CALM干预改善乳腺癌幸存者癌症相关认知障碍的神经机制：一项基于功能磁共振成像的研究
Neural mechanisms of CALM intervention to improve CRCI in breast cancer survivors: an fMRI-based study.
作者信息
Gan Chen, Xu Jian, Yao Senbang, Zheng Xinyi, Hu Longyu, Ling Meiwen, Zhang Mingjun, Cheng Huaidong
机构信息
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University Hefei, Anhui, China.
Anhui Medical University Hefei, Anhui, China.
出版信息
Am J Cancer Res. 2025 Apr 15;15(4):1733-1746. doi: 10.62347/OOVH5568. eCollection 2025.
BACKGROUND
Managing Cancer and Living Meaningfully (CALM) intervention's impact on chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCs) was investigated through resting-state functional magnetic resonance imaging (rs-fMRI) to elucidate the underlying neural mechanisms involved.
METHODS
68 BCs were randomly assigned to either the CALM group (33 patients) or the care-as-usual (CAU) group (35 patients). Cognitive function was assessed before and after the intervention in both groups using the Mini Mental State Examination (MMSE) scale. Pre- and post-intervention rs-fMRI data were also collected for regional homogeneity (ReHo) and functional connectivity (FC) analyses in the CALM group. A total of 68 BCs were randomly assigned to either the CALM group (n = 33) or the care-as-usual (CAU) group (n = 35). Cognitive function was evaluated pre- and post-intervention using the Mini-Mental State Examination (MMSE). In the CALM group, rs-fMRI data were acquired before and after the intervention to assess alterations in regional homogeneity (ReHo) and functional connectivity (FC).
RESULTS
CALM intervention demonstrated a greater enhancement in cognitive function compared to CAU ( = 0.004). Following CALM, ReHo exhibited an increase in bilateral occipital and temporal regions, including the superior, middle, and inferior occipital gyri, lingual gyrus, as well as the middle and superior temporal gyri, while a decrease was observed in frontal and cingulate regions, including the bilateral middle, medial, and dorsolateral superior frontal gyri, anterior cingulate and paracingulate gyri, precuneus, posterior cingulate, and left angular gyrus. FC analysis revealed diminished connectivity between the middle frontal gyrus and occipital/calcarine regions, whereas connectivity strengthened with the left anterior cingulate/paracingulate and right orbital frontal regions. ΔMMSE exhibited a positive correlation with ReHo in the left middle frontal gyrus ( = 0.355, = 0.042) and a reduction in middle frontal-occipital FC (left calcarine: = 0.353, = 0.044; right/left middle occipital: = 0.388/0.423, = 0.029/0.014).
CONCLUSION
CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical.
背景
通过静息态功能磁共振成像（rs-fMRI）研究了“管理癌症与有意义地生活”（CALM）干预对乳腺癌幸存者（BCs）化疗相关认知障碍（CRCI）的影响，以阐明其中潜在的神经机制。
方法
68名乳腺癌幸存者被随机分为CALM组（33例患者）或常规护理（CAU）组（35例患者）。两组均在干预前后使用简易精神状态检查表（MMSE）评估认知功能。CALM组还收集了干预前后的rs-fMRI数据，用于局部一致性（ReHo）和功能连接（FC）分析。总共68名乳腺癌幸存者被随机分为CALM组（n = 33）或常规护理（CAU）组（n = 35）。使用简易精神状态检查表（MMSE）在干预前后评估认知功能。在CALM组中，在干预前后采集rs-fMRI数据，以评估局部一致性（ReHo）和功能连接（FC）的变化。
结果
与常规护理相比，CALM干预显示出对认知功能更大的改善（P = 0.004）。CALM干预后，双侧枕叶和颞叶区域的局部一致性增加，包括枕上回、枕中回、枕下回、舌回以及颞中回和颞上回，而额叶和扣带回区域减少，包括双侧额中回、额内侧回、额上回背外侧、前扣带回和旁扣带回、楔前叶、后扣带回以及左侧角回。功能连接分析显示额中回与枕叶/距状裂区域之间的连接减少，而与左侧前扣带回/旁扣带回和右侧眶额区域的连接增强。简易精神状态检查表变化值（ΔMMSE）与左侧额中回的局部一致性呈正相关（P = 0.355，r = 0.042），额中回-枕叶功能连接减少（左侧距状裂：P = 0.353，r = 0.044；右侧/左侧枕中回：P = 0.388/0.423，r = 0.029/0.014）。
结论
CALM干预可减轻乳腺癌幸存者的化疗相关认知障碍，其中额中回可能起关键作用。
需注意，原文最后一句“CONCLUSION: CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical.”表述有误，正确表述可能是“CONCLUSION: CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical role.” 翻译后的内容按照正确理解进行了适当调整。
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