Very-long Term Neurocognitive Outcomes in Breast Cancer Survivors (ProbC2)

乳腺癌幸存者的超长期神经认知结果（ProbC2）

• 批准号: 10558447
• 负责人: Oxana G Palesh
• 金额: $ 31.52万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10558447
• 关键词: Acceleration; Address; Aftercare; Age; Aging; Brain; Breast Cancer survivor; Chemotherapy-Oncologic Procedure; Cognition; Cognitive; Cognitive deficits; Control Groups; Data; Decision Making; Disease remission; Elderly; Funding Mechanisms; Impaired cognition; Impairment; Incidence; Knowledge; Literature; Longitudinal Studies; Malignant Neoplasms; Measures; Methods; Morbidity - disease rate; Nature; Neurobiology; Neurocognitive; Neuropsychological Tests; Neuropsychology; Outcome; Participant; Patients; Performance; Phenotype; Physiological Processes; Process; Prospective Studies; Quality of life; Reporting; Research; Structure; Survivors; Time; Woman; Work; aging brain; cancer-related cognitive impairment; chemobrain; chemotherapy; clinically significant; cognitive change; cognitive function; cognitive neuroscience; cognitive testing; cohort; comparison control; connectome; disability; experience; follow-up; high risk; longitudinal, prospective study; malignant breast neoplasm; mortality; neural; neural circuit; neuroimaging; neuromechanism; resilience; standardize measure

PROJECT SUMMARY/ABSTRACT Chemotherapy-related cognitive impairment (CRCI) is associated with reduced quality of life and survival making it a significant problem that remains understudied. Research by our group and others has demonstrated that CRCI is associated with altered brain structure and function from pretreatment to post treatment. There is significant overlap between chemotherapy actions and physiologic processes involved in aging. Neurocognitive have been found in patients up to 20+ years post- treatment and work by our group and others suggests an accelerated brain aging phenotype in breast cancer survivors treated with chemotherapy. We have also observed that patients may demonstrate unique trajectories of cognitive impairment that require further study. Existing prospective, longitudinal studies of cancer and cognition, including our own, have been limited to relatively short-term post- treatment follow-ups (e.g. 6-12 months). To begin addressing these limitations, we aim to extend our current prospective study (CA172145), which longitudinally examines cognitive function and brain structure/function pre-surgery, 1-month post chemotherapy, and 1-year post chemotherapy. We will continue to assess cohorts of women treated with chemotherapy, chemotherapy naïve patients, and healthy controls at yearly intervals for 5 additional years (up to 10 years). Using non-invasive neuroimaging methods, we will advance our original aims from the initial project to measure very long- term neurobiologic outcomes with an emphasis on the assessment of neural connectivity rather than specific regional changes (Aim 1). We will also examine very long-term cognitive outcomes as measured by standardized neuropsychological testing (Aim 2). Finally, we will explore different trajectories or subtypes of impairment and their neural phenotypes (Aim 3). The proposed project will significantly advance the understanding of chemotherapy-related cognitive impairments by extending our knowledge on very long-term neurobiological outcomes along with the different subtypes of cognitive impairments and associated neural profiles following breast cancer chemotherapy.

项目摘要/摘要 与化学疗法相关的认知障碍（CRCI）与生活质量降低有关 生存使其成为一个重要的问题，仍然被理解。我们小组和其他人的研究 已经证明CRCI与预处理的大脑结构和功能改变有关 在治疗后。化学疗法作用与生理学之间存在显着重叠 涉及衰老的过程。在长达20年以上的患者中发现了神经认知 我们小组和其他人的治疗和工作表明乳房中的脑衰老表型加速 用化学疗法治疗的癌症存活。我们还观察到患者可以证明 认知障碍的独特轨迹需要进一步研究。现有的前瞻性，纵向 包括我们自己在内的癌症和认知的研究仅限于相对短期的研究 治疗随访（例如6-12个月）。为了开始解决这些限制，我们旨在扩展我们的 当前的前瞻性研究（CA172145），纵向研究认知功能和大脑 术前的结构/功能，化疗后1个月和化学疗法1年。我们将 继续评估接受化学疗法，化学疗法幼稚患者和 每年的健康对照持续5年（长达10年）。使用非侵入性 神经影像学方法，我们将使我们的原始目标从初始项目中提高，以衡量很长的时间 术语神经生物学结果，重点是评估神经元连接性，而不是 特定的区域变化（目标1）。我们还将研究非常长期的认知结果 通过标准化的神经心理学测试测量（AIM 2）。最后，我们将探索不同的 障碍及其神经表型的轨迹或亚型（AIM 3）。拟议的项目将 通过扩展，可以显着提高对化疗相关的认知障碍的理解 我们对非常长期神经生物学结果以及不同亚型的知识 乳腺癌化学疗法后的认知障碍和相关的神经特征。