Prefrontal cortex abnormalities associated with breast cancer chemotherapy

与乳腺癌化疗相关的前额皮质异常

• 批准号: 8712422
• 负责人: SHELLI R KESLER
• 金额: $ 31.6万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-26 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8712422
• 关键词: Adjuvant; Affect; Age; Attention; Brain; Chemotherapy-Oncologic Procedure; Cognitive; Cognitive deficits; Control Groups; Corpus striatum structure; Disease; Disease model; Dose; Female; Hormonal; Hormones; Impaired cognition; Impairment; Individual; Integration Host Factors; Intervention; Laboratories; Magnetic Resonance; Magnetic Resonance Imaging; Measures; Mediating; Memory; Methods; Morbidity - disease rate; Operative Surgical Procedures; Outcome; Parietal; Participant; Patients; Performance; Prefrontal Cortex; Prior Chemotherapy; Process; Psychiatric therapeutic procedure; Public Health; Quality of life; Radiation; Radiation therapy; Recovery; Research; Schedule; Severity of illness; Structure; Thinking; Time; Treatment Factor; Woman; burden of illness; chemotherapy; cognitive function; cognitive reserve; disability; executive function; experience; gray matter; high risk; hormone therapy; improved; malignant breast neoplasm; memory process; neuroimaging; neuropsychological; processing speed; relating to nervous system; skills; therapy development; time interval

DESCRIPTION (provided by applicant): Our laboratory, as well as others, has demonstrated abnormalities in brain structure and function associated with breast cancer chemotherapy, most consistently in the prefrontal cortex. The prefrontal cortex is critical for skills such as multi-tasking, attention, processing speed and memory; skills that are often impaired in patients who have undergone breast cancer chemotherapy. Because prefrontal cortex changes have also been observed in patients prior to chemotherapy treatment as well as in those treated with radiation and/or hormonal blockade, the specific effects of chemotherapy on prefrontal cortex remain unclear. It is also currently unknown why some patients treated with chemotherapy show improvement in cognitive function over time while others do not. The proposed research will examine prefrontal cortex structure and function as well as cognitive status in 50 patients with primary breast cancer scheduled for chemotherapy. These patients will be evaluated across the treatment course, from pre-surgery to 12 months post-chemotherapy. We will compare the chemotherapy-treated group to 50 patients who do not receive chemotherapy and to 50 healthy females who are all assessed at the same time intervals as the chemotherapy-treated group. We will utilize non-invasive neuroimaging (MRI) methods to measure prefrontal cortex volume and functional activation in combination with neuropsychological measures of executive function, memory, processing speed and attention. We will also explore possible predictors of individual outcome such as demographic, disease, psychiatric and treatment factors. Increasing our understanding regarding the neurobiologic mechanisms underlying chemotherapy-related cognitive impairments may improve identification of patients at highest risk for cognitive deficit and aid the development of treatments for these impairments.

描述（由申请人提供）：我们的实验室以及其他实验室都证明了与乳腺癌化学疗法相关的大脑结构和功能异常，最持续在前额叶皮层中。前额叶皮层对于诸如多任务，注意力，处理速度和内存等技能至关重要。接受乳腺癌化学疗法的患者通常会受损的技能。由于在化学疗法治疗之前的患者以及接受辐射和/或激素阻断治疗的患者之前也观察到了前额叶皮质的变化，因此化学疗法对前额叶皮层的特定作用尚不清楚。目前，目前尚不清楚为什么一些接受化学疗法治疗的患者随着时间的推移会提高认知功能，而另一些则没有。拟议的研究将检查50例原发性乳腺癌患者计划进行化学疗法的前额叶皮层结构和功能以及认知状况。这些患者将在整个治疗过程中进行评估，从手术前到化学后12个月。我们将将接受化疗治疗的组与50例未接受化疗的患者和50名健康女性进行比较，这些患者均与化学疗法治疗组相同的时间间隔进行评估。我们将利用非侵入性神经成像（MRI）方法来测量前额叶皮层的体积和功能激活，并结合执行功能，记忆，处理速度和注意力的神经心理学测量。我们还将探索个人结果的可能预测因素，例如人口统计学，疾病，精神病和治疗因素。我们对与化学疗法相关的认知障碍背后的神经生物学机制的理解提高，可能会改善对认知缺陷风险最高风险的患者的鉴定，并有助于对这些障碍的治疗发展。