conclusion, RSFC decreased in frontal, parietal, and cingulate cortices post-HDC/ASCT, NF was relatively stable, and several PCy increased. These findings are congruent with other studies in cancer patients and provide supporting evidence for the vulnerability of frontoparietal regions to chemotherapy's adverse effects.
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Affiliation(s)
- Denise D. Correa
- Department of Neurology, MSKCC—Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY 10065, USA
| | - Behroze A. Vachha
- Department of Radiology, UMass Chan Medical School, Worcester, MA 01665, USA
| | - Raymond E. Baser
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Adrian Koch
- Department of Neurology, MSKCC—Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Phillip Wong
- Department of Immune Monitoring Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Suril Gohel
- Department of Heath Informatics, Rutgers University School of Health Professions, Newark, NJ 08854, USA
| | - Sergio Giralt
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - James C. Root
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Departments of Psychiatry, Weill Cornell Medical College, New York, NY 10065, USA
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21
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Kesler SR, Henneghan AM, Prinsloo S, Palesh O, Wintermark M. Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment. Front Med (Lausanne) 2023; 10:1199605. [PMID: 37720513 PMCID: PMC10499624 DOI: 10.3389/fmed.2023.1199605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Cancer related cognitive impairment (CRCI) is commonly associated with cancer and its treatments, yet the present binary diagnostic approach fails to capture the full spectrum of this syndrome. Cognitive function is highly complex and exists on a continuum that is poorly characterized by dichotomous categories. Advanced statistical methodologies applied to symptom assessments have demonstrated that there are multiple subclasses of CRCI. However, studies suggest that relying on symptom assessments alone may fail to account for significant differences in the neural mechanisms that underlie a specific cognitive phenotype. Treatment plans that address the specific physiologic mechanisms involved in an individual patient's condition is the heart of precision medicine. In this narrative review, we discuss how biotyping, a precision medicine framework being utilized in other mental disorders, could be applied to CRCI. Specifically, we discuss how neuroimaging can be used to determine biotypes of CRCI, which allow for increased precision in prediction and diagnosis of CRCI via biologic mechanistic data. Biotypes may also provide more precise clinical endpoints for intervention trials. Biotyping could be made more feasible with proxy imaging technologies or liquid biomarkers. Large cross-sectional phenotyping studies are needed in addition to evaluation of longitudinal trajectories, and data sharing/pooling is highly feasible with currently available digital infrastructures.
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Affiliation(s)
- Shelli R. Kesler
- Division of Adult Health, School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Diagnostic Medicine, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
| | - Ashley M. Henneghan
- Division of Adult Health, School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
| | - Sarah Prinsloo
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Oxana Palesh
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Max Wintermark
- Department of Neuroradiology, The University of Texas MD Anderson Cancer, Houston, TX, United States
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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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23
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Chen VCH, Chuang W, Chen CW, Tsai YH, McIntyre RS, Weng JC. Detecting microstructural alterations of cerebral white matter associated with breast cancer and chemotherapy revealed by generalized q-sampling MRI. Front Psychiatry 2023; 14:1161246. [PMID: 37363171 PMCID: PMC10289548 DOI: 10.3389/fpsyt.2023.1161246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Previous studies have discussed the impact of chemotherapy on the brain microstructure. There is no evidence of the impact regarding cancer-related psychiatric comorbidity on cancer survivors. We aimed to evaluate the impact of both chemotherapy and mental health problem on brain microstructural alterations and consequent cognitive dysfunction in breast cancer survivors. Methods In this cross-sectional study conducted in a tertiary center, data from 125 female breast cancer survivors who had not received chemotherapy (BB = 65; 49.86 ± 8.23 years) and had received chemotherapy (BA = 60; 49.82 ± 7.89 years) as well as from 71 age-matched healthy controls (47.18 ± 8.08 years) was collected. Chemotherapeutic agents used were docetaxel and epirubicin. We used neuropsychological testing and questionnaire to evaluate psychiatric comorbidity, cognitive dysfunction as well as generalized sampling imaging (GQI) and graph theoretical analysis (GTA) to detect microstructural alterations in the brain. Findings Cross-comparison between groups revealed that neurotoxicity caused by chemotherapy and cancer-related psychiatric comorbidity may affect the corpus callosum and middle frontal gyrus. In addition, GQI indices were correlated with the testing scores of cognitive function, quality of life, anxiety, and depression. Furthermore, weaker connections between brain regions and lower segregated ability were found in the post-treatment group. Conclusion This study suggests that chemotherapy and cancer-related mental health problem both play an important role in the development of white matter alterations and cognitive dysfunction.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wei Chuang
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Wei Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Roger S. McIntyre
- Mood Disorder Psychopharmacology Unit, Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan
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24
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Torre M, Bukhari H, Nithianandam V, Zanella CA, Mata DA, Feany MB. A Drosophila model of chemotherapy-related cognitive impairment. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.01.543297. [PMID: 37333281 PMCID: PMC10274738 DOI: 10.1101/2023.06.01.543297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Chemotherapy-related cognitive impairment (CRCI) is a common adverse effect of treatment and is characterized by deficits involving multiple cognitive domains including memory. Despite the significant morbidity of CRCI and the expected increase in cancer survivors over the coming decades, the pathophysiology of CRCI remains incompletely understood, highlighting the need for new model systems to study CRCI. Given the powerful array of genetic approaches and facile high throughput screening ability in Drosophila, our goal was to validate a Drosophila model of CRCI. We administered the chemotherapeutic agents cisplatin, cyclophosphamide, and doxorubicin to adult Drosophila. Neurocognitive deficits were observed with all tested chemotherapies, especially cisplatin. We then performed histologic and immunohistochemical analysis of cisplatin-treated Drosophila tissue, demonstrating neuropathologic evidence of increased neurodegeneration, DNA damage, and oxidative stress. Thus, our Drosophila model of CRCI recapitulates clinical, radiologic, and histologic alterations reported in chemotherapy patients. Our new Drosophila model can be used for mechanistic dissection of pathways contributing to CRCI and pharmacologic screens to identify novel therapies to ameliorate CRCI.
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Affiliation(s)
- Matthew Torre
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Hassan Bukhari
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Vanitha Nithianandam
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Camila A Zanella
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | - Mel B Feany
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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25
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Ospina-Romero M, Brenowitz WD, Glymour MM, Westrick A, Graff RE, Hayes-Larson E, Mayeda ER, Ackley SF, Kobayashi LC. Education, incident cancer, and rate of memory decline in a national sample of US adults in mid-to-later-life. J Geriatr Oncol 2023; 14:101530. [PMID: 37210786 PMCID: PMC10332197 DOI: 10.1016/j.jgo.2023.101530] [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: 08/31/2022] [Revised: 03/30/2023] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Middle-aged and older adults who develop cancer experience memory loss following diagnosis, but memory decline in the years before and after cancer diagnosis is slower compared to their cancer-free counterparts. Educational attainment strongly predicts memory function during aging, but it is unclear whether education protects against memory loss related to cancer incidence or modifies long-term memory trajectories in middle-aged and older cancer survivors. MATERIALS AND METHODS Data were from 14,449 adults (3,248 with incident cancer, excluding non-melanoma skin cancer) aged 50+ in the population-based US Health and Retirement Study from 1998 to 2016. Memory was assessed every two years as a composite of immediate and delayed word recall tests and proxy assessments for impaired individuals. Memory scores all time points were standardized at to the baseline distribution. Using multivariate-adjusted linear mixed-effects models, we estimated rates of memory decline in the years before cancer diagnosis, shortly after diagnosis, and in the years after diagnosis. We compared rates of memory decline between incident cancer cases and age-matched cancer-free adults, overall and according to level of education (<12 years, "low"; 12 to <16 years, "intermediate"; ≥16 years, "high"). RESULTS Incident cancer diagnoses were followed by short-term declines in memory averaging 0.06 standard deviation (SD) units (95% confidence interval [CI]: -0.084, -0.036). Those with low education experienced the strongest magnitude of short-term decline in memory after diagnosis (-0.10 SD units, 95% CI: -0.15, -0.05), but this estimate was not statistically significantly different from the short-term decline in memory experienced by those with high education (-0.04 SD units, 95% CI: -0.08, 0.01; p-value for education as an effect modifier = 0.15). In the years prior to and following an incident cancer diagnosis, higher educational attainment was associated with better memory, but it did not modify the difference in rate of long-term memory decline between cancer survivors and those who remained cancer-free. DISCUSSION Education was associated with better memory function over time among both cancer survivors and cancer-free adults aged 50 and over. Low education may be associated with a stronger short-term decline in memory after a cancer diagnosis.
