Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Medical Psychology, Anhui Medical University, Hefei, China.
Sci Rep. 2017 Feb 17;7:42684. doi: 10.1038/srep42684.
To investigate the neural mechanisms underlying attention deficits that are related to neoadjuvant chemotherapy in combination with cerebral perfusion. Thirty one patients with breast cancer who were scheduled to receive neoadjuvant chemotherapy and 34 healthy control subjects were included. The patients completed two assessments of the attention network tasks (ANT), neuropsychological background tests, and the arterial spin labeling scan, which were performed before neoadjuvant chemotherapy and after completing chemotherapy. After neoadjuvant chemotherapy, the patients exhibited reduced performance in the alerting and executive control attention networks but not the orienting network (p < 0.05) and showed significant increases in cerebral blood flow (CBF) in the left posterior cingulate gyrus, left middle occipital gyrus, bilateral precentral gyrus, inferior parietal gyrus, supramarginal gyrus, angular gyrus, precuneus, cuneus, superior occipital gyrus, calcarine cortex, and temporal gyrus (p < 0.01 corrected) when compared with patients before chemotherapy and healthy controls. A significant correlation was found between the decrease performance of ANT and the increase in CBF changes in some brain regions of the patients with breast cancer. The results demonstrated that neoadjuvant chemotherapy influences hemodynamic activity in different brain areas through increasing cerebral perfusion, which reduces the attention abilities in breast cancer patients.
为了研究与新辅助化疗联合脑灌注相关的注意力缺陷的神经机制，纳入了 31 名计划接受新辅助化疗的乳腺癌患者和 34 名健康对照者。患者在新辅助化疗前和化疗完成后完成了两次注意力网络任务（ANT）评估、神经心理学背景测试和动脉自旋标记扫描。新辅助化疗后，患者在警觉和执行控制注意力网络中的表现下降，但在定向网络中没有（p < 0.05），并且左后扣带回、左中枕叶、双侧中央前回、下顶叶、缘上回、角回、楔前叶、楔叶、顶叶上回、距状回皮质和颞叶的脑血流（CBF）显著增加（p < 0.01 校正）与化疗前的患者和健康对照组相比。乳腺癌患者的 ANT 表现下降与某些脑区 CBF 变化之间存在显著相关性。结果表明，新辅助化疗通过增加脑灌注来影响不同脑区的血液动力学活动，从而降低乳腺癌患者的注意力能力。
