Altered Brain Function in Chemotherapy for Breast Cancer

乳腺癌化疗改变脑功能

• 批准号: 7759504
• 负责人: BERNADINE E. CIMPRICH
• 金额: $ 51.08万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-15 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7759504
• 关键词: Acute; Address; Adjuvant Chemotherapy; Adjuvant Therapy; Adverse effects; Age; Attention; Biological; Brain; Brain imaging; Brain region; Breast Cancer Treatment; Cancer Survivor; Cerebrum; Cognitive; Cognitive deficits; Decision Making; Development; Distress; Education; Event; Fatigue; Foundations; Functional Magnetic Resonance Imaging; Image Analysis; Imaging technology; Impaired cognition; Impairment; Incidence; Intervention; Knowledge; Lead; Learning; Life; Link; Long-Term Effects; Longitudinal Studies; Measurement; Measures; Neurophysiology - biologic function; Neuropsychological Tests; Newly Diagnosed; Patient Self-Report; Patients; Pattern; Performance; Principal Investigator; Problem Solving; Process; Quality of life; Recovery; Reporting; Research; Research Personnel; Research Priority; Role; Severities; Short-Term Memory; Source; Staging; Symptoms; System; Technology; Testing; Time; Woman; Work; base; chemobrain; chemotherapy; cognitive function; daily functioning; design; improved; malignant breast neoplasm; physical state; programs; psychologic; relating to nervous system

DESCRIPTION (provided by applicant): Although cognitive impairment is a common, distressing side effect of adjuvant chemotherapy for breast cancer, the fundamental brain mechanisms have not been systematically examined. Previous research suggests that cognitive alterations in women treated for breast cancer may be related to basic cognitive processes, attention and working memory, that are prerequisites for effective functioning in daily life. Thus, the specific aims are to determine: (1) whether functional alterations occur in neural brain activation patterns on functional magnetic resonance imaging (fMRI) testing of attention and working memory and in cognitive performance in women treated with adjuvant chemotherapy for breast cancer over time; (2) whether systematic functional changes in neural brain activation patterns observed on fMRI testing of attention and working memory are associated with changes in objective and subjective indicators of cognitive functioning over time. A longitudinal study will be conducted with 105 women, including 70 patients newly diagnosed with Stage I or II breast cancer treated with adjuvant chemotherapy (n = 35) or without chemotherapy (n = 35), and 35 women as healthy controls. Three repeated measures will be obtained to evaluate acute and longer-term effects of adjuvant chemotherapy on attention and working memory over a one-year interval: pre-chemotherapy; one month post- chemotherapy; and seven months post-chemotherapy to permit optimal recovery from treatment. An established attention and verbal working memory task will be used during fMRI testing. The event- related fMRI analysis will evaluate neural function in brain regions underlying attention and working memory based on research and implicated in preliminary findings. Neuropsychological test performance and self-report assessments will be used to test hypothesized associations with brain activation patterns on fMRI testing. Covariates of age, education, psychological state, physical symptom distress, and selected biological functional indicators will be assessed and controlled. The study will provide new information about the role of basic processes of attention and working memory in the emergence of cognitive side effects of adjuvant chemotherapy for breast cancer and will establish a foundation for targeted interventions to improve cognitive functioning in breast cancer survivors.

描述（由申请人提供）：尽管认知障碍是辅助化疗对乳腺癌的常见副作用，但尚未系统地检查基本的大脑机制。先前的研究表明，接受乳腺癌治疗的女性的认知改变可能与基本的认知过程，注意力和工作记忆有关，这是在日常生活中有效发挥作用的先决条件。因此，具体目的是确定：（1）在功能性磁共振成像（fMRI）的神经脑激活模式中是否发生了功能改变（fMRI）对注意力和工作记忆的测试以及对乳腺癌辅助化学治疗的女性的认知表现，对乳腺癌的认知表现会随着时间的流逝而来； （2）在fMRI的注意力和工作记忆测试中观察到的神经脑激活模式的系统功能变化是否与随着时间的推移的认知功能的客观和主观指标的变化有关。将对105名女性进行纵向研究，其中包括70名用辅助化疗治疗（n = 35）或没有化学疗法（n = 35）的患有I期或II期乳腺癌的患者，以及35名女性作为健康对照。将获得三个重复措施，以评估佐剂化学疗法对注意力和工作记忆的急性和长期影响的一年间隔：化学疗法；化疗后一个月；化学疗法七个月以允许从治疗中恢复最佳。在fMRI测试期间，将使用既定的注意力和口头工作记忆任务。与事件相关的功能磁共振成像分析将根据研究的关注和工作记忆的基础上的神经功能评估，并与初步发现有关。神经心理学测试表现和自我报告评估将用于测试fMRI测试中脑激活模式的假设关联。年龄，教育，心理状态，身体症状困扰以及选定的生物功能指标的协变量将得到评估和控制。这项研究将提供有关辅助化疗对乳腺癌的认知副作用出现的基本关注和工作记忆过程的作用的新信息，并将为有针对性的干预措施建立基础，以改善乳腺癌幸存者的认知功能。