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Affiliation(s)
- Monica Ospina-Romero
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America; Department of Pathology and Laboratory Medicine, University of Wisconsin, United States of America.
| | - Willa D Brenowitz
- Department of Psychiatry, University of California San Francisco, United States of America; Kaiser Permanente Center for Health Research, Portland, United States of America
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Ashly Westrick
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
| | - Rebecca E Graff
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Lindsay C Kobayashi
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
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Parada H, Pichardo MS, Gallo LC, Talavera GA, McDaniels‐Davidson C, Penedo FJ, Lee DJ, Tarraf W, Garcia TP, Daviglus ML, González HM. Neurocognitive test performance following cancer among middle-aged and older adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the SOL-Investigation of Neurocognitive Aging Ancillary Study. Cancer Med 2023; 12:11860-11870. [PMID: 36999972 PMCID: PMC10242865 DOI: 10.1002/cam4.5863] [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: 01/27/2023] [Revised: 02/20/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cancer patients and survivors often experience acute cognitive impairments; however, the long-term cognitive impact remains unclear particularly among Hispanics/Latinos. We examined the association between cancer history and neurocognitive test performance among middle-aged and older Hispanic/Latinos. METHODS Participants included 9639 Hispanic/Latino adults from the community-based and prospective Hispanic Community Health Study/Study of Latinos. At baseline (2008-2011; V1), participants self-reported their cancer history. At V1 and again at a 7-year follow-up (2015-2018; V2), trained technicians administered neurocognitive tests including the Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency Test (WF), and Digit Symbol Substitution Test (DSS). We used survey linear regression to estimate the overall, sex-specific, and cancer site-specific [i.e., cervix, breast, uterus, and prostate] adjusted associations between cancer history and neurocognitive test performance at V1 and changes from V1 to V2. RESULTS At V1, a history of cancer (6.4%) versus no history of cancer (93.6%) was associated with higher WF scores (β = 0.14, SE = 0.06; p = 0.03) and global cognition (β = 0.09, SE = 0.04; p = 0.04). Among women, a history of cervical cancer predicted decreases in SEVLT-Recall scores (β = -0.31, SE = 0.13; p = 0.02) from V1 to V2, and among men, a history of prostate cancer was associated with higher V1 WF scores (β = 0.29, SE = 0.12; p = 0.02) and predicted increases in SEVLT-Sum (β = 0.46, SE = 0.22; p = 0.04) from V1 to V2. CONCLUSION Among women, a history of cervical cancer was associated with 7-year memory decline, which may reflect the impacts of systemic cancer therapies. Among men, however, a history of prostate cancer was associated with improvements in cognitive performance, perhaps due in part to engaging in health promoting behaviors following cancer.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public HealthSan Diego State UniversitySan DiegoCaliforniaUSA
- UC San Diego Health Moores Cancer CenterLa JollaCaliforniaUSA
| | - Margaret S. Pichardo
- Department of SurgeryHospitals of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | | | - Corinne McDaniels‐Davidson
- Division of Health Promotion and Behavioral Science, School of Public HealthSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Frank J. Penedo
- Departments of Psychology and MedicineUniversity of Miami College of Arts and Sciences and Miller School of MedicineMiamiFloridaUSA
| | - David J. Lee
- Department of Public Health SciencesUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Tayna P. Garcia
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois ChicagoChicagoIllinoisUSA
| | - Hector M. González
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
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Tometich DB, Mosher CE, Cyders M, McDonald BC, Saykin AJ, Small BJ, Zhai W, Zhou X, Jim HSL, Jacobsen P, Ahles TA, Root JC, Graham D, Patel SK, Mandelblatt J. An Examination of the Longitudinal Relationship Between Cognitive Function and Physical Activity Among Older Breast Cancer Survivors in the Thinking and Living With Cancer Study. Ann Behav Med 2023; 57:237-248. [PMID: 36356044 PMCID: PMC10074030 DOI: 10.1093/abm/kaac048] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Older cancer survivors are at risk for cognitive decline. Physical activity can improve cognition, and better cognitive function may facilitate greater physical activity. PURPOSE We examined the potential bidirectional relationship between cognitive function and physical activity in older breast cancer survivors and controls. METHODS The sample included women with newly diagnosed, nonmetastatic breast cancer (n = 395) and women without cancer (n = 374) ages 60-98. Participants were recruited as part of a larger multisite study, assessed prior to systemic therapy, and followed yearly for 36 months. Attention, processing speed, and executive function was measured using six neuropsychological tests, self-reported cognitive function using the Perceived Cognitive Impairments subscale of the Functional Assessment of Cancer Therapy-Cognitive Function , and physical activity using the International Physical Activity Questionnaire-Short Form. Separate random intercepts cross-lagged panel models were used to examine the between- and within-person effects for survivors and controls, controlling for age, education, and study site. RESULTS Survivors reported significantly less physical activity than controls at baseline (1,284.92 vs. 2,085.98 MET min/week, p < .05). When survivors reported higher activity, they simultaneously had better objective cognition at 12 months (β = 0.24, p = .04) and reported better perceived cognition at 12 and 24 months (β = 0.25, p = .03), but this relationship was not seen in controls. Cognition did not predict subsequent physical activity or vice versa in either group. CONCLUSIONS Cognition and physical activity are cross-sectionally associated in survivors, but the expected prospective relationships were not found.
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Affiliation(s)
- Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Melissa Cyders
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Brenna C McDonald
- Department of Radiology & Imaging Sciences, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Andrew J Saykin
- Department of Radiology & Imaging Sciences, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Brent J Small
- College of Behavioral and Community Sciences, School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Wanting Zhai
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
| | - Xingtao Zhou
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Paul Jacobsen
- Division of Cancer Control and Population Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Tim A Ahles
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - James C Root
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Deena Graham
- Department of Oncology, John Theurer Cancer Center, Hackensack, NJ, USA
| | - Sunita K Patel
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Jeanne Mandelblatt
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
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28
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Correa DD, Vachha BA, Baser RE, Koch A, Wong P, Gohel S, Giralt S, Root JC. Neuroimaging and Neurocognitive Outcomes in Older Patients with Multiple Myeloma Treated with Chemotherapy and Autologous Stem Cell Transplantation. RESEARCH SQUARE 2023:rs.3.rs-2733807. [PMID: 37066224 PMCID: PMC10104268 DOI: 10.21203/rs.3.rs-2733807/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Many patients with hematological malignancies treated with stem cell transplantation (SCT) experience cognitive dysfunction. However, few studies have investigated treatment-related neurotoxicity in older adults with multiple myeloma (MM) treated with high dose chemotherapy (HDC) and autologous SCT (HDC/ASCT). In this study, we examined gray matter (GM) volume, resting state functional connectivity (RSFC), neurocognitive function (NF), and proinflammatory cytokines (PCy) in older patients with MM pre- and post-HDC/ASCT. Methods Eighteen MM patients underwent magnetic resonance imaging, neurocognitive tests, and serum PCy measurement prior to HDC/ASCT, and fifteen patients completed follow ups an average of five months post-HDC/ASCT. Results There were significant decreases in RSFC from pre- to post-HDC/ASCT in (1) the central executive network (CEN) involving the left dorsolateral prefrontal cortex and right posterior parietal cortex (p = 0.022), and (2) the CEN involving the right posterior parietal cortex and the salience network involving the right dorsal anterior cingulate cortex (p = 0.029); these comparisons were no longer significant after multiple comparisons correction. There were no significant changes in GM volumes or NF, except for improvement in attention (Digit Span Backward, p = 0.03). There were significant increases in several PCy post-HDC/ASCT (p ≤ 0.05). Conclusions This pilot study showed decreased RSFC involving the left frontal, right posterior parietal and right anterior cingulate cortices in MM patients post-HDC/ASCT, relatively stable NF, and increases in PCy. These findings are congruent with studies in patients with hematological malignancies and other cancers and provide supporting evidence for the vulnerability of frontoparietal regions to chemotherapy adverse effects.
