Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Sci Rep. 2019 Jan 14;9(1):104. doi: 10.1038/s41598-018-36380-6.
Breast cancer is the most common cancer among women worldwide. Adjuvant chemotherapy has significantly reduced mortality but increased cognitive impairments, including attention function, making quality of life issues a crucial concern. This study enrolled nineteen breast cancer patients who were treated with standard chemotherapy within 6 months and 20 sex-matched healthy controls to investigate the brain effects of chemotherapy. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) with mean fractional amplitude of low-frequency fluctuation (mfALFF) analysis and were correlated with neuropsychological tests, including the Mini-Mental State Examination (MMSE), the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), and the Impact of Event Scale-Revised (IES-R), to explore the possible underlying mechanism of cognitive alternations. We found increased mfALFF over the frontoparietal lobe and decreased mfALFF over the occipital lobe in the cancer patients compared with the healthy controls; the altered brain regions may be associated with the dorsal attention network (DAN) and may be explained by a compensatory mechanism. Both MMSE and CAMS-R scores showed a positive correlation with mfALFF in the occipital lobe but a negative correlation in the frontoparietal lobe. By contrast, IES-R scores showed a positive correlation with mfALFF in the frontoparietal lobe but a negative correlation in the occipital lobe. These alterations are potentially related to the effects of both chemotherapy and psychological distress. Future research involving a larger sample size of patients with breast cancer is recommended.
乳腺癌是全世界女性最常见的癌症。辅助化疗显著降低了死亡率，但增加了认知障碍，包括注意力功能，使生活质量问题成为一个关键关注点。本研究纳入了 19 名在 6 个月内接受标准化疗的乳腺癌患者和 20 名性别匹配的健康对照者，以研究化疗对大脑的影响。所有参与者均接受静息态功能磁共振成像(rs-fMRI)，并进行平均低频振幅(mfALFF)分析，同时进行神经心理学测试，包括简易精神状态检查(MMSE)、认知与情感正念量表修订版(CAMS-R)和修订后的事件影响量表(IES-R)，以探讨认知改变的可能潜在机制。与健康对照组相比，我们发现癌症患者的额顶叶和枕叶区域的 mfALFF 增加，而枕叶区域的 mfALFF 减少；改变的脑区可能与背侧注意网络(DAN)有关，可能是一种代偿机制。MMSE 和 CAMS-R 评分与枕叶的 mfALFF 呈正相关，与额顶叶的 mfALFF 呈负相关。相比之下，IES-R 评分与额顶叶的 mfALFF 呈正相关，与枕叶的 mfALFF 呈负相关。这些改变可能与化疗和心理困扰的影响有关。建议对更大样本量的乳腺癌患者进行进一步研究。
