Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study

Abstract

IntroductionChemotherapy-induced cognitive impairment (i.e., “chemobrain”) is a common neurotoxic side-effect experienced by many cancer survivors who undergone chemotherapy. However, the central mechanism underlying chemotherapy-related cognitive impairment is still unclear. The purpose of this study was to investigate the changes of intrinsic brain activity and their associations with cognitive impairment in colorectal cancer (CRC) patients after chemotherapy.MethodsResting‐state functional magnetic resonance imaging data of 29 CRC patients following chemotherapy and 29 matched healthy controls (HCs) were collected in this study, as well as cognitive test data including Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA) and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). The measure of fractional amplitude of low-frequency fluctuation (fALFF) was calculated and compared between groups. The correlations between the fALFF of impaired brain region and cognitive performance were also analyzed.ResultsCompared with HCs, CRC patients following chemotherapy showed decreased fALFF values in the left anterior cingulate gyrus (ACG) and middle frontal gyrus, as well as increased fALFF values in the left superior frontal gyrus (orbital part) and middle occipital gyrus. Moreover, positive associations were identified between fALFF values of the left ACG and the total scores of MMSE, MoCA and FACT-Cog in the patient group.ConclusionThese findings indicated that CRC patients after chemotherapy had decreased intrinsic brain activity in the left ACG, which might be vulnerable to the neurotoxic side-effect of chemotherapeutic drugs and related to chemotherapy-induced cognitive impairment.

Functional changes of the prefrontal cortex, insula, caudate and associated cognitive impairment (chemobrain) in NSCLC patients receiving different chemotherapy regimen

“…The details about parameters of MRI acquisition and steps of MRI preprocessing were described in our previous study ( 31 ), as well as the software applied in the preprocessing ( Figure 1 ). The preprocessing steps were as follows: (1) removal of first 6 time points; (2) slice timing; (3) realign; (4) normalized by using T1 image unified segmentation.…”

Diagnosis of chemotherapy-related cognitive impairment

“…w grupie pacjentów poddanych chemioterapii z powodu niedrobnokomórkowego raka płuca wykazano obniżony średni wynik testu MMSE 26,8 pkt (SD 1,2) [12]. Podobnie w innym badaniu wśród pacjentów po chemioterapii z powodu raka jelita grubego wynik MMSE wyniósł średnio 25,6 pkt (SD 1,6) [13]. W badaniu z zastosowaniem deksmetylfenidatu w leczeniu znużenia po chemioterapii natomiast wyniki wskazują na średnią MMSE 28,7 pkt (SD 1,6) [14].…”

“…Także Liu i wsp. w swoich dwóch pracach dotyczących odpowiednio pacjentów poddanych leczeniu raka jelita grubego [13] i niedrobnokomórkowego płuca [12] uzyskują w MoCA kolejno średnio po 27 pkt (SD 1,0) oraz 26,6 pkt (SD 1,0). Są to wyniki będące na granicy normy.…”

“…w pracy dotyczącej chorych z nowotworami złośliwymi różnych układów narządowych (pokarmowy, moczowo-płciowy, oddechowy) po zastosowanym leczeniu także wykazywali gorsze wyniki w opisywanym teście [28]. W innych badaniach wykazano u pacjentów z niedrobnokomórkowym rakiem płuca średni wynik 98,9 pkt (SD 5,0) [12], a z rakiem jelita grubego -98,2 pkt (SD 4,5) [13] w teście FACT-Cog.…”