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Affiliation(s)
| | | | | | | | | | - Suril Gohel
- Rutgers University School of Health Professions
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Berger AM, Grem J, Garlinghouse M, Lyden E, Schmid K. Neurocognitive function and quality-of-life in patients with colorectal cancer. Eur J Oncol Nurs 2023; 64:102304. [PMID: 37137248 DOI: 10.1016/j.ejon.2023.102304] [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: 12/08/2022] [Revised: 02/09/2023] [Accepted: 02/19/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Colorectal cancer (CRC) survivors report significant long-term physical and cognitive declines post-treatment. Our purpose was to combine task-evoked Event-Related Potential (ERP) and resting state functional magnetic resonance imaging (rsf/MRI) methodologies to characterize the physiological underpinnings and cognitive sequelae of chemotherapy-related cognitive impairment, including changes in Quality-Of-Life (QOL) in patients with CRC, as compared to healthy control (HC) participants. METHODS This descriptive study recruited and obtained baseline data from patients with CRC at medical and surgical oncology visits four to six weeks post-op and followed them at 12- and 24-weeks. Procedures employed ERP, pencil and paper neuropsychological testing (N-P), structural/functional rsf/MRI, and self-report QOL methodologies. Data analyses included correlations, one-way ANOVA, Chi-square tests, and linear mixed models. RESULTS Study participants (n = 40) across groups (n = 15, 11, 14) were balanced on age, sex, education, and race, but not marital status Several significant associations were found between changes in Dorsal Attention Network (DAN)-related ERP measures (P2, N2, N2P2, N2pc amplitudes), with QOL measures between baseline and last visits (p < 0.05-0.001). Additionally, rsf/MRI findings showed increased network activity in a single node of the DAN post-treatment, which was associated with poorer performance on N-P tests of attention and working memory, as well as a focal decline in grey matter volume in the area. CONCLUSIONS Our methodology revealed structural and functional changes within the DAN associated with altered spatial attention, working memory, and ability to inhibit. These disruptions may be responsible for decreased QOL ratings in patients with CRC. This study provides a putative mechanism of understanding how altered brain structural/functional relationships impact cognition, QOL, and nursing care in patients with CRC. NCI TRIAL ID NCI-2020-05952, University of Nebraska Medical Center, Clinical Trials.gov ID NCT03683004.
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Affiliation(s)
- Ann M Berger
- College of Nursing, 985330 Nebraska Medical Center, University of Nebraska Medical Center (UNMC), Omaha, NE, 68198-5330, USA.
| | - Jean Grem
- College of Medicine and Fred and Pamela Buffett Cancer Center, UNMC, Omaha, NE, USA
| | | | | | - Kendra Schmid
- Academic Affairs, Graduate Studies, Department of Biostatistics, UNMC, Omaha, NE, USA
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Yang J, Deng Y, Liu D, Tan Y, Lin M, Zhou X, Zhang J, Yu H, Hu Y, Tang Y, Jiang S, Zhang J. Brain network deficits in breast cancer patients after early neoadjuvant chemotherapy: A longitudinal MRI study. J Neurosci Res 2023; 101:1138-1153. [PMID: 36791216 DOI: 10.1002/jnr.25178] [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: 08/28/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
Breast cancer (BC) patients who undergo chemotherapy are likely to develop chemotherapy-related cognitive impairment (CRCI). Recent studies of BC patients after chemotherapy have used graph theory to investigate the topological properties of the brain functional connectome. However, little is known about structural morphological networks in BC patients after early neoadjuvant chemotherapy (NAC). Brain morphological network organization in 47 female participants with BC was investigated before and after NAC. Topological properties of brain networks were ascertained based on morphological similarities in regional gray matter using a graph theory approach based on 3D T1-weighted MRI data. Nonparametric permutation testing was used to assess longitudinal-group differences in topological metrics. Compared with BC patients before NAC, BC patients after early NAC showed significantly increased global efficiency (p = .048), decreased path length (p = .033), and abnormal nodal properties and connectivity, mainly located in the central executive network (CEN). The change in the network efficiency of the right caudate was negatively correlated with the change in the Self-Rating Anxiety Scale score (r = -.435, p = .008), and the change in the nodal degree of the left superior frontal gyrus (dorsolateral part) was positively correlated with the change in the Functional Assessment of Cancer Therapy score (r = .547, p = .002). BC participants showed randomization in global properties and dysconnectivity in the CEN after early NAC. NAC may disrupt the cognitive balance of the brain morphological network in individuals with BC.
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Affiliation(s)
- Jing Yang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yongchun Deng
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing, China.,Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing University Cancer Hospital, School of Medicine, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Meng Lin
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaoyu Zhou
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jing Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Hong Yu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yixin Hu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yu Tang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Shixi Jiang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
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Quality of Life Issues Following Breast Cancer Treatment. Surg Clin North Am 2023; 103:155-167. [DOI: 10.1016/j.suc.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Root JC, Gaynor AM, Ahsan A, Jung D, Schofield E, Ryan E, Li Y, Ahles TA. Remote, Computerised Cognitive Assessment for Breast Cancer- and Treatment-Related Cognitive Dysfunction: Psychometric Characteristics of the Cogsuite Neurocognitive Battery. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023:6991200. [PMID: 36655820 PMCID: PMC10369363 DOI: 10.1093/arclin/acac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Cancer-related cognitive dysfunction (CRCD) is a significant concern for breast cancer survivors. The Cogsuite battery was developed to improve sensitivity to CRCD with the use of cognitive experimental measures, clarify specific cognitive processes impacted and to be capable of being administered either in-office or remotely. METHODS In sum, 357 breast cancer survivors and non-cancer controls completed the Cogsuite Battery in-office (n = 76) or remotely (n = 281). Measure validity, sensitivity to demographic factors, correlations with standard neuropsychological measures and intercorrelations of Cogsuite variables were assessed. Test-retest reliability was evaluated in-office (n = 24) and remotely (n = 80). RESULTS Test-retest reliability for most variables assessed was adequate to strong. Internal validity, as indicated by the confirmation of expected condition effects within each measure, was established for all measures. Assessment of external validity found age, but not education, was a significant predictor in the majority of measures. Assessment of criterion validity found that Cogsuite variables were correlated with standard measures in psychomotor speed, working memory and executive function, but not associated with self-reported cognition or mood. CONCLUSIONS Cogsuite is reliable and valid, and is sensitive to the effects of increasing age on cognition. The addition of the Cogsuite battery to standard assessment may improve sensitivity to CRCD and identify underlying processes that may be affected. Remote use of the Cogsuite battery in appropriate settings will lessen the burden for providers, researchers and survivors in research and clinical contexts.
