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功能脑映射中接受不同化疗方案的乳腺癌幸存者的神经相关性:一项基于 qEEG/HEG 的研究。

Neural correlates in functional brain mapping among breast cancer survivors receiving different chemotherapy regimens: a qEEG/HEG-based investigation.

机构信息

Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Jpn J Clin Oncol. 2022 Nov 3;52(11):1253-1264. doi: 10.1093/jjco/hyac121.

Abstract

BACKGROUND

Post-chemotherapy cognitive impairment commonly known as 'chemobrain' or 'chemofog' is a well-established clinical disorder affecting various cognitive domains including attention, visuospatial working memory, executive function, etc. Although several studies have confirmed the chemobrain in recent years, scant experiments have evaluated the potential neurotoxicity of different chemotherapy regimens and agents. In this study, we aimed to evaluate the extent of attention deficits, one of the commonly affected cognitive domains, among breast cancer patients treated with different chemotherapy regimens through neuroimaging techniques.

METHODS

Breast cancer patients treated with two commonly prescribed chemotherapy regimens, Adriamycin, Cyclophosphamide and Taxol and Taxotere, Adriamycin and Cyclophosphamide, and healthy volunteers were recruited. Near-infrared hemoencephalography and quantitative electroencephalography assessments were recorded for each participant at rest and during task performance to compare the functional cortical changes associated with each chemotherapy regimen.

RESULTS

Although no differences were observed in hemoencephalography results across groups, the quantitative electroencephalography analysis revealed increased power of high alpha/low beta in left fronto-centro-parietal regions involved in dorsal and ventral attention networks in the Adriamycin, Cyclophosphamide and Taxol-treated group compared with the Taxotere, Adriamycin and Cyclophosphamide and control group. The Adriamycin, Cyclophosphamide and Taxol-treated cases had the highest current source density values in dorsal attention network and ventral attention network and ventral attention network-related centers in 10 and 15 Hz associated with the lowest Z-scored Fast Fourier Transform coherence in the mentioned regions.

CONCLUSIONS

The negatively affected neurocognitive profile in breast cancer patients treated with the Adriamycin, Cyclophosphamide and Taxol regimen proposes presumably neurotoxic sequelae of this chemotherapy regimen as compared with the Taxotere, Adriamycin and Cyclophosphamide regimen.

摘要

背景

化疗后认知障碍,通常被称为“化疗脑”或“化疗雾”,是一种已被确立的临床障碍,影响包括注意力、视空间工作记忆、执行功能等多个认知领域。尽管近年来有几项研究证实了“化疗脑”的存在,但很少有实验评估不同化疗方案和药物的潜在神经毒性。在这项研究中,我们旨在通过神经影像学技术评估接受不同化疗方案治疗的乳腺癌患者中注意力缺陷(受影响的常见认知领域之一)的程度。

方法

招募接受两种常用化疗方案(阿霉素、环磷酰胺和紫杉醇)和多西紫杉醇、阿霉素和环磷酰胺治疗的乳腺癌患者以及健康志愿者。为每位参与者在静息和任务执行期间记录近红外脑血流图和定量脑电图评估,以比较与每种化疗方案相关的功能皮质变化。

结果

尽管各组的脑血流图结果无差异,但定量脑电图分析显示,与多西紫杉醇、阿霉素和环磷酰胺组和对照组相比,接受阿霉素、环磷酰胺和紫杉醇治疗的患者左额-中央-顶叶区域的高α/低β功率增加,该区域涉及背侧和腹侧注意力网络。接受阿霉素、环磷酰胺和紫杉醇治疗的病例在 10 和 15 Hz 时,在背侧注意力网络和腹侧注意力网络相关中心的电流源密度值最高,与上述区域的最低 Z 分快傅里叶变换相干性相关。

结论

与多西紫杉醇、阿霉素和环磷酰胺方案相比,接受阿霉素、环磷酰胺和紫杉醇方案治疗的乳腺癌患者的神经认知状况受到负面影响,提示该化疗方案可能存在神经毒性后遗症。

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