Structural brain changes and associated self-perceived cognitive deficits in chemotherapy-exposed patients with breast cancer: a longitudinal T1 and DTI study

초록

Previous studies have prevalently reported self-perceived cognitive impairment in patients with breast cancer after chemotherapy. However, most brain structure studies in patients have revealed heterogeneous results, especially demonstrating a structural decrease immediately after chemotherapy and increases after 1 year of treatment. Therefore, precisely investigating the brain structure is important within a certain period after chemotherapy. We combined T1-weighted anatomical magnetic resonance imaging and diffusion tensor imaging (DTI) data to investigate longitudinal changes in the structural brain in patients with breast cancer before and after chemotherapy, especially within 6 months to 1 year after chemotherapy, using voxel-based morphometry (VBM) and tract-based spatial statistics approaches. T1 VBM analyses revealed an increased gray matter volume in several frontal areas, insula, and supramarginal gyrus after chemotherapy compared with that before chemotherapy. Additionally, increased white matter volume (WMV) was observed in the uncinate fasciculus (UF) and corpus callosum (CC), as well as WMV reduction in the cerebellum and occipital fusiform gyrus after chemotherapy. DTI analyses revealed increased axial diffusivity in widespread areas. Moreover, correlation analyses demonstrated a negative association between changes in WMV in the UF and CC and changes in scores on the Functional Assessment of Cancer Therapy-Cognitive Function scale. These results from combined T1 and DTI data provide insight into structural brain changes over time and their associated subjective cognitive impairment in chemotherapy-exposed patients with breast cancer.

키워드