Brain connectivity tracks effects of chemotherapy separately from behavioral measures
Brain connectivity tracks effects of chemotherapy separately from behavioral measures
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DOI：
10.1016/j.nicl.2019.101654
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Berman, Marc G.
中科院分区：
文献类型：
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作者：
Kardan, Omid;Reuter-Lorenz, Patricia A.;Berman, Marc G.
癌症研究中的几项研究表明，化疗后的认知功能障碍是一个严重的问题，在非专业术语中被称为“化学脑损伤”。目前，导致这种功能障碍的大脑综合功能的变化仍然知之甚少。神经成像的最新发展表明，功能连接模式可以提供一个广泛适用的认知表现和其他心理测量指标的神经标记物。目前的研究使用了多变量分析方法来确定化疗导致的大脑静息状态功能连接中断的模式，以及这些中断与痛苦和认知表现的行为指标之间的联系程度。62例女性患者(22例健康对照，18例接受辅助化疗，22例未接受化疗)在治疗后3个时间点(M0，辅助治疗前)、1个月(M1)、7个月(M7)进行神经认知功能评定，并进行问卷调查和睁眼静息fMRI扫描。结果表明，乳腺癌患者在化疗后立即出现认知健康缺陷，并随着时间的推移而改善。与这种心理轨迹平行的是静息状态功能连接的中断和后来的恢复，主要是在顶叶和额叶大脑区域。中介分析表明，功能连通性改变模式是认知健康下降的一个可分离的治疗症状。目前的研究表明，应该为患者开发更有针对性的支持，以改善化疗对神经功能和认知健康的这些多方面的副作用。
Several studies in cancer research have suggested that cognitive dysfunction following chemotherapy, referred to in lay terms as "chemobrain", is a serious problem. At present, the changes in integrative brain function that underlie such dysfunction remain poorly understood. Recent developments in neuroimaging suggest that patterns of functional connectivity can provide a broadly applicable neuromarker of cognitive performance and other psychometric measures. The current study used multivariate analysis methods to identify patterns of disruption in resting state functional connectivity of the brain due to chemotherapy and the degree to which the disruptions can be linked to behavioral measures of distress and cognitive performance. Sixty two women (22 healthy control, 18 patients treated with adjuvant chemotherapy, and 22 treated without chemotherapy) were evaluated with neurocognitive measures followed by self-report questionnaires and open eyes resting-state fMRI scanning at three time points: diagnosis (M0, pre-adjuvant treatment), 1 month (M1), and 7 months (M7) after treatment. The results indicated deficits in cognitive health of breast cancer patients immediately after chemotherapy that improved over time. This psychological trajectory was paralleled by a disruption and later recovery of resting-state functional connectivity, mostly in the parietal and frontal brain regions. Mediation analysis showed that the functional connectivity alteration pattern is a separable treatment symptom from the decreased cognitive health. Current study indicates that more targeted support for patients should be developed to ameliorate these multi-faceted side effects of chemotherapy treatment on neural functioning and cognitive health.