All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
J Clin Oncol. 2014 Jul 1;32(19):2031-8. doi: 10.1200/JCO.2013.53.6219. Epub 2014 May 27.
To examine whether cognitive complaints after treatment for breast cancer are associated with detectable changes in brain activity during multitasking.
Eighteen patients who were scheduled to receive chemotherapy performed a functional magnetic resonance imaging multitasking task in the scanner before the start of treatment (t1) and 4 to 6 months after finishing treatment (t2). Sixteen patients who were not scheduled to receive chemotherapy and 17 matched healthy controls performed the same task at matched intervals. Task difficulty level was adjusted individually to match performance across participants. Statistical Parametric Mapping 8 (SPM8) software was used for within-group, between-group, and group-by-time interaction image analyses.
Voxel-based paired t tests revealed significantly decreased activation (P < .05) from t1 to t2 at matched performance in the multitasking network of chemotherapy-treated patients, whereas no changes were noted in either of the control groups. At baseline, there were no differences between the groups. Furthermore, in contrast to controls, the chemotherapy-treated patients reported a significant increase in cognitive complaints (P < .05) at t2. Significant (P < .05) correlations were found between these increases and decreases in multitasking-related brain activation. Moreover, a significant group-by-time interaction (P < .05) was found whereby chemotherapy-treated patients showed decreased activation and healthy controls did not.
These results suggest that changes in brain activity may underlie chemotherapy-induced cognitive complaints. The observed changes might be related to chemotherapy-induced damage to the brain or reduced connectivity between brain regions rather than to changes in effort or changes in functional strategy. To the best of our knowledge, this is the first longitudinal study providing evidence for a relationship between longitudinal changes in cognitive complaints and changes in brain activation after chemotherapy.
探讨乳腺癌治疗后认知主诉是否与多重任务期间大脑活动的可检测变化有关。
18 例计划接受化疗的患者在治疗开始前（t1）和治疗结束后 4 至 6 个月（t2）在扫描仪中进行功能磁共振成像多重任务。16 例未计划接受化疗的患者和 17 名匹配的健康对照在匹配的时间间隔内进行了相同的任务。通过个体调整任务难度水平，使参与者的表现相匹配。使用统计参数映射 8（SPM8）软件进行组内、组间和组间时间交互图像分析。
基于体素的配对 t 检验显示，化疗组患者在多重任务网络中，以匹配的表现从 t1 到 t2 时，激活显著降低（P <.05），而对照组均未观察到变化。在基线时，组间无差异。此外，与对照组相比，化疗组患者在 t2 时报告认知主诉显著增加（P <.05）。在多重任务相关脑激活的增加和减少之间发现了显著的相关性（P <.05）。此外，还发现了显著的组间时间交互作用（P <.05），即化疗组患者的激活减少，而健康对照组则没有。
这些结果表明，大脑活动的变化可能是化疗引起认知主诉的基础。观察到的变化可能与化疗引起的大脑损伤或大脑区域之间的连接减少有关，而不是与努力或功能策略的变化有关。据我们所知，这是第一项提供化疗后认知主诉的纵向变化与大脑激活变化之间关系的纵向研究证据。