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Affiliation(s)
- James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10027, USA.,Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10027, USA
| | - Anam Ahsan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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Liu S, Ni J, Yan F, Yin N, Li X, Ma R, Wu J, Zhou G, Feng J. Functional changes of the prefrontal cortex, insula, caudate and associated cognitive impairment (chemobrain) in NSCLC patients receiving different chemotherapy regimen. Front Oncol 2022; 12:1027515. [PMID: 36408140 PMCID: PMC9667024 DOI: 10.3389/fonc.2022.1027515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Chemotherapy-induced cognitive impairment (CICI), termed "chemobrain", is highly prevalent in cancer patients following the administration of chemotherapeutic agents. However, the potential pathophysiological mechanisms underlying CICI remain unknown. This study aimed to explore the functional changes of the brain and associated cognitive impairment in non-small cell lung cancer (NSCLC) patients receiving different chemotherapy regimen. METHODS A total of 49 NSCLC patients (25 patients receiving pemetrexed plus carboplatin chemotherapy (PeCC) and 24 patients receiving paclitaxel plus carboplatin chemotherapy (PaCC)) and 61 healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning, as well as cognitive function tests including Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). Brain functional activities were measured by regional homogeneity (ReHo) values, which were calculated and compared between groups. In addition, the associations between ReHo values of changed brain regions and scores of cognitive scales were evaluated. RESULTS NSCLC patients showed decreased scores of MMSE, MoCA and FACT-Cog and decreased ReHo values in the bilateral superior frontal gyrus (medial), middle frontal gyrus, left inferior frontal gyrus (orbital part) and increased ReHo values in the bilateral insula and caudate. Compared with HCs, patients receiving PeCC demonstrated decreased ReHo values in the right superior frontal gyrus (dorsolateral), left superior frontal gyrus (medial orbital), middle frontal gyrus, insula and rectus gyrus while patients receiving PaCC presented increased ReHo values in the right rolandic operculum, left insula and right caudate. Compared with patients receiving PaCC, patients receiving PeCC had decreased ReHo values in the left superior frontal gyrus (orbital part), middle frontal gyrus and increased ReHo values in the left inferior temporal gyrus, lingual gyrus. Moreover, positive relationships were found between ReHo values of the left and right superior frontal gyrus (medial) and the total scores of FACT-Cog in the patient group. CONCLUSION The findings provided evidences that carboplatin-based chemotherapy could cause CICI accompanied by functional changes in the prefrontal cortex, insula, caudate. These might be the pathophysiological basis for CICI of NSCLC patients and were affected by the differences of chemotherapeutic agent administration through different biological mechanisms.
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Affiliation(s)
- Siwen Liu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Ni
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Yan
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Na Yin
- Department of Radiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyou Li
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Rong Ma
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jianzhong Wu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Guoren Zhou
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Jifeng Feng, ; Guoren Zhou,
| | - Jifeng Feng
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China,Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Jifeng Feng, ; Guoren Zhou,
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Lorenzo-López L, Lema-Arranz C, Fernández-Bertólez N, Costa S, Costa C, Teixeira JP, Pásaro E, Valdiglesias V, Laffon B. Relationship between DNA damage measured by the comet-assay and cognitive function. MUTATION RESEARCH/GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2022; 883-884:503557. [DOI: 10.1016/j.mrgentox.2022.503557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022]
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Gaynor AM, Ahles TA, Ryan E, Schofield E, Li Y, Patel SK, McNeal K, Traina T, Root JC. Initial encoding deficits with intact memory retention in older long-term breast cancer survivors. J Cancer Surviv 2022; 16:940-947. [PMID: 34357556 PMCID: PMC10321572 DOI: 10.1007/s11764-021-01086-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Cancer survivors frequently report significant forgetfulness, but standard neuropsychological tests often fail to detect primary memory deficits. Past research has suggested survivors may misattribute forgetfulness to memory decay rather than impairments in initial encoding, but no studies have tested whether this pattern is evident in older survivors, who are more vulnerable to age-related memory difficulties. We examined whether long-term breast cancer survivors treated in older adulthood demonstrate deficits in initial encoding, as opposed to increased rates of memory decay, relative to non-cancer controls. METHODS Three hundred twenty-eight breast cancer survivors age 60 and above, 5-15 years post-treatment, and 162 age-matched non-cancer controls completed list learning and narrative memory assessments at four time-points over 2 years. Performance on learning trials and delayed recall was analyzed at each time-point to assess group differences in memory encoding, and memory decay was assessed by analyzing changes in performance across delays. RESULTS Univariate ANCOVAs correcting for age and education showed that survivors had worse initial encoding performance across multiple time-points, which were compensated for with multiple learning trials to produce recall performance comparable to controls. There were no significant group differences in memory decay. CONCLUSIONS Older long-term breast cancer survivors exhibit a consistent pattern of initial encoding deficits, but memory retention was comparable to controls. Future research should consider the role of encoding deficits and age-related factors when evaluating cognitive function in older survivors. IMPLICATIONS FOR CANCER SURVIVORS Commonly reported memory problems may stem from encoding deficits in older long-term cancer survivors.
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Affiliation(s)
- Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA.
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
| | - Sunita K Patel
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Katrazyna McNeal
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
| | - Tiffany Traina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA
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Bradley-Garcia M, Winocur G, Sekeres MJ. Episodic Memory and Recollection Network Disruptions Following Chemotherapy Treatment in Breast Cancer Survivors: A Review of Neuroimaging Findings. Cancers (Basel) 2022; 14:4752. [PMID: 36230678 PMCID: PMC9563268 DOI: 10.3390/cancers14194752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Long-term memory disturbances are amongst the most common and disruptive cognitive symptoms experienced by breast cancer survivors following chemotherapy. To date, most clinical assessments of long-term memory dysfunction in breast cancer survivors have utilized basic verbal and visual memory tasks that do not capture the complexities of everyday event memories. Complex event memories, including episodic memory and autobiographical memory, critically rely on hippocampal processing for encoding and retrieval. Systemic chemotherapy treatments used in breast cancer commonly cause neurotoxicity within the hippocampus, thereby creating a vulnerability to memory impairment. We review structural and functional neuroimaging studies that have identified disruptions in the recollection network and related episodic memory impairments in chemotherapy-treated breast cancer survivors, and argue for the need to better characterize hippocampally mediated memory dysfunction following chemotherapy treatments. Given the importance of autobiographical memory for a person's sense of identity, ability to plan for the future, and general functioning, under-appreciation of how this type of memory is impacted by cancer treatment can lead to overlooking or minimizing the negative experiences of breast cancer survivors, and neglecting a cognitive domain that may benefit from intervention strategies.
