Chen Vincent Chin-Hung, Wu Yi-Fang, Tsai Yuan-Hsiung, Weng Jun-Cheng
School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
J Clin Med. 2024 Jan 24;13(3):668. doi: 10.3390/jcm13030668.
Adjuvant chemotherapy for breast cancer might impact cognitive function and brain structure. In this study, we investigated the cerebral microstructural changes in breast cancer survivors after adjuvant chemotherapy and the correlation with cognitive function with both cross-sectional and longitudinal study designs. All participants underwent structural MRI. In total, we recruited 67 prechemotherapy patients (BB), 67 postchemotherapy patients (BA), and 77 healthy controls (BH). For the follow-up study, 28 participants in the BH and 28 in the BB groups returned for imaging and assessment (BHF, BBF). Voxel-based morphometry analysis was performed to evaluate differences in brain volume; vertex-based shape analysis was used to assess the shape alterations of subcortical regions. Moreover, multiple regression was applied to assess the association between the changes in neuropsychological assessment and brain volume. The results showed brain volume reduction in the temporal and parietal gyrus in BB and BA patients. Among each group, we also found significant shape alterations in the caudate and thalamus. Volume reductions in the temporal regions and shape changes in the caudate and hippocampus were also observed in patients from time point 1 to time point 2 (postchemotherapy). An association between brain volume and cognitive performance was also found in the limbic system. Based on our findings, we can provide a better understanding of the cerebral structural changes in breast cancer survivors, establish a subsequent prediction model, and serve as a reference for subsequent treatment.
乳腺癌辅助化疗可能会影响认知功能和脑结构。在本研究中，我们采用横断面和纵向研究设计，调查了乳腺癌幸存者在辅助化疗后的脑微结构变化及其与认知功能的相关性。所有参与者均接受了结构磁共振成像（MRI）检查。我们总共招募了67名化疗前患者（BB组）、67名化疗后患者（BA组）和77名健康对照者（BH组）。在随访研究中，BH组和BB组分别有28名参与者返回进行成像和评估（BHF组、BBF组）。采用基于体素的形态学分析来评估脑容量差异；采用基于顶点的形状分析来评估皮质下区域的形状改变。此外，应用多元回归分析来评估神经心理学评估变化与脑容量之间的关联。结果显示，BB组和BA组患者的颞叶和顶叶脑回脑容量减少。在每组中，我们还发现尾状核和丘脑有明显的形状改变。在化疗后从时间点1到时间点2的患者中，也观察到颞叶区域脑容量减少以及尾状核和海马体形状改变。在边缘系统中还发现脑容量与认知表现之间存在关联。基于我们的研究结果，我们可以更好地了解乳腺癌幸存者的脑结构变化，建立后续的预测模型，并为后续治疗提供参考。
