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Melis M, Blommaert J, Van der Gucht K, Smeets A, McDonald BC, Sunaert S, Smith A, Deprez S. The impact of mindfulness on working memory-related brain activation in breast cancer survivors with cognitive complaints. J Cancer Surviv 2023:10.1007/s11764-023-01484-0. [PMID: 37922071 DOI: 10.1007/s11764-023-01484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) has been associated with altered brain activation after chemotherapy in areas related to working memory. Hence, improving working memory capacity and associated brain activation might aid in the recovery of CRCI. In this study, we investigated the potential of a mindfulness-based intervention (MBI) to impact working memory-related brain activation. METHODS Female breast cancer survivors reporting cognitive complaints (N=117) were randomized into a mindfulness (n=43; MBI), physical training (n=36; PT), or waitlist control condition (n=38; WL). Participants completed MRI scans before the intervention, immediately after, and three months post-intervention. Task-based functional MRI was used to measure differences between groups over time in working memory-related brain activation while performing a visual-verbal n-back task. RESULTS Data of 83 participants (32/26/25 MBI/PT/WL) was included. Compared to the waitlist group, MBI participants showed reduced task-related activation in the right middle frontal and angular gyrus and increased activation in the right dorsal posterior cingulate cortex over time. Compared to the physical training group, MBI participants showed reduced brain activation in the bilateral superior parietal lobule and right dorsal anterior cingulate cortex over time. No differences between physical training and no intervention were identified. CONCLUSION This study showed that an 8-week mindfulness-based intervention can significantly alter brain activation across brain regions involved in working memory, attentional control, and emotion processing during performance of a working memory task. This might aid in the recovery of CRCI. IMPLICATIONS FOR CANCER SURVIVORS Mindfulness might alter brain activation patterns while performing a working memory task, which might ultimately aid in restoring higher order cognitive functions.
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Affiliation(s)
- Michelle Melis
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium.
- Research Foundation Flanders (FWO), Flanders, Belgium.
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute, KU Leuven, Leuven, Belgium.
| | - Jeroen Blommaert
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Katleen Van der Gucht
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Neuromodulation Laboratory, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ann Smeets
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Multidisciplinary Breast Center, Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Stefan Sunaert
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Andra Smith
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Sabine Deprez
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Herestraat 49-box 7003, 3000, Leuven, UZ, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Liu Y, Liu JE, Chen S, Zhao F, Chen L, Li R. Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients: A Systematic Review and Network Meta-analysis. Cancer Nurs 2023; 46:E305-E319. [PMID: 37607381 DOI: 10.1097/ncc.0000000000001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neurotoxicity is a major adverse effect of chemotherapy in breast cancer (BC) patients. A number of nonpharmacologic interventions are used to alleviate chemotherapy-related cognitive impairment (CRCI), but no studies have compared their effectiveness. OBJECTIVES The aim of this study was to identify and compare the effectiveness of different nonpharmacologic interventions for CRCI in BC patients. METHODS A systematic review and network meta-analysis was conducted following the Cochrane guidelines. All randomized controlled trials were searched in the Cochrane Library, PubMed, MEDLINE (via OVID), Web of Science, EMBASE, and CINAHL databases from inception to September 2021. Studies using nonpharmacologic interventions to manage CRCI symptoms were included. A network meta-analysis and a comparative effects ranking were completed by STATA v14.0. RESULTS Twelve studies with 8 nonpharmacologic interventions were included. For subjective outcomes on CRCI, there was no significant difference between nonpharmacologic interventions. For objective outcomes, qigong and exercise were more effective than the psychotherapy. Qigong and exercise were also more effective than music therapy. The top 3 interventions were psychotherapy (83.4%), music therapy (60.8%), and electroacupuncture (52.5%) for subjective outcomes and qigong (87.7%), exercise (82.1%), and electroacupuncture (70.3%) for objective outcomes. CONCLUSION In the subjective evaluation, it was difficult to judge which interventions are best, but psychotherapy had the greatest probability. For objective evaluation, qigong and exercise may be the best nonpharmacologic interventions. IMPLICATIONS FOR PRACTICE This study provides evidence for the effectiveness of nonpharmacologic interventions for CRCI in BC patients and facilitates support for future clinical trials and work.