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Affiliation(s)
| | - Gordon Winocur
- Rotman Research Institute, Baycrest Centre, Toronto, ON M6A 2E1, Canada
- Department of Psychology, Department of Psychiatry, University of Toronto, Toronto, ON M5S 3G3, Canada
- Department of Psychology, Trent University, Peterborough, ON K9J 7B8, Canada
| | - Melanie J Sekeres
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Signal Variability and Cognitive Function in Older Long-Term Survivors of Breast Cancer with Exposure to Chemotherapy: A Prospective Longitudinal Resting-State fMRI Study. Brain Sci 2022; 12:brainsci12101283. [PMID: 36291217 PMCID: PMC9599386 DOI: 10.3390/brainsci12101283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023] Open
Abstract
The purpose of this study was to assess the effect of chemotherapy on brain functional resting-state signal variability and cognitive function in older long-term survivors of breast cancer. This prospective longitudinal study enrolled women age ≥ 65 years of age who were breast cancer survivors after exposure to chemotherapy (CH), age-matched survivors not exposed to chemotherapy, and healthy controls. Participants completed resting-state functional brain MRI and neurocognitive testing upon enrollment (timepoint 1, TP1) and again two years later (timepoint 2, TP2). There were 20 participants in each of the three groups at TP1. The CH group showed a significant decrease in SDBOLD (blood-oxygen-level-dependent signal variability in standard deviation) in the right middle occipital gyrus (ΔSDBOLD = -0.0018, p = 0.0085, q (pFDR) = 0.043 at MNI (42, -76, 17)) and right middle temporal gyrus (ΔSDBOLD = -0.0021, p = 0.0006, q (pFDR) = 0.001 at MNI (63, -39, -12)). There were negative correlations between the crystallized composite scores and SDBOLD values at the right inferior occipital gyrus (correlation coefficient r = -0.84, p = 0.001, q (pFDR) = 0.016) and right middle temporal gyrus (r = -0.88, p = 0.000, q (pFDR) = 0.017) for the CH group at TP1. SDBOLD could be a potentially useful neuroimaging marker for older long-term survivors of breast cancer with exposure to chemotherapy.
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Gates P, Krishnasamy M, Wilson C, Hawkes EA, Doré V, Perchyonok Y, Rowe CC, Walker AK, Vardy JL, de Ruiter MB, Cushion T, Dhillon HM, Gough K. Cancer-related cognitive impairment in patients with newly diagnosed aggressive lymphoma undergoing standard chemotherapy: a longitudinal feasibility study. Support Care Cancer 2022; 30:7731-7743. [PMID: 35699780 PMCID: PMC9385796 DOI: 10.1007/s00520-022-07153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) is a recognised adverse consequence of cancer and its treatment. This study assessed the feasibility of collecting longitudinal data on cognition in patients with newly diagnosed, aggressive lymphoma undergoing standard therapy with curative intent via self-report, neuropsychological assessment, peripheral markers of inflammation, and neuroimaging. An exploration and description of patterns of cancer-related cognitive impairment over the course of treatment and recovery was also undertaken and will be reported separately. METHODS Eligible participants completed repeated measures of cognition including self-report and neuropsychological assessment, and correlates of cognition including blood cell-based inflammatory markers, and neuroimaging at three pre-specified timepoints, time 1 (T1) - pre-treatment (treatment naïve), time 2 (T2) - mid-treatment, and time 3 (T3) - 6 to 8 weeks post-completion of treatment. RESULTS 30/33 eligible patients (91%, 95% CI: 76%, 97%) were recruited over 10 months. The recruitment rate was 3 patients/month (95% CI: 2.0, 4.3 patients/month). Reasons for declining included feeling overwhelmed and rapid treatment commencement. Mean age was 57 years (SD = 17 years) and 16/30 (53%) were male. Most patients (20/30, 67%) had diffuse large B cell lymphoma or Hodgkin lymphoma (4/30, 13%). The neuroimaging sub-study was optional, 11/30 participants (37%) were eligible to take part, and all agreed. The remaining 19 participants were ineligible as their diagnostic PET/CT scan was completed prior. Retention and compliance with all assessments were 89 to 100% at all timepoints. Only one participant was withdrawn due to disease progression. CONCLUSIONS Findings from this study including excellent recruitment, retention, and compliance rates demonstrate it is feasible to longitudinally assess cognition in people with newly diagnosed aggressive lymphoma during their initial treatment and recovery to inform the development of future research to improve patient experiences and cognitive outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619001649101.
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Affiliation(s)
- Priscilla Gates
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia.
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Meinir Krishnasamy
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Research and Education Nursing, Victorian Comprehensive Cancer Centre Alliance, Melbourne, Victoria, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia
- School of Psychology and Public Health, LaTrobe University, Melbourne, Victoria, Australia
| | - Eliza A Hawkes
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute (ONJCRI), Austin Health, Melbourne, Victoria, Australia
| | - Vincent Doré
- Department Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
- The Australian E-Health Research Centre, CSIRO Health & Biosecurity, Melbourne, Victoria, Australia
| | - Yuliya Perchyonok
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department Radiology, Austin Health, Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Adam K Walker
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Janette L Vardy
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Concord Cancer Centre, Concord Repatriation and General Hospital, Concord, New South Wales, Australia
| | | | - Tania Cushion
- Department of Clinical Haematology, Austin Health, Melbourne, Victoria, Australia
| | - Haryana M Dhillon
- Faculty of Science, School of Psychology, Centre for Medical Psychology& Evidence-Based Decision-Making, The University of Sydney, Sydney, New South Wales, Australia
| | - Karla Gough
- Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Vasaghi Gharamaleki M, Mousavi SZ, Owrangi M, Gholamzadeh MJ, Kamali AM, Dehghani M, Chakrabarti P, Nami M. Neural correlates in functional brain mapping among breast cancer survivors receiving different chemotherapy regimens: a qEEG/HEG-based investigation. Jpn J Clin Oncol 2022; 52:1253-1264. [PMID: 35946328 DOI: 10.1093/jjco/hyac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/13/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Post-chemotherapy cognitive impairment commonly known as 'chemobrain' or 'chemofog' is a well-established clinical disorder affecting various cognitive domains including attention, visuospatial working memory, executive function, etc. Although several studies have confirmed the chemobrain in recent years, scant experiments have evaluated the potential neurotoxicity of different chemotherapy regimens and agents. In this study, we aimed to evaluate the extent of attention deficits, one of the commonly affected cognitive domains, among breast cancer patients treated with different chemotherapy regimens through neuroimaging techniques. METHODS Breast cancer patients treated with two commonly prescribed chemotherapy regimens, Adriamycin, Cyclophosphamide and Taxol and Taxotere, Adriamycin and Cyclophosphamide, and healthy volunteers were recruited. Near-infrared hemoencephalography and quantitative electroencephalography assessments were recorded for each participant at rest and during task performance to compare the functional cortical changes associated with each chemotherapy regimen. RESULTS Although no differences were observed in hemoencephalography results across groups, the quantitative electroencephalography analysis revealed increased power of high alpha/low beta in left fronto-centro-parietal regions involved in dorsal and ventral attention networks in the Adriamycin, Cyclophosphamide and Taxol-treated group compared with the Taxotere, Adriamycin and Cyclophosphamide and control group. The Adriamycin, Cyclophosphamide and Taxol-treated cases had the highest current source density values in dorsal attention network and ventral attention network and ventral attention network-related centers in 10 and 15 Hz associated with the lowest Z-scored Fast Fourier Transform coherence in the mentioned regions. CONCLUSIONS The negatively affected neurocognitive profile in breast cancer patients treated with the Adriamycin, Cyclophosphamide and Taxol regimen proposes presumably neurotoxic sequelae of this chemotherapy regimen as compared with the Taxotere, Adriamycin and Cyclophosphamide regimen.
