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化疗诱发的结直肠癌患者脑功能异常:一项静息态功能磁共振成像研究

Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting-state functional magnetic resonance imaging study.

作者信息

Liu Siwen, Guo Yesong, Ni Jie, Yin Na, Li Chenchen, Pan Xuan, Ma Rong, Wu Jianzhong, Li Shengwei, Li Xiaoyou

机构信息

Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.

Department of Radiotherapy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Oncol. 2022 Jul 18;12:900855. doi: 10.3389/fonc.2022.900855. eCollection 2022.

Abstract

INTRODUCTION

Chemotherapy-induced cognitive impairment (i.e., "chemobrain") is a common neurotoxic side-effect experienced by many cancer survivors who undergone chemotherapy. However, the central mechanism underlying chemotherapy-related cognitive impairment is still unclear. The purpose of this study was to investigate the changes of intrinsic brain activity and their associations with cognitive impairment in colorectal cancer (CRC) patients after chemotherapy.

METHODS

Resting-state functional magnetic resonance imaging data of 29 CRC patients following chemotherapy and 29 matched healthy controls (HCs) were collected in this study, as well as cognitive test data including Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA) and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). The measure of fractional amplitude of low-frequency fluctuation (fALFF) was calculated and compared between groups. The correlations between the fALFF of impaired brain region and cognitive performance were also analyzed.

RESULTS

Compared with HCs, CRC patients following chemotherapy showed decreased fALFF values in the left anterior cingulate gyrus (ACG) and middle frontal gyrus, as well as increased fALFF values in the left superior frontal gyrus (orbital part) and middle occipital gyrus. Moreover, positive associations were identified between fALFF values of the left ACG and the total scores of MMSE, MoCA and FACT-Cog in the patient group.

CONCLUSION

These findings indicated that CRC patients after chemotherapy had decreased intrinsic brain activity in the left ACG, which might be vulnerable to the neurotoxic side-effect of chemotherapeutic drugs and related to chemotherapy-induced cognitive impairment.

摘要

引言

化疗引起的认知障碍(即“化疗脑”)是许多接受过化疗的癌症幸存者常见的神经毒性副作用。然而,化疗相关认知障碍的中枢机制仍不清楚。本研究的目的是调查化疗后结直肠癌(CRC)患者大脑内在活动的变化及其与认知障碍的关联。

方法

本研究收集了29例化疗后的CRC患者及29例匹配的健康对照(HC)的静息态功能磁共振成像数据,以及包括简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)和癌症治疗功能评估-认知功能量表(FACT-Cog)在内的认知测试数据。计算并比较了两组之间的低频振幅分数(fALFF)测量值。还分析了受损脑区的fALFF与认知表现之间的相关性。

结果

与HC相比,化疗后的CRC患者左侧前扣带回(ACG)和额中回的fALFF值降低,而左侧额上回(眶部)和枕中回的fALFF值升高。此外,在患者组中,左侧ACG的fALFF值与MMSE、MoCA和FACT-Cog的总分之间存在正相关。

结论

这些发现表明,化疗后的CRC患者左侧ACG的大脑内在活动降低,这可能易受化疗药物的神经毒性副作用影响,并与化疗引起的认知障碍有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeed/9339615/bef24f8b387c/fonc-12-900855-g001.jpg

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