Chemotherapy-related cognitive impairment in patients with breast cancer based on MRS and DTI analysis

Tong, Taishan; Lu, Hailiang; Zong, Jian; Lv, Qing; Chu, Xiangcheng

doi:10.1007/s12282-020-01094-z

Cited by 26 publications

(30 citation statements)

References 44 publications

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“…Brain damage in treated women with breast malignancies could be confirmed by neuroimaging studies. Changes in the concentration of metabolites in the CNS and the integrity of the white matter were detected by magnetic resonance spectroscopy and diffusion tensor imaging in breast cancer survivors [ 14 ]. According to multimodal magnetic resonance imaging (MRI) data, patients have significant changes in the brain that were not present before chemotherapy [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Potential Molecular Biomarkers of Central Nervous System Damage in Breast Cancer Survivors

Поспелова

Krasnikova

Фионик

et al. 2022

JCM

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Damage of the central nervous system (CNS), manifested by cognitive impairment, occurs in 80% of women with breast cancer (BC) as a complication of surgical treatment and radiochemotherapy. In this study, the levels of ICAM-1, PECAM-1, NSE, and anti-NR-2 antibodies which are associated with the damage of the CNS and the endothelium were measured in the blood by ELISA as potential biomarkers that might reflect pathogenetic mechanisms in these patients. A total of 102 patients enrolled in this single-center trial were divided into four groups: (1) 26 patients after breast cancer treatment, (2) 21 patients with chronic brain ischemia (CBI) and asymptomatic carotid stenosis (ICA stenosis) (CBI + ICA stenosis), (3) 35 patients with CBI but without asymptomatic carotid stenosis, and (4) 20 healthy female volunteers (control group). Intergroup analysis demonstrated that in the group of patients following BC treatment there was a significant increase of ICAM-1 (mean difference: −368.56, 95% CI −450.30 to −286.69, p < 0.001) and PECAM-1 (mean difference: −47.75, 95% CI −68.73 to −26.77, p < 0.001) molecules, as compared to the group of healthy volunteers. Additionally, a decrease of anti-NR-2 antibodies (mean difference: 0.89, 95% CI 0.41 to 1.48, p < 0.001) was detected. The intergroup comparison revealed comparable levels of ICAM-1 (mean difference: −33.58, 95% CI −58.10 to 125.26, p = 0.76), PECAM-1 (mean difference: −5.03, 95% CI −29.93 to 19.87, p = 0.95), as well as anti-NR-2 antibodies (mean difference: −0.05, 95% CI −0.26 to 0.16, p = 0.93) in patients after BC treatment and in patients with CBI + ICA stenosis. The NSE level in the group CBI + ICA stenosis was significantly higher than in women following BC treatment (mean difference: −43.64, 95% CI 3.31 to −83.99, p = 0.03). Comparable levels of ICAM-1 were also detected in patients after BC treatment and in the group of CBI (mean difference: −21.28, 95% CI −111.03 to 68.48, p = 0.92). The level of PECAM-1 molecules in patients after BC treatment was also comparable to group of CBI (mean difference: −13.68, 95% CI −35.51 to 8.15, p = 0.35). In conclusion, among other mechanisms, endothelial dysfunction might play a role in the damage of the CNS in breast cancer survivors.

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Section: Introductionmentioning

confidence: 99%

Potential Molecular Biomarkers of Central Nervous System Damage in Breast Cancer Survivors

Поспелова

Krasnikova

Фионик

et al. 2022

JCM

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“…NAA↓ 4% in GM at 2.1y in PA vs HC. ↔ Cr, Cho 15/?F (11 ± 4) PA I No 43/?F (14 ± 5) HC No Stouten-Kemperman [ 87 ] 3T 19/19F (56 ± 6) Breast I–III RTx, FEC + CTC, TMX 1 H-MRS NAA/Cr↓ 6% at left centrum semiovale at 12y in high-CTx + vs low-CTx + , CTx-, and HC 24/24F (60 ± 6) Breast I–III RTx, FEC, TMX 15/15F (58 ± 6) Breast I RTx, TMX 7% 20/20F (60 ± 5) HC No Stadlbauer [ 46 ] 3T 18/8F (54 ± 11) rec GBM IV BEV 10 mg/kg 1 H-MRS ↔ Cr, Cho, NAA in BEV + and BEV- at 3-7 m vs T0 18/6F (53 ± 15) rec GBM IV no BEV Sundgren [ 81 ] 1.5T 11/1F (44 ± 16) Intrcran I–II 3D-CRTx 50-60 Gy 1 H-MRS NAA/Cr↓ 9–21%, Cho/Cr↓ 9%-23% at T1 till 6 m vs T0 Tong [ 88 ] 3T 24/24F (43 ± 4) Breast I–II RTx 29%, DTX/PTX + CP, HTx 54% 1 H-MRS NAA↓ 1–4% in posterior cingulate gyrus and dorsal thalamus at 2-3w after vs T0, ↔ NAA in CTx- vs T0 20/20F (42 ± 4) Breast 0–I RTx 20%, HTx 50% ...…”

