Disrupted brain network functional dynamics and hyper‐correlation of structural and functional connectome topology in patients with breast cancer prior to treatment

Abstract

IntroductionSeveral previous studies have demonstrated that cancer chemotherapy is associated with brain injury and cognitive dysfunction. However, evidence suggests that cancer pathogenesis alone may play a role, even in non‐CNS cancers.MethodsUsing a multimodal neuroimaging approach, we measured structural and functional connectome topology as well as functional network dynamics in newly diagnosed patients with breast cancer. Our study involved a novel, pretreatment assessment that occurred prior to the initiation of any cancer therapies, including surgery with anesthesia. We enrolled 74 patients with breast cancer age 29–65 and 50 frequency‐matched healthy female controls who underwent anatomic and resting‐state functional MRI as well as cognitive testing.ResultsCompared to controls, patients with breast cancer demonstrated significantly lower functional network dynamics (p = .046) and cognitive functioning (p < .02, corrected). The breast cancer group also showed subtle alterations in structural local clustering and functional local clustering (p < .05, uncorrected) as well as significantly increased correlation between structural global clustering and functional global clustering compared to controls (p = .03). This hyper‐correlation between structural and functional topologies was significantly associated with cognitive dysfunction (p = .005).ConclusionsOur findings could not be accounted for by psychological distress and suggest that non‐CNS cancer may directly and/or indirectly affect the brain via mechanisms such as tumor‐induced neurogenesis, inflammation, and/or vascular changes, for example. Our results also have broader implications concerning the importance of the balance between structural and functional connectome properties as a potential biomarker of general neurologic deficit.

Cancer and dementia: Two sides of the same coin?

“…Less is known about the cognitive functioning in cancer patients prior to surgery. Thus far, three studies have been conducted evaluating cognitive function in newly diagnosed breast cancer patients . Interestingly, these patients also show worse neuropsychological test performance and alterations on MRI scans compared to controls that cannot be explained by the distress accompanied by cancer diagnosis, suggesting that cancer itself may induce changes in the normal functioning of the brain.…”

Management of side effects during and post-treatment in breast cancer survivors

“…Cancer‐related treatments, such as chemotherapy, radiation, hormonal therapy, and surgery contribute to the burden of side effects experienced by patients . Recent research findings suggest that tumor physiology itself may also play an important role in causing symptoms that are typically associated with treatment side effects, specifically cognitive deficits . This may help explain why certain symptoms sometimes begin before any treatment is started and may compound the side effects experienced upon completion of cancer treatment.…”

Abnormal Functional and Structural networks in Rectal Cancer with Depressive risk: A Graph Theory Analysis

“…Recently, researchers use graph theory to analyze complex brain functional networks after chemotherapy. It has been proved that chemotherapy-related cognitive deficits were associated with abnormal topological alterations of brain functional and structural network [39][40][41]. In this study, increased shortest path length and decreased local efficiency in RC patients with surgery and chemotherapy could be seen as a brain compensation mechanism, which included changing the global pathway and adjusting regional activity to preserve a seesaw-like balance of the brain network.…”