Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2020 Feb 18;26:e921700. doi: 10.12659/MSM.921700.
BACKGROUND Few studies have examined functional brain changes specifically associated with chemotherapy (CTx) in patients with lung cancer. This prospective longitudinal research aimed to explore the change in intrinsic brain activity by investigating patients with lung cancer after CTx. MATERIAL AND METHODS Sixteen patients and 20 healthy individuals were enrolled in this study. The amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), dynamic amplitude of low-frequency fluctuation (dALFF), and dynamic regional homogeneity (dReHo) were computed. The group differences in resting state functional magnetic resonance imaging (rs-fMRI) parameters were compared. Alterations in the rs-fMRI parameters from before CTx to after CTx were assessed using the paired t-test. We performed correlation analyses between rs-fMRI parameters and Montreal Cognitive Assessment (MoCA) scores. RESULTS We found statistically significant differences in MoCA scores before CTx and after CTx. Compared to the healthy group, rs-fMRI values decreased in the frontal regions as well as parietal regions compared to values before CTx. In addition, we found significantly decreased rs-fMRI values in the default-mode network (DMN) region of the brain before CTx compared to after CTx. We found no significant correlations between altered intrinsic activity values and MoCA scores. CONCLUSIONS The current study indicated that patients with lung cancer after CTx had decreased dynamic brain activity in the DMN region, and the DMN is vulnerable when patients undergoing CTx.
很少有研究专门探讨肺癌患者化疗（CTx）后与大脑功能相关的变化。本前瞻性纵向研究旨在通过研究肺癌患者在 CTx 后，探索大脑固有活动的变化。
本研究纳入了 16 名肺癌患者和 20 名健康对照者。计算了静息态功能磁共振成像（rs-fMRI）的局部一致性（ReHo）、低频振幅（ALFF）、低频振幅的动态变化（dALFF）和局部一致性的动态变化（dReHo）。比较了 rs-fMRI 参数在组间的差异。采用配对 t 检验评估 CTx 前后 rs-fMRI 参数的变化。我们还对 rs-fMRI 参数与蒙特利尔认知评估（MoCA）评分进行了相关性分析。
我们发现 CTx 前后 MoCA 评分存在显著差异。与健康对照组相比，CTx 后患者的额叶和顶叶区域的 rs-fMRI 值较 CTx 前降低。此外，我们发现 CTx 前患者的默认模式网络（DMN）区域的 rs-fMRI 值较 CTx 后显著降低。我们没有发现内在活动值的改变与 MoCA 评分之间存在显著相关性。
本研究表明，肺癌患者在接受 CTx 后，DMN 区域的大脑动态活动减少，而 DMN 在患者接受 CTx 时较为脆弱。