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Affiliation(s)
| | - Seyedeh Zahra Mousavi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Owrangi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
| | - Mehdi Dehghani
- Hematology Research Center, Department of Hematology and Medical Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
- Swiss Alternative Medicine, Geneva, Switzerland
- Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, Republic of Panama
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
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40
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Khan MA, Bhurani D, Hoda U, Sehar N, Agarwal N. Cognitive impairment and elevated peripheral cytokines in breast cancer patients receiving chemotherapy. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:786-793. [PMID: 36252586 PMCID: PMC9703892 DOI: 10.1055/s-0042-1755234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Anthracyclines-based regimen (5-fluorouracil, doxorubicin, and cyclophosphamide (FAC); cyclophosphamide, epirubicin, and 5-fluorouracil [CEF]) and non-anthracycline based regimens (cyclophosphamide, methotrexate, and 5-fluorouracil [CMF]) are widely used as neoadjuvant chemotherapy for breast cancer patients. OBJECTIVE The present study was conducted to observe the effects of FAC, CEF, and CMF regimen on cognition and circulatory proinflammatory cytokines (interleukin 6 [IL-6] and interleukin 1β [IL-1β]) for the duration of three cycles of chemotherapy in breast cancer patients. METHODS Eighty newly diagnosed HER-2 negative breast cancer patients were enrolled and divided into 3 groups as FAC- (n = 27), CEF- (n = 26), and CMF- (n = 27) receiving patients. Serum IL-6 and IL-1β levels were measured by using enzyme-linked immunosorbent assay (ELISA), and cognition was assessed using the Mini-Mental State examination (MMSE) questionnaire. RESULTS Anthracycline-based regimen was found to increase the levels of IL-6, IL-1β, and decreased MMSE scores compared with CMF regimen (p < 0.05). CONCLUSION Anthracycline-based regimen caused comparatively higher peripheral inflammation, which could be the reason for more decline in cognition in anthracycline-receiving patients than non-anthracycline group.
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Affiliation(s)
- Mohd Ashif Khan
- Jamia Hamdard, School of Chemical and Life Sciences, Centre for Translational and Clinical Research, New Delhi, India,Jamia Hamdard, School of Pharmaceutical Education and Research, Department of Pharmaceutical Medicine, New Delhi, India
| | - Dinesh Bhurani
- Rajiv Gandhi Cancer Institute & Research Centre, Department of Hemato-Oncology & Bone Marrow Transplantation, Rohini, New Delhi, India
| | - Ubedul Hoda
- Jamia Hamdard, School of Pharmaceutical Education and Research, Department of Pharmacology, New Delhi, India
| | - Nouroz Sehar
- Jamia Hamdard, School of Chemical and Life Sciences, Department of Medical Elementology and Toxicology, New Delhi, India
| | - Nidhi Agarwal
- Jamia Hamdard, School of Chemical and Life Sciences, Centre for Translational and Clinical Research, New Delhi, India
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Melara RD, Ahles TA, Prashad N, Fernbach M, Edelman JA, Root J. Longitudinal Effects of Breast Cancer Treatment on Neural Correlates of Attention. Arch Clin Neuropsychol 2022; 38:12-24. [PMID: 35901461 PMCID: PMC9868529 DOI: 10.1093/arclin/acac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Cognitive dysfunction has been observed consistently in a subset of breast cancer survivors. Yet, the precise physiological and processing origins of dysfunction remain unknown. The current study examined the utility of methods and procedures based on cognitive neuroscience to study cognitive change associated with cancer and cancer treatment. METHODS We used electroencephalogram and behavioral measures in a longitudinal design to investigate pre- versus post-treatment effects on attention performance in breast cancer patients (n = 15) compared with healthy controls (n = 24), as participants completed the revised Attention Network Test, a cognitive measure of alerting, orienting, and inhibitory control of attention. RESULTS We found no group differences in behavioral performance from pretest to posttest, but significant event-related potential effects of cancer treatment in processing cue validity: After treatment, patients revealed decreased N1 amplitude and increased P3 amplitude, suggesting a suppressed early (N1) response and an exaggerated late (P3) response to invalid cues. CONCLUSIONS The results suggest that treatment-related attentional disruption begins in early sensory/perceptual processing and extends to compensatory top-down executive processes.
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Affiliation(s)
- Robert D Melara
- Corresponding author at: Department of Psychology, City College, City University of New York, 160 Convent Avenue, NAC 7-120, New York, NY 10031, USA. Tel.: +1-212-650-5716. E-mail address: (R. D. Melara)
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Science Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Neelam Prashad
- Department of Psychiatry and Behavioral Science Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Madalyn Fernbach
- Department of Psychiatry and Behavioral Science Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jay A Edelman
- Department of Biology, City College, City University of New York, New York, New York, USA
| | - James Root
- Department of Psychiatry and Behavioral Science Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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42
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McDonald BC, Van Dyk K, Deardorff RL, Bailey JN, Zhai W, Carroll JE, Root JC, Ahles TA, Mandelblatt JS, Saykin AJ. Multimodal MRI examination of structural and functional brain changes in older women with breast cancer in the first year of antiestrogen hormonal therapy. Breast Cancer Res Treat 2022; 194:113-126. [PMID: 35476252 PMCID: PMC9255382 DOI: 10.1007/s10549-022-06597-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/05/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Cancer patients are concerned about treatment-related cognitive problems. We examined effects of antiestrogen hormonal therapy on brain imaging metrics in older women with breast cancer. METHODS Women aged 60 + treated with hormonal therapy only and matched non-cancer controls (n = 29/group) completed MRI and objective and self-reported cognitive assessment at pre-treatment/enrollment and 12 months later. Gray matter was examined using voxel-based morphometry (VBM), FreeSurfer, and brain age calculations. Functional MRI (fMRI) assessed working memory-related activation. Analyses examined cross-sectional and longitudinal differences and tested associations between brain metrics, cognition, and days on hormonal therapy. RESULTS The cancer group showed regional reductions over 12 months in frontal, temporal, and parietal gray matter on VBM, reduced FreeSurfer cortical thickness in prefrontal, parietal, and insular regions, and increased working memory-related fMRI activation in frontal, cingulate, and visual association cortex. Controls showed only reductions in fusiform gyrus on VBM and FreeSurfer temporal and parietal cortex thickness. Women with breast cancer showed higher estimated brain age and lower regional gray matter volume than controls at both time points. The cancer group showed a trend toward lower performance in attention, processing speed, and executive function at follow-up. There were no significant associations between brain imaging metrics and cognition or days on hormonal therapy. CONCLUSION Older women with breast cancer showed brain changes in the first year of hormonal therapy. Increased brain activation during working memory processing may be a sign of functional compensation for treatment-related structural changes. This hypothesis should be tested in larger samples over longer time periods. CLINICALTRIALS GOV IDENTIFIER NCT03451383.
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Affiliation(s)
- Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA.
| | - Kathleen Van Dyk
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and UCLA Jonnson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rachael L Deardorff
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Jessica N Bailey
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Wanting Zhai
- Georgetown University and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Judith E Carroll
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and UCLA Jonnson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, CA, USA
| | - James C Root
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeanne S Mandelblatt
- Georgetown University and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
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Boone AE, Hart E, Wolf TJ. Transdisciplinary Preliminary Evaluation of Goal Maintenance in Cancer-Related Cognitive Impairment. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:324-332. [PMID: 35761479 DOI: 10.1177/15394492221103150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women treated for breast cancer often experience decreases in executive functioning, including goal maintenance, which interferes with daily living. The objective of this study was to conduct a preliminary comparison of cognitive neuroscience assessment performance with neuropsychological, self-report, and performance-based assessments of goal maintenance in women with breast cancer. Women treated for breast cancer in the preceding 3 years completed a battery of cognitive assessments. Relationships between assessment methods were evaluated using Spearman rho correlations. Consistent with prior literature, the AY condition of the Dot Pattern Expectancy (DPX) assessment had the highest error rate. No consistent relationships between the DPX and other methods of assessment were identified; however, some moderate correlations were identified between assessments. Women treated for breast cancer present with DPX performance patterns similar to that of healthy controls in past literature. A larger study is required to confirm relationships between measures of goal maintenance across disciplines.
