Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect St, Burlington, VT, 05401, USA,
Brain Imaging Behav. 2013 Dec;7(4):524-32. doi: 10.1007/s11682-013-9244-1.
Adjuvant chemotherapy is associated with improvements in long-term cancer survival. However, reports of cognitive impairment following treatment emphasize the importance of understanding the long-term effects of chemotherapy on brain functioning. Cognitive deficits found in chemotherapy patients suggest a change in brain functioning that affects specific cognitive domains such as attentional processing and executive functioning. This study examined the processes potentially underlying these changes in cognition by examining brain functional connectivity pre- and post-chemotherapy in women with breast cancer. Functional connectivity examines the temporal correlation between spatially remote brain regions in an effort to understand how brain networks support specific cognitive functions. Nine women diagnosed with breast cancer completed a functional magnetic resonance imaging (fMRI) session before chemotherapy, 1 month after, and 1 year after the completion of chemotherapy. Seed-based functional connectivity analyses were completed using seeds in the intraparietal sulcus (IPS) to examine connectivity in the dorsal anterior attention network and in the posterior cingulate cortex (PCC) to examine connectivity in the default mode network. Results showed decreased functional connectivity 1 month after chemotherapy that partially returned to baseline at 1 year in the dorsal attention network. Decreased connectivity was seen in the default mode network at 1 month and 1 year following chemotherapy. In addition, increased subjective memory complaints were noted at 1 month and 1 year post-chemotherapy. These findings suggest a detrimental effect of chemotherapy on brain functional connectivity that is potentially related to subjective cognitive assessment.
辅助化疗可改善癌症患者的长期生存。然而，有报道称化疗后会出现认知障碍，这强调了了解化疗对大脑功能的长期影响的重要性。化疗患者的认知缺陷表明大脑功能发生了变化，影响了特定的认知领域，如注意力处理和执行功能。本研究通过检查乳腺癌女性化疗前后的大脑功能连接，来研究这些认知变化背后的潜在过程。功能连接旨在通过检查空间上遥远的大脑区域之间的时间相关性，来理解大脑网络如何支持特定的认知功能。9 名被诊断患有乳腺癌的女性在化疗前、化疗后 1 个月和化疗结束后 1 年完成了一次功能磁共振成像（fMRI）检查。使用顶内沟（IPS）中的种子进行基于种子的功能连接分析，以检查背侧前注意网络中的连接，以及后扣带皮层（PCC）中的连接，以检查默认模式网络中的连接。结果显示，化疗后 1 个月时的功能连接减少，1 年后部分恢复到基线水平。化疗后 1 个月和 1 年时，默认模式网络中的连接减少。此外，化疗后 1 个月和 1 年时出现了更多的主观记忆主诉。这些发现表明，化疗对大脑功能连接具有有害影响，这可能与主观认知评估有关。
