Alterations in brain structure related to breast cancer and its treatment: chemotherapy and other considerations.
Alterations in brain structure related to breast cancer and its treatment: chemotherapy and other considerations.
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DOI：
10.1007/s11682-013-9256-x
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发表时间：
2013-12
影响因子：
3.2
通讯作者：
Saykin, Andrew J.
中科院分区：
文献类型：
--
作者：
McDonald, Brenna C.;Saykin, Andrew J.
关键词：
在过去的30年里，癌症及其治疗的认知效应一直是∼越来越多的研究主题。最近的研究集中于更好地了解这些效应的神经相关性，重点是乳腺癌患者的化疗后效应。结构磁共振研究利用自动和手动方法来量化接受化疗的乳腺癌患者与未接受化疗的患者和/或健康对照组的灰质和白质特征(例如，区域体积和密度)。虽然到目前为止的大部分工作都是回顾性的，但也有少量的基线(系统前治疗)和前瞻性纵向研究。数据一直显示，接受化疗的患者的灰质和白质体积和密度较低，特别是在额叶和颞叶脑区。宿主因素和/或癌症疾病过程和其他治疗方法(例如，抗雌激素治疗)似乎也可能导致观察到的差异，尽管这些影响的相对贡献尚未得到详细调查。这些结构异常已被证明与主观和客观认知功能有关，以及可能有助于阐明其潜在机制的生物学因素(S)。这篇综述考察了目前发表的观察结果，并讨论了主要主题和未来研究的有希望的方向。
Cognitive effects of cancer and its treatment have been a topic of increasing investigation over the past ∼30 years. Recent studies have focused on better understanding the neural correlates of these effects, with an emphasis on post-chemotherapy effects in breast cancer patients. Structural MRI studies have utilized both automated and manual approaches to quantify gray and white matter characteristics (e.g., regional volume and density) in breast cancer patients treated with chemotherapy relative to patients who did not receive chemotherapy and/or healthy controls. While most work to date has been retrospective, a small number of baseline (pre-systemic therapy) and prospective longitudinal studies have been conducted. Data have consistently shown lower gray and white matter volume and density in patients treated with chemotherapy, particularly in frontal and temporal brain regions. Host factors and/or the cancer disease process and other therapies (e.g., antiestrogen treatment) also seem likely to contribute to the observed differences, though the relative contributions of these effects have not yet been investigated in detail. These structural abnormalities have been shown to relate to subjective and objective cognitive functioning, as well as to biological factors that may help to elucidate the underlying mechanism(s). This review examines the currently available published observations and discusses the major themes and promising directions for future studies.
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