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Affiliation(s)
| | - Eric Hart
- University of Missouri, Columbia, USA
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Hu Y, Zhang Q, Cui C, Zhang Y. Altered Regional Brain Glucose Metabolism in Diffuse Large B-Cell Lymphoma Patients Treated With Cyclophosphamide, Epirubicin, Vincristine, and Prednisone: An Fluorodeoxyglucose Positron Emission Tomography Study of 205 Cases. Front Neurosci 2022; 16:914556. [PMID: 35784854 PMCID: PMC9240384 DOI: 10.3389/fnins.2022.914556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background A growing number of neuroimaging studies reported that chemotherapy might impair brain functions, leading to persistent cognitive alterations in a subset of cancer patients. The present study aimed to investigate the regional brain glucose metabolism differences between diffuse large B cell lymphoma (DLBCL) patients treated with cyclophosphamide, epirubicin, vincristine, and prednisone and controls using positron emission tomography with 18F-labeled fluoro-2-deoxyglucose integrated with computed tomography (18F-FDG PET/CT) scanning. Methods We analyzed 18F-FDG PET data from 205 right-handed subjects (for avoiding the influence of handedness factors on brain function), including 105 post-chemotherapy DLBCL patients and 100 controls. The two groups had similar average age, gender ratio, and years of education. First, we compared the regional brain glucose metabolism using a voxel-based two-sample t-test. Second, we compared the interregional correlation. Finally, we investigated the correlations between the regional brain glucose metabolism and the number of chemotherapy cycles. Results Compared with the controls, the post-chemotherapy group showed higher metabolism in the right hippocampus and parahippocampal gyrus (region of interest (ROI) 1) and the left hippocampus (ROI 2), and lower metabolism in the left medial orbitofrontal gyrus (ROI 3), the left medial superior frontal gyrus (ROI 4), and the left superior frontal gyrus (ROI 5). The two groups had different interregional correlations between ROI 3 and ROI 5. In some brain regions—mainly located in the bilateral frontal gyrus—the number of chemotherapy cycles was positively correlated with the regional brain glucose metabolism. Meanwhile, in some bilateral hippocampus regions, these two parameters were negatively correlated. Conclusion The present study provides solid data on the regional brain glucose metabolism differences between post-chemotherapy DLBCL patients and controls. These results should improve our understanding of human brain functions alterations in post-chemotherapy DLBCL patients and suggest that 18F-FDG PET/CT scanning is a valuable neuroimaging technology for studying chemotherapy-induced brain function changes.
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Affiliation(s)
- Yuxiao Hu
- Department of PET/CT Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Yuxiao Hu,
| | - Qin Zhang
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- Qin Zhang,
| | - Can Cui
- Department of PET/CT Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Zhang
- Department of PET/CT Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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45
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Zhou X, Tan Y, Yu H, Liu J, Lan X, Deng Y, Yu F, Wang C, Chen J, Zeng X, Liu D, Zhang J. Early alterations in cortical morphology after neoadjuvant chemotherapy in breast cancer patients: A longitudinal magnetic resonance imaging study. Hum Brain Mapp 2022; 43:4513-4528. [PMID: 35665982 PMCID: PMC9491291 DOI: 10.1002/hbm.25969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/18/2022] [Accepted: 05/22/2022] [Indexed: 11/13/2022] Open
Abstract
There is growing evidence that chemotherapy may have a significant impact on the brains of breast cancer patients, causing changes in cortical morphology. However, early morphological alterations induced by chemotherapy in breast cancer patients are unclear. To investigate the patterns of those alterations, we compared female breast cancer patients (n = 45) longitudinally before (time point 0, TP0) and after (time point 1, TP1) the first cycle of neoadjuvant chemotherapy, using voxel‐based morphometry (VBM) and surface‐based morphometry (SBM). VBM and SBM alteration data underwent correlation analysis. We also compared cognition‐related neuropsychological tests in the breast cancer patients between TP0 and TP1. Reductions in gray matter volume, cortical thickness, sulcal depth, and gyrification index were found in most brain areas, while increments were found to be mainly concentrated in and around the hippocampus. Reductions of fractal dimension mainly occurred in the limbic and occipital lobes, while increments mainly occurred in the anterior and posterior central gyrus. Significant correlations were found between altered VBM and altered SBM mainly in the bilateral superior frontal gyrus. We found no significant differences in the cognition‐related neuropsychological tests before and after chemotherapy. The altered brain regions are in line with those associated with impaired cognitive domains in previous studies. We conclude that breast cancer patients showed widespread morphological alterations soon after neoadjuvant chemotherapy, despite an absence of cognitive impairments. The affected brain regions may indicate major targets of early brain damage after chemotherapy.
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Affiliation(s)
- Xiaoyu Zhou
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Hong Yu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiang Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yongchun Deng
- Breast Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Feng Yu
- Breast Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Chengfang Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiao Chen
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaohua Zeng
- Breast Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
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Durán-Gómez N, López-Jurado CF, Nadal-Delgado M, Pérez-Civantos D, Guerrero-Martín J, Cáceres MC. Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer Based on Functional Assessment and NIRS Analysis. J Clin Med 2022; 11:jcm11092363. [PMID: 35566489 PMCID: PMC9100963 DOI: 10.3390/jcm11092363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/03/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Chemotherapy-related cognitive impairment (CRCI), or “chemobrain,” isdefined as a phenomenon of cognitive deficits in cancer patients after chemotherapy and is characterized by deficits in areas of cognition, including memory, attention, speed of processing, and executive function, which seriously affect quality of life. The purpose of this study is to investigate the impact of CRCI in breast cancer (BC) patients in chemotherapy treatment (CT+) or not (CT−) and to analyze their relationship with detectable objective changes in cerebral activity during the execution of a phonological and semantic verbal fluency task (PVF and SVF). Methods: An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 180 women with BC were included. We used Cognitive Scale (FACT-Cog) for neuropsychological subjective assessment, obtaining scores of perceived cognitive impairment (PCI), and near-infrared spectroscopy system (NIRS) for neuropsychological objective assessment during a verbal fluency task (PVF and SVF), determining alterations in the prefrontal cortex (PFC) assessed as changes in regional saturation index (rSO2). Results: A total of 41.7% percent of the patients in the sample had PCI. CT+ was significantly associated with a worse impact in PCI (X¯ = 50.60 ± 15.64 vs. X¯ = 55.01 ± 12.10; p = 0.005). Average rSO2 decreased significantly in CT+ (X¯ = 63.30 ± 8.02 vs. X¯ = 67.98 ± 7.80; p < 0.001), and BC patients showed a significant decrease in PVF and SVF on average (X¯ = 41.99 ± 9.52 vs. X¯ = 47.03 ± 9.31, and X¯ = 33.43 ± 11.0 vs. X¯ = 36.14 ± 10.68, respectively; p < 0.001). Conclusions: Our findings suggest that cognitive impairments in the domain of executive functioning exist among patients with BC who received CT. The results corroborate the hypothesis that CT is an important factor in cognitive impairment in patients with BC, which has been demonstrated by both subjective (PCI) and objective (PVF, SVF, and rSO2) neuropsychological measures. The combination of doxorubicin, cyclophosphamide, and docetaxel induce cognitive impairment.
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Affiliation(s)
- Noelia Durán-Gómez
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.F.L.-J.); (J.G.-M.); (M.C.C.)
- Correspondence: ; Tel.: +34-92-428-9466
| | - Casimiro Fermín López-Jurado
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.F.L.-J.); (J.G.-M.); (M.C.C.)
| | | | - Demetrio Pérez-Civantos
- Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, Hospital Universitario de Badajoz, 06006 Badajoz, Spain;
| | - Jorge Guerrero-Martín
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.F.L.-J.); (J.G.-M.); (M.C.C.)
| | - Macarena C. Cáceres
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.F.L.-J.); (J.G.-M.); (M.C.C.)
