Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute-IDIBELL, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Spain.
Department of Cognition, Development and Education Psychology, University of Barcelona, Barcelona, Spain.
Eur J Neurol. 2021 Apr;28(4):1324-1333. doi: 10.1111/ene.14670. Epub 2020 Dec 30.
Cancer treatments have deleterious effects on both brain structure and the cognition of lung cancer patients. Physical activity (PA) has beneficial effects on the cognition of healthy adults by eliciting brain plasticity, especially on the medial temporal lobe (hippocampus). Therefore, the aim was to study the neuroprotective effects of a 3-month PA programme (PAP) on the brain structure and cognitive performance of lung cancer patients.
Twelve patients (seven non-small-cell lung cancer [NSCLC] patients following chemotherapy, five small-cell lung cancer [SCLC] patients following chemotherapy and prophylactic cranial irradiation) agreed to complete the PAP and underwent baseline and 3-month (post-PAP) brain magnetic resonance imaging and neuropsychological evaluations (PAP group). Twelve lung cancer patients (seven NSCLC, five SCLC; non-PAP group) and 12 healthy sex-, age- and education-matched controls were recruited and completed two evaluations separated by the same amount of time. A region of interest voxel-based morphometry analysis focused on bilateral hippocampi was performed.
Physical activity programme patients presented greater grey matter volume (GMV) across time in both hippocampi. Moreover, it was observed that SCLC patients in both the PAP and non-PAP groups presented a time-dependent GMV loss in bilateral hippocampi that was not significant in NSCLC patients. Importantly, the PA intervention decreased the magnitude of that GMV loss, becoming thus especially beneficial at the brain structural level for SCLC patients.
Our study demonstrates, using a neuroimaging approach for the first time, that PA is able to stop the deleterious effects of systemic chemotherapy and brain radiation on brain structures of the lung cancer population, especially in SCLC patients.
癌症治疗对肺癌患者的大脑结构和认知都有不良影响。身体活动（PA）通过引发大脑可塑性，对健康成年人的认知有有益影响，特别是对内侧颞叶（海马体）。因此，本研究旨在探讨为期 3 个月的 PA 方案（PAP）对肺癌患者大脑结构和认知表现的神经保护作用。
12 名患者（化疗后的 7 名非小细胞肺癌 [NSCLC] 患者，化疗和预防性颅脑照射后的 5 名小细胞肺癌 [SCLC] 患者）同意完成 PAP，并接受基线和 3 个月（PAP 后）的大脑磁共振成像和神经心理学评估（PAP 组）。招募了 12 名肺癌患者（化疗后的 7 名 NSCLC，化疗和预防性颅脑照射后的 5 名 SCLC；非 PAP 组）和 12 名性别、年龄和教育程度匹配的健康对照者，并在相同的时间间隔内完成了两次评估。我们进行了基于感兴趣区的体素形态计量学分析，重点关注双侧海马体。
PAP 组患者的双侧海马体的灰质体积（GMV）在整个研究过程中均有增加。此外，我们观察到，PAP 组和非 PAP 组的 SCLC 患者的双侧海马体 GMV 随时间呈下降趋势，而 NSCLC 患者的 GMV 则无显著变化。重要的是，PA 干预减少了 GMV 下降的幅度，因此对 SCLC 患者的大脑结构水平尤其有益。
本研究首次使用神经影像学方法证明，PA 能够阻止全身化疗和脑部放疗对肺癌患者大脑结构的不良影响，尤其是对 SCLC 患者。
