Objective Patients with breast cancer face cognitive impairment that affects their quality of life; partially attributable to treatment. Our aim was to detail the prevalence and change of cognitive impairment during the course of treatment. We also investigated the effect of therapy (chemotherapy [CT]) vs. radiotherapy and/or endocrine therapy vs. healthy controls). Methods This article reviews longitudinal cohort studies published to date in Medline and Embase that (i) assess cognition before and after therapy, (ii) report prevalence cognitive impairment or change, and (iii) use standardized and valid neuropsychological tests. We used the original authors' criteria for cognitive impairment. Results The title and abstract of 891 articles were screened, resulting in the identification of 90 potentially relevant articles while applying the eligibility criteria. After full‐text examination, 17 studies were included. Prevalence of cognitive impairment range from 25% before therapy, through 24% after therapy to 21% at maximal 1‐year follow‐up (FU). Compared to their pretreatment cognitive functioning, 24% of patients decline after treatment and 24% at 1‐year FU. Some studies also reported cognitive improvement showing that 15% and 31% of patients improve, respectively. In general, patients undergoing CT have a higher chance of cognitive impairment and decline than no‐CT patients and healthy controls. Conclusions This study shows that one out of four breast cancer patients shows cognitive impairment prior to treatment administration CT and a significant number of patients decline during the course of disease, suggesting that cognitive impairment is not exclusively related to CT and/or no‐CT therapies. This study shows that assessment of cognitive functioning, ideally over time, is crucial and may help the implementation of personalized rehabilitation pathways.

Ms Hortensius contributed to the concept and design of the review and to the interpretation of data, performed the search, selected the articles, checked the data extraction, drafted the initial manuscript, and revised the manuscript; Ms Dijkshoorn contributed to the concept and design of the review and to the interpretation of data, selected the articles, extracted data, and reviewed the manuscript; Drs Ecury-Goossen, Steggerda, Hoebeek, and Benders contributed to the concept and design of the review and to the interpretation of data and critically reviewed the manuscript for intellectual content; Dr Dudink contributed to the concept and design of the review and to the interpretation of data, conceptualized the review, supervised article selection and data extraction, and reviewed the manuscript critically for intellectual content; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Patients with glioblastoma face abysmal overall survival, cognitive deficits, poor quality of life and limitations to social participation; partly attributable to surgery. Emotion recognition deficits mediated by pathophysiological mechanisms in the right inferior fronto-occipital fasciculus and right inferior longitudinal fasciculus have been demonstrated in traumatic brain injury and dementia, with negative associations for social participation. We hypothesise similar mechanisms occur in patients undergoing resection surgery for glioblastoma. Here, we apply tract-based spatial statistics using a combination of automated image registration methods alongside cognitive testing before and after surgery. In this prospective, longitudinal, observational study of 15 patients, surgery is associated with an increase of emotion recognition deficits (p = 0.009) and this is correlated with decreases in fractional anisotropy in the Inferior Longitudinal Fasciculus, Inferior Fronto-Occipital Fasciculus, Anterior Thalamic Radiation and Uncinate Fasciculus; all in the right hemisphere (p = 0.014). Methodologically, the combination of registration steps used demonstrate that tract-based spatial statistics can be applied in the context of large, scan distorting lesions such as glioblastoma. These results can inform clinical consultations with patients undergoing surgery, support consideration for social cognition rehabilitation and are consistent with theoretical mechanisms that implicate these tracts in emotion recognition deficits across different diseases.

the cerebellum is connected to numerous regions of the contralateral side of the cerebrum. Motor and cognitive deficits following neonatal cerebellar hemorrhages (CbH) in extremely preterm neonates may be related to remote cortical alterations, following disrupted cerebello-cerebral connectivity as was previously shown within six CbH infants. In this retrospective case series study, we used MRI and advanced surface-based analyses to reconstruct gray matter (GM) changes in cortical thickness and cortical surface area in extremely preterm neonates (median age = 26; range: 24.9-26.7 gestational weeks) with large isolated unilateral CbH (N = 5 patients). Each CbH infant was matched with their own preterm infant cohort (range: 20-36 infants) based on sex and gestational age at birth. On a macro level, our data revealed that the contralateral cerebral hemisphere of CbH neonates did not show less cortical thickness or cortical surface area than their ipsilateral cerebral hemisphere at term. None of the cases differed from their matched cohort groups in average cortical thickness or average cortical surface area in the ipsilateral or contralateral cerebral hemisphere. On a micro (i.e. vertex) level, we established high variability in significant local cortical GM alteration patterns across case-cohort groups, in which the cases showed thicker or bigger volume in some regions, among which the caudal middle frontal gyrus, insula and parahippocampal gyrus, and thinner or less volume in other regions, among which the cuneus, precuneus and supratentorial gyrus. This study highlights that cerebellar injury during postnatal stages may have widespread bilateral influence on the early maturation of cerebral cortical regions, which implicate complex cerebello-cerebral interactions to be present at term birth. The cerebellum is fundamental for cognitive and coordinated motor function, varying from sensorimotor mapping to language regulation (as reviewed by Caligiore et al.) 1. Pioneering work in both animal and human studies has established that the cerebellum collaborates with the cerebral cortex and sends output to, and receives input from, contralateral cortical areas via enclosed-loops 2-5 , In human these projection areas include multiple higher-order cerebral regions, such as the dorsolateral prefrontal cortex, the parietal and superior temporal lobes 6-8. Cerebello-cerebral loops are thought to be anatomically separated and involved in distinct functional processes 1,9. Many of these efferent and afferent connections have been identified as early as term-equivalent age (TEA) in preterm infants 10-12. Cerebellar hemorrhage (CbH) is a common neonatal complication with an ultrasound-detected incidence of 7.6% in extremely preterm infants (gestational age at birth <28 weeks) 13. In general the most immature and the sickest children are at a higher risk for developing CbH 14,15 , The actual incidence, however, may be higher as it has likely been underdiagnosed clinically. A recent review demonstrates that between 43% and 75% of t...