Cerebral Hyporesponsiveness and Cognitive Impairment 10 Years After Chemotherapy for Breast Cancer
Cerebral Hyporesponsiveness and Cognitive Impairment 10 Years After Chemotherapy for Breast Cancer
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DOI：
10.1002/hbm.21102
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发表时间：
2011-08-01
影响因子：
4.8
通讯作者：
Schagen, Sanne B.
中科院分区：
文献类型：
--
作者：
de Ruiter, Michiel B.;Reneman, Liesbeth;Schagen, Sanne B.
在乳腺癌幸存者中，化疗与认知障碍有关，但这种副作用背后的神经回路在很大程度上是未知的。此外，长期减值还没有得到很好的研究。在本研究中，对接受大剂量辅助化疗近10年的乳腺癌幸存者(化疗组，n=19)和没有化疗指征的乳腺癌幸存者(对照组，n=15)进行了功能磁共振成像(FMRI)和神经心理测试。在一项涉及计划能力的执行功能任务(伦敦塔)和一项评估情景记忆的配对伙伴任务中，大胆的激活和表现被测量。对于化疗组和对照组，我们发现在配对任务中，伦敦塔的背侧前额叶皮质和海马旁回的低反应。此外，与对照组的研究结果相比，化疗组显示出显著的计划能力受损，并接近显著的识别记忆受损。全脑分析显示，在伦敦塔和配对伙伴任务中，化疗组与对照组在双侧顶后皮质非常相似的区域反应迟钝。神经心理测试显示，随着时间的推移，化疗组的认知损害模式相对稳定。这些结果表明，大剂量辅助化疗与长期认知障碍有关。这些损害的基础是(A)背外侧前额叶皮质和海马旁回的任务特异性低反应，以及(B)包括注意加工的外侧顶后皮质的全身性低反应。Hum Brain Mapp 32：1206-1219,2010。(C)2010年Wiley-Liss公司
Chemotherapy is associated with cognitive impairment in a subgroup of breast cancer survivors, but the neural circuitry underlying this side effect is largely unknown. Moreover, long-term impairment has not been studied well. In the present study, functional magnetic resonance imaging (fMRI) and neuropsychological testing were performed in breast cancer survivors almost 10 years after high-dose adjuvant chemotherapy (chemo group, n = 19) and in breast cancer survivors for whom chemotherapy had not been indicated (control group, n = 15). BOLD activation and performance were measured during an executive function task involving planning abilities (Tower of London) and a paired associates task for assessment of episodic memory. For the chemo group versus the control group, we found hyporesponsiveness of dorsolateral prefrontal cortex in the Tower of London, and of parahippocampal gyrus in the paired associates task. Also, the chemo group showed significantly impaired planning performance and borderline significantly impaired recognition memory as compared to findings in the control group. Whole-brain analyses demonstrated hyporesponsiveness of the chemo versus the control group in very similar regions of bilateral posterior parietal cortex during both the Tower of London and the paired associates task. Neuropsychological testing showed a relatively stable pattern of cognitive impairment in the chemo group over time. These results indicate that high-dose adjuvant chemotherapy is associated with long-term cognitive impairments. These impairments are underpinned by (a) task-specific hyporesponsiveness of dorsolateral prefrontal cortex and parahippocampal gyrus, and (b) a generalized hyporesponsiveness of lateral posterior parietal cortex encompassing attentional processing. Hum Brain Mapp 32:1206-1219, 2010. (C) 2010 Wiley-Liss, Inc.