Section: Resultsmentioning

confidence: 99%

“…But NAA/Cr decrease was shown also after 10 years in comparison with CTx-naïve patients treated with RTx only [ 86 ], or after 12 years in comparison with healthy controls or patients without chemo- or hormone-therapy [ 87 ]. Lastly, NAA and Cr decrease in the posterior cingulate gyrus and dorsal thalamus at 2–3 weeks after therapy was shown compared with baseline in patients with RCTx but not in patients with hormone therapy only [ 88 ].…”

Section: Resultsmentioning

confidence: 99%

“…And no imaging correlations were found with the decreased executive function [ 85 ]. Auditory verbal learning scores correlated with NAA in posterior cingulate gyrus ( r 2 = 0.470–0.5, p < 0.01) [ 88 ]. Finally, a higher global deficit score (GDS) was weakly associated with inflammation on TSPO-PET in the frontal lobe after CTx in breast cancer [ 94 ].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review on the use of quantitative imaging to detect cancer therapy adverse effects in normal-appearing brain tissue

Petr

Hogeboom

Nikulin

et al. 2021

Magn Reson Mater Phy

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Cancer therapy for both central nervous system (CNS) and non-CNS tumors has been previously associated with transient and long-term cognitive deterioration, commonly referred to as ‘chemo fog’. This therapy-related damage to otherwise normal-appearing brain tissue is reported using post-mortem neuropathological analysis. Although the literature on monitoring therapy effects on structural magnetic resonance imaging (MRI) is well established, such macroscopic structural changes appear relatively late and irreversible. Early quantitative MRI biomarkers of therapy-induced damage would potentially permit taking these treatment side effects into account, paving the way towards a more personalized treatment planning.This systematic review (PROSPERO number 224196) provides an overview of quantitative tomographic imaging methods, potentially identifying the adverse side effects of cancer therapy in normal-appearing brain tissue. Seventy studies were obtained from the MEDLINE and Web of Science databases. Studies reporting changes in normal-appearing brain tissue using MRI, PET, or SPECT quantitative biomarkers, related to radio-, chemo-, immuno-, or hormone therapy for any kind of solid, cystic, or liquid tumor were included. The main findings of the reviewed studies were summarized, providing also the risk of bias of each study assessed using a modified QUADAS-2 tool. For each imaging method, this review provides the methodological background, and the benefits and shortcomings of each method from the imaging perspective. Finally, a set of recommendations is proposed to support future research.

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“…An structural neuroimaging research in breast cancer patients found that microstructural abnormalities of some certain vulnerable white matter regions after chemotherapy 20 . And some literatures used neuroimaging technology to explore the correlation between brain structure and functional imaging and cognitive impairment 21,22,23 , trying to clarify the underlying mechanism of CRCI. So far, most of the relationship between neuroanatomy and cognitive function come from studies on breast cancer patients 15,24 , although there are reports of CRCI for lung cancer populations 10,16 , it is much less than breast cancer and results are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Cortex Structure Changes And Their Correlation With Cognitive Function In Lung Cancer Patients

Yuan

Gao

et al. 2022

Preprint

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To assess differences in cerebral cortex structure changes between lung cancer and healthy controls, and to analyze their correlation with cognitive function. 33 patients diagonosed with primary lung cancer have been enrolled in a prospective study. Before starting treatment and 2-4 months after recieving treatment, the patients underwent assessment of cognitive function, and activities of daily living, as well as a T1-weighted magnetic resonance imaging. The patients were compaired with 33 sex, age and education-matched healthy controls. Neuropsychological assessment, MoCA and Tail Making Test (TMT), shows that 78.8% of newly diagnosed lung cancer patients had mild to moderate cognitive impairment. patients' visual space and executive ability deteriorated after treatment (t=2.66, d=0.66, P=0.02). At baseline, some cerebral cortex of frontal, temporal and parietal lobes were atrophied, especially anterior central gyrus, rostral middle frontal cortex, superior temporal gyrus, middle temporal gyrus and temporal pole. After treatment, the rostral middle frontal cortex of the right brain was further atrophied (P＜0.005). There was a positively correlation between atrophied cortical thickness in newly diagnosed lung cancer patients and the score of part A of TMT. Temporal pole volume was positively correlated with naming (r=0.39, P=0.03) and language (r=0.43, P=0.02), while middle temporal gyrus was positively correlated with attention (r=0.39, P=0.03) and orientation (r=0.39, P=0.04). In summary, this study suggests that cancer itself and treatment lead to cognitive impairment, as well as cortical thickness and volume reduction, and cerebral cortex structure changes are correlated with cognitive function. Confirming the existence of cancer-related cognitive impairment and cancer-related brain injury.

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Chemotherapy-related cognitive impairment in patients with breast cancer based on MRS and DTI analysis

Cited by 26 publications

References 44 publications

Potential Molecular Biomarkers of Central Nervous System Damage in Breast Cancer Survivors

Potential Molecular Biomarkers of Central Nervous System Damage in Breast Cancer Survivors

A systematic review on the use of quantitative imaging to detect cancer therapy adverse effects in normal-appearing brain tissue

Cerebral Cortex Structure Changes And Their Correlation With Cognitive Function In Lung Cancer Patients

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