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47
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Saward JB, Ellis EG, Cobden AL, Caeyenberghs K. Mapping cognitive deficits in cancer patients after chemotherapy: An Activation Likelihood Estimation meta-analysis of task-related fMRI studies. Brain Imaging Behav 2022; 16:2320-2334. [PMID: 35366180 PMCID: PMC9581855 DOI: 10.1007/s11682-022-00655-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2022] [Indexed: 12/23/2022]
Abstract
Recent neuroimaging studies have reported alterations in brain activation during cognitive tasks in cancer patients who have undergone chemotherapy treatment. However, the location of these altered brain activation patterns after chemotherapy varies considerably across studies. The aim of the present meta-analysis was to quantitatively synthesise this body of evidence using Activation Likelihood Estimation to identify reliable regions of altered brain activation in cancer patients treated with chemotherapy, compared to healthy controls and no chemotherapy controls. Our systematic search identified 12 studies that adopted task-related fMRI on non-central nervous system cancer patients who received chemotherapy relative to controls. All studies were included in the analyses and were grouped into four contrasts. Cancer patients treated with chemotherapy showed reduced activation in the left superior parietal lobe/precuneus (family-wise error corrected p < .05) compared to no chemotherapy controls. No significant clusters were found in three of our contrasts. The majority of studies did not support an association between altered brain activation and cognitive performance after chemotherapy. Findings point towards a possible chemotherapy-induced alteration, which could inform targeted treatment strategies. With continued work in this field using homogenous task-related protocols and cancer populations, fMRI may be used as a biomarker of cognitive deficits in the future.
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Affiliation(s)
- Jacqueline B Saward
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Elizabeth G Ellis
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Annalee L Cobden
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
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André N, Gastinger S, Rébillard A. Chronic Fatigue in Cancer, Brain Connectivity and Reluctance to Engage in Physical Activity: A Mini-Review. Front Oncol 2022; 11:774347. [PMID: 34988017 PMCID: PMC8721035 DOI: 10.3389/fonc.2021.774347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
A large amount of evidence shows that after a cancer diagnosis, patients significantly reduce their level of physical activity. Usually, this reduction is attributed to cancer-related fatigue. However, to our knowledge, no study has clearly demonstrated that fatigue alters effort-based decision-making in cancer. This mini-review aimed to provide evidence that chronic fatigue in cancer patients causes changes in brain connectivity that impact effort-based decision-making. Indeed, three patterns of activation to compensate for dysfunctional networks have been reported: greater variability in the executive network and hyperactivation in the executive network, which account for less efficient and costly processes in the frontal cortex, and reduced deactivation in the default mode network. Nevertheless, these activation patterns are also observed with other factors, such as anticipatory stressors (worry, rumination or sleep loss), that might also cause reluctance to engage in physical activity. Effort-based decision-making involving weighing costs against benefits and physical activity interventions should increase immediate benefits to facilitate engagement in effortful activities.
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Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning (UMR CNRS 7295), University of Poitiers, Sport Sciences Faculty, Poitiers, France.,Maison des Sciences de l'Homme et de la Société (USR CNRS 3565), Université de Poitiers, Poitiers, France
| | - Steven Gastinger
- M2S-EA7470, University of Rennes, Rennes, France.,APCoSS - Institut de Formation en Education Physique et en Sport (IFEPSA), UCO Angers, Angers, France
| | - Amélie Rébillard
- M2S-EA7470, University of Rennes, Rennes, France.,Institut Universitaire de France (IUF), Paris, France
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Boberg E, Iacobaeus E, Greenfield MS, Wang Y, Msghina M, Le Blanc K. Reduced prefrontal cortex and sympathetic nervous system activity correlate with fatigue after aHSCT. Bone Marrow Transplant 2022; 57:360-369. [PMID: 34864824 PMCID: PMC8907068 DOI: 10.1038/s41409-021-01539-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022]
Abstract
Long-term fatigue and cognitive dysfunction affects 35% of allogeneic haematopoietic stem cell transplantation (aHSCT) survivors, suggesting a dysfunctional prefrontal cortex. In this study, we assessed prefrontal cortex and sympathetic nervous system activity in aHSCT patients with fatigue (n = 12), non-fatigued patients (n = 12) and healthy controls (n = 27). Measurement of near-infrared spectroscopy and electrodermal activity was carried out at rest and during cognitive performance (Stroop, verbal fluency and emotion regulation tasks). Prefrontal cortex and sympathetic nervous system activity were also analyzed in response to dopamine and noradrenaline increase after a single dose of methylphenidate. Baseline cognitive performance was similar in the two patient groups. However, after methylphenidate, only non-fatigued patients improved in Stroop accuracy and had better verbal fluency task performance compared to the fatigued group. Task-related activation of prefrontal cortex in fatigued patients was lower compared to non-fatigued patients during all cognitive tests, both before and after methylphenidate administration. During the Stroop task, reaction time, prefrontal cortex activation, and sympathetic nervous system activity were all lower in fatigued patients compared to healthy controls, but similar in non-fatigued patients and healthy controls.Reduced prefrontal cortex activity and sympathetic arousal suggests novel treatment targets to improve fatigue after aHSCT.
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Affiliation(s)
- Erik Boberg
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. .,Department of Haematology, Karolinska University Hospital, Stockholm, Sweden.
| | - Ellen Iacobaeus
- grid.4714.60000 0004 1937 0626Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Yanlu Wang
- grid.24381.3c0000 0000 9241 5705Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Radiology, Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mussie Msghina
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.15895.300000 0001 0738 8966School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Katarina Le Blanc
- grid.4714.60000 0004 1937 0626Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Cellular therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden
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He S, Lim CYS, Dhillon HM, Shaw J. Australian oncology health professionals' knowledge, perceptions, and clinical practice related to cancer-related cognitive impairment and utility of a factsheet. Support Care Cancer 2022; 30:4729-4738. [PMID: 35122530 PMCID: PMC9046357 DOI: 10.1007/s00520-022-06868-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) can have debilitating effects on cancer survivors' quality of life. Despite this, patients often report a lack of information provided by health professionals (HPs) to assist with understanding and managing cognitive changes. This study aimed to explore Australian oncology HPs' understanding of and clinical practice related to CRCI including the use of a Cancer Council Australia CRCI factsheet. METHODS Australian oncology HPs (medical oncologists, cancer nurses, and clinical psychologists) completed a questionnaire that assessed CRCI knowledge, prior to receiving the factsheet. Semi-structured interviews were conducted to explore their perceptions of CRCI and the factsheet. Interviews were recorded, transcribed, and analyzed using framework analysis to identify key themes. RESULTS Questionnaires were completed by twenty-nine HPs. Most HPs had moderate to high knowledge of CRCI, yet low knowledge of the relationship between CRCI and cancer. Twenty-six (response rate 90%) HPs; medical oncologists (n = 7), cancer nurses (n = 12), and clinical psychologists (n = 7), consented to be interviewed. Three main themes were identified: (1) Is CRCI impact real or over-rated?; (2) If it is important, they will tell me: identifying and responding to CRCI in clinical practice; and (3) Using a factsheet in clinical practice. CONCLUSION This study's multi-disciplinary exploration of Australian oncology HPs' perceptions of CRCI highlighted that health professional perceptions drive CRCI discussions with patients. Further education to support clinicians to discuss CRCI is required. Consideration of the barriers and facilitators within healthcare settings is important for successful integration of the factsheet into routine care.
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Affiliation(s)
- Sharon He
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
| | - Chloe Yi Shing Lim
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Haryana M. Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
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