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Affiliation(s)
- Yu Liu
- Author Affiliation: School of Nursing, Capital Medical University, People's Republic of China
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Melis M, Schroyen G, Blommaert J, Leenaerts N, Smeets A, Van Der Gucht K, Sunaert S, Deprez S. The Impact of Mindfulness on Functional Brain Connectivity and Peripheral Inflammation in Breast Cancer Survivors with Cognitive Complaints. Cancers (Basel) 2023; 15:3632. [PMID: 37509292 PMCID: PMC10377401 DOI: 10.3390/cancers15143632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) has been linked to functional brain changes and inflammatory processes. Hence, interventions targeting these underlying mechanisms are needed. In this study, we investigated the effects of a mindfulness-based intervention on brain function and inflammatory profiles in breast cancer survivors with CRCI. METHODS Female breast cancer survivors reporting cognitive complaints (n = 117) were randomly assigned to a mindfulness-based intervention (n = 43), physical training (n = 36), or waitlist control condition (n = 38). Region-of-interest (ROI) and graph theory analyses of resting state functional MRI data were performed to study longitudinal group differences in functional connectivity and organization in the default mode, dorsal attention, salience, and frontoparietal network. Additionally, bead-based immunoassays were used to investigate the differences in inflammatory profiles on serum samples. Measures were collected before, immediately after and three months post-intervention. RESULTS No ROI-to-ROI functional connectivity changes were identified. Compared to no intervention, graph analysis showed a larger decrease in clustering coefficient after mindfulness and physical training. Additionally, a larger increase in global efficiency after physical training was identified. Furthermore, the physical training group showed a larger decrease in an inflammatory profile compared to no intervention (IL-12p70, IFN-γ, IL-1β, and IL-8). CONCLUSION Both mindfulness and physical training induced changes in the functional organization of networks related to attention, emotion processing, and executive functioning. While both interventions reduced functional segregation, only physical training increased functional integration of the neural network. In conclusion, physical training had the most pronounced effects on functional network organization and biomarkers of inflammation, two mechanisms that might be involved in CRCI.
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Affiliation(s)
- Michelle Melis
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
| | - Gwen Schroyen
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
| | - Jeroen Blommaert
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Oncology, Gynecological Oncology, Catholic University Leuven, 3000 Leuven, Belgium
| | - Nicolas Leenaerts
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Neurosciences, Mind-Body Research, Catholic University Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Oncology, Surgical Oncology, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Surgical Oncology, Multidisciplinary Breast Center, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Katleen Van Der Gucht
- Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, Catholic University Leuven, 3000 Leuven, Belgium
- Neuromodulation Laboratory, Biomedical Sciences Group, Department of Rehabilitation Sciences, Catholic University Leuven, 3000 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
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Ma DDF, Fennessy K, Kliman D. Potential benefits of a virtual, home-based combined exercise and mindfulness training program for HSC transplant survivors: a single-arm pilot study. BMC Sports Sci Med Rehabil 2022; 14:167. [PMID: 36064618 PMCID: PMC9444110 DOI: 10.1186/s13102-022-00554-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/22/2022] [Indexed: 11/10/2022]
Abstract
Purpose Impaired quality of life (QOL) including reduced physical fitness is a recognized late effect of hemopoietic cell transplantation (HCT). Guided exercise and mindfulness-based stress management (MBSM) programs have shown promise, mainly in the inpatient setting. We aimed to examine the feasibility of a virtual, home-based, combined exercise and MBSM program. Methods Patients attending post-HCT clinic were invited to participate in this single-arm pre-post study. Eligibility criteria included age 18–75 years, > 6 months post allogeneic HCT. Consented participants attended an in-person session, followed by weekly exercise and MBSM training for 6 weeks via videoconferencing. Assessments were performed pre-training, and at 3-, 6- and 12-months and compared using a linear mixed effects model. Results 21 of 24 patients consenting to the study completed the program (median age 56 years [IQR 46–62], median time post-HCT 37 months [IQR 26–46]). Six-minute walk test scores were significantly higher at 3 (mean difference 79.6, 95%CI 28–131, ES 0.55) and 12 months (mean difference 48.4, 95%CI 13–84, ES 0.33) compared to baseline. Sit-to-stand test was significantly higher at 3 (mean difference 4.4, 95%CI 1.4–7.4, ES 0.68) and 12 months (mean difference 3.9, 95%CI 0.24–7.6, ES 0.61). Dominant hand grip was significantly stronger at 3 (mean difference 0.16, 95%CI 0.04–0.28, ES 0.45), and 12 months (mean difference 0.21, 95%CI 0.08–0.24, ES 0.62). Significantly higher FACT-BMT total (mean difference 6.9, 95%CI 1.5–12.4, ES 0.49) and FACT-G scores (mean difference 5.2, 95%CI 1.4–9.1, ES 0.48) were found at 3 months. Over 80% of participants rated the virtual combined modal program highly and no adverse events were reported. Conclusion A 6-week virtual, home-based exercise and MBSM program was an acceptable, and potentially effective intervention for sustained improvement of some physical capacity and QOL outcomes in HCT survivors. Virtual-based healthcare service is highly relevant particularly during pandemics. To our knowledge, this study has the longest follow-up observation period for Internet based combined modality training program reported to date and warrants additional investigation. Trial Registration Research protocol approved by St Vincent’s Hospital Ethics Committee (HREC 12/SVH/175), approved 27/09/2012, trial commenced 24/05/13 and the first participant 07/06/13. Retrospectively registered with ANZCTR (ACTRN12613001054707) 23/09/2013. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00554-7.
