Accelerated vascular aging and persistent cognitive impairment in older female breast cancer survivors
Accelerated vascular aging and persistent cognitive impairment in older female breast cancer survivors
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DOI：
10.1007/s11357-018-0025-z
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发表时间：
2018-06-01
期刊：
影响因子：
5.6
通讯作者：
Benbrook, Doris M.
中科院分区：
文献类型：
--
作者：
Carlson, Barbara W.;Craft, Melissa A.;Benbrook, Doris M.
过去三十年来，乳腺癌治疗的进步显着提高了存活率，超过 310 万存活者预计能活到 70 多岁和 80 多岁。如果不采取症状缓解干预措施，近 35% 的幸存者将出现改变生活且令人痛苦的认知症状。这项初步研究探讨了 2/3 期浸润性导管乳腺癌化疗后 12-18 个月的女性血管老化血清标志物、脑氧合偏侧性和认知障碍严重程度之间的关联。 15 名女性（52-84 岁）接受了简短的认知评估（蒙特利尔认知评估 [MOCA]）和抽血来评估血管老化标志物（白细胞介素 6 [IL-6]、肿瘤坏死因子 α [TNF-α]、C 反应蛋白 [CRP] 和胰岛素生长因子 1 [IGF-1]）。所有这些都接受了基于计算机的测试方案，已知该方案可以增加额叶内的血流量。在测试期间和之后记录脑氧合血红蛋白饱和度百分比（rcSO(2)）。 rcSO(2) 中的偏侧性定义为左右 rcSO(2) 之间 >= 3% 的差异（|rcSO(2) 平均值（右 -）平均值（左）|）。 8 名参与者的 MOCA 评分在 21 分至 25 分之间，表明存在轻度认知障碍。 CRP (r = -.24)、IL-6 (r = .34) 和 TNF-alpha (r = .002) 均与 MOCA 评分无关。 IL-6 越高，偏侧性越大 (r = .41)。 rcSO(2) 中存在偏侧性的受试者的 MOCA 评分显着低于没有偏侧性的受试者 (F ((1,14)) = 13.5, p = 003）。较低的 IGF-1 与较大的偏侧性 (r = - .66, p = .007) 和较低的认知功能 (r = .58) 显着相关。这些发现表明，持续性认知障碍与表型变化相关，而表型变化与血管加速老化一致。
Advances in breast cancer treatment have markedly increased survivorship over the past three decades, with over 3.1 million survivors expected to live into their 70s and 80s. Without symptom relief interventions, nearly 35% of these survivors will have life-altering and distressing cognitive symptoms. This pilot study explored associations between serum markers of vascular aging, laterality in cerebral oxygenation, and severity of cognitive impairment in women, 12-18 months after chemotherapy for stage 2/3 invasive ductal breast cancer. Fifteen women (52-84 years) underwent a brief cognitive assessment (Montreal Cognitive Assessment [MOCA]) and blood draws to assess markers of vascular aging (interleukin-6 [IL-6], tumor necrosis factor alpha [TNF-alpha], C-reactive protein [CRP], and insulin growth factor-1 [IGF-1]). All underwent a computer-based test protocol that is known to increase blood flow within the frontal lobes. Percent cerebral oxyhemoglobin saturation (rcSO(2)) was recorded during and after testing. Laterality in rcSO(2) was defined by >= 3% difference between left and right rcSO(2) (|rcSO(2) mean(RIGHT -) mean(LEFT)|). Eight participants had MOCA scores between 21 and 25 points, suggestive of mild cognitive impairment. Neither CRP (r = -.24) nor IL-6 (r = .34) nor TNF-alpha (r = .002) were associated with MOCA scores. Higher IL-6 was associated with greater laterality (r = .41). MOCA scores were significantly lower in subjects with laterality in rcSO(2) than in those without laterality (F ((1,14)) = 13.5, p = 003). Lower IGF-1 was significantly associated with greater laterality (r = - .66, p = .007) and lower cognitive function (r = .58). These findings suggest that persistent cognitive impairment is associated with phenotypical changes consistent with accelerated vascular aging.