Durán-Gómez Noelia, López-Jurado Casimiro Fermín, Nadal-Delgado Marta, Pérez-Civantos Demetrio, Guerrero-Martín Jorge, Cáceres Macarena C
Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain.
Hospital Universitario de Badajoz, 06006 Badajoz, Spain.
J Clin Med. 2022 Apr 23;11(9):2363. doi: 10.3390/jcm11092363.
Background: Chemotherapy-related cognitive impairment (CRCI), or “chemobrain,” isdefined as a phenomenon of cognitive deficits in cancer patients after chemotherapy and is characterized by deficits in areas of cognition, including memory, attention, speed of processing, and executive function, which seriously affect quality of life. The purpose of this study is to investigate the impact of CRCI in breast cancer (BC) patients in chemotherapy treatment (CT+) or not (CT−) and to analyze their relationship with detectable objective changes in cerebral activity during the execution of a phonological and semantic verbal fluency task (PVF and SVF). Methods: An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 180 women with BC were included. We used Cognitive Scale (FACT-Cog) for neuropsychological subjective assessment, obtaining scores of perceived cognitive impairment (PCI), and near-infrared spectroscopy system (NIRS) for neuropsychological objective assessment during a verbal fluency task (PVF and SVF), determining alterations in the prefrontal cortex (PFC) assessed as changes in regional saturation index (rSO2). Results: A total of 41.7% percent of the patients in the sample had PCI. CT+ was significantly associated with a worse impact in PCI (X¯ = 50.60 ± 15.64 vs. X¯ = 55.01 ± 12.10; p = 0.005). Average rSO2 decreased significantly in CT+ (X¯ = 63.30 ± 8.02 vs. X¯ = 67.98 ± 7.80; p < 0.001), and BC patients showed a significant decrease in PVF and SVF on average (X¯ = 41.99 ± 9.52 vs. X¯ = 47.03 ± 9.31, and X¯ = 33.43 ± 11.0 vs. X¯ = 36.14 ± 10.68, respectively; p < 0.001). Conclusions: Our findings suggest that cognitive impairments in the domain of executive functioning exist among patients with BC who received CT. The results corroborate the hypothesis that CT is an important factor in cognitive impairment in patients with BC, which has been demonstrated by both subjective (PCI) and objective (PVF, SVF, and rSO2) neuropsychological measures. The combination of doxorubicin, cyclophosphamide, and docetaxel induce cognitive impairment.
化疗相关认知障碍（CRCI），即“化疗脑”，被定义为癌症患者化疗后出现的认知缺陷现象，其特征为认知领域的缺陷，包括记忆、注意力、处理速度和执行功能，严重影响生活质量。本研究的目的是调查CRCI对接受化疗（CT+）或未接受化疗（CT−）的乳腺癌（BC）患者的影响，并分析其与语音和语义言语流畅性任务（PVF和SVF）执行过程中大脑活动可检测到的客观变化之间的关系。方法：在西班牙巴达霍斯大学医院进行了一项观察性横断面研究。共纳入180名BC女性患者。我们使用认知量表（FACT-Cog）进行神经心理学主观评估，获得感知认知障碍（PCI）评分，并在言语流畅性任务（PVF和SVF）期间使用近红外光谱系统（NIRS）进行神经心理学客观评估，通过区域饱和度指数（rSO2）的变化来确定前额叶皮质（PFC）的改变。结果：样本中共有41.7%的患者存在PCI。CT+与PCI的更严重影响显著相关（X¯ = 50.60 ± 15. .64 vs. X¯ = 55.01 ± 12.10；p = 0.005）。CT+组的平均rSO2显著降低（X¯ = 63.30 ± 8.02 vs. X¯ = 67.98 ± 7.80；p < 0.001），并且BC患者的PVF和SVF平均显著降低（分别为X¯ = 41.99 ± 9.52 vs. X¯ = 47.03 ± 9.31，以及X¯ = 33.43 ± 11.0 vs. X¯ = 36.14 ± 10.68；p < 0.001）。结论：我们的研究结果表明，接受CT的BC患者存在执行功能领域的认知障碍。结果证实了CT是BC患者认知障碍的一个重要因素这一假设，这已通过主观（PCI）和客观（PVF、SVF和rSO2）神经心理学测量得到证明。多柔比星、环磷酰胺和多西他赛的联合使用会导致认知障碍。