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Affiliation(s)
- David D F Ma
- Department of Haematology and Bone Marrow Transplant, St Vincent's Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW, Australia.
| | - Kate Fennessy
- Department of Haematology and Bone Marrow Transplant, St Vincent's Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW, Australia
| | - David Kliman
- Department of Haematology and Bone Marrow Transplant, St Vincent's Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
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Rossini PG, Ostacoli L, Pagani M, Malandrone F, Oliva F, Cominu L, Annetta MC, Carletto S. The Neural Signature of Psychological Interventions in Persons With Cancer: A Scoping Review. Integr Cancer Ther 2022; 21:15347354221096808. [PMID: 35635127 PMCID: PMC9158410 DOI: 10.1177/15347354221096808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: People diagnosed with cancer have to deal with the debilitating psychological implications of this disease. Although the clinical efficacy of psychological interventions is well documented, relatively little has been written on the neural correlates of these treatments in the context of oncology. The present work is the first to provide an overall perspective of the existing literature on this topic. It also considers the potential directions for future research. Methods: This scoping review was carried out across 5 databases (EMBASE, PsycINFO, OVID MEDLINE, CINAHL, COCHRANE CENTRAL), from conception dates until 3 December 2021. Results: From an initial set of 4172 records, 13 papers were selected for this review. They consisted of 9 randomized controlled studies (RCTs), 1 quasi-experiment, 2 single case studies, and 1 secondary quantitative analysis. The studies were also heterogeneous in terms of the patient and control populations, psychological interventions, and neuroimaging methodologies used. The findings from these few studies suggest that psychological interventions in oncology patients may modulate both cortical and subcortical brain activity, consistent with the brain areas involved in distress reactions in general and to cancer specifically. The implications of this scoping review in terms of future research are also discussed. Conclusions: The literature on the neural correlates of psychological interventions in cancer patients is very limited, and thus requires further exploration. The provision of psychological interventions offers cancer patients a more integrated approach to care, which may in turn help preserve both the physical and the psychological wellbeing of individuals with cancer.
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Affiliation(s)
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies – CNR, Rome, Italy
| | - Francesca Malandrone
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Luca Cominu
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Maria Chiara Annetta
- Clinical Psychology Unit, University Hospital “Città della Salute e della Scienza”, Turin, Italy
| | - Sara Carletto
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, Turin, Italy
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Mampay M, Flint MS, Sheridan GK. Tumour brain: Pretreatment cognitive and affective disorders caused by peripheral cancers. Br J Pharmacol 2021; 178:3977-3996. [PMID: 34029379 DOI: 10.1111/bph.15571] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, blood-brain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis.
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Affiliation(s)
- Myrthe Mampay
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Melanie S Flint
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Graham K Sheridan
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
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Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021; 10:jcm10092015. [PMID: 34066752 PMCID: PMC8125804 DOI: 10.3390/jcm10092015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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Blount DS, McDonough DJ, Gao Z. Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021. [PMID: 34066752 DOI: 10.3390/jcm10092015.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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Affiliation(s)
- Daphne S Blount
- College of Biological Science, University of Minnesota-Twin Cities, 1445 Gortner Ave, Saint Paul, MN 55108, USA
| | - Daniel J McDonough
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
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McDonald BC. Structural Neuroimaging Findings Related to Adult Non-CNS Cancer and Treatment: Review, Integration, and Implications for Treatment of Cognitive Dysfunction. Neurotherapeutics 2021; 18:792-810. [PMID: 34402034 PMCID: PMC8423886 DOI: 10.1007/s13311-021-01096-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 12/13/2022] Open
Abstract
Cancer- and treatment-related cognitive dysfunction (CRCD) is a common challenge faced by patients diagnosed with non-central nervous system (CNS) cancer. It has become increasingly recognized that multiple factors likely play a role in these symptoms, including the cancer disease process, systemic treatments (e.g., chemotherapy and endocrine therapies), and risk factors that may predispose an individual to both cancer and cognitive dysfunction. As the field has evolved, advanced neuroimaging techniques have been applied to better understand the neural correlates of CRCD. This review focuses on structural neuroimaging findings related to CRCD in adult non-CNS cancer populations, including examination of gray matter volume/density and white matter integrity differences between cancer patients and comparison groups, as well as emerging findings regarding structural network abnormalities. Overall, this literature has demonstrated consistent findings of reduced gray matter volume/density and white matter integrity in cancer patients relative to comparison groups. These are most prominent in individuals treated with chemotherapy, though alterations have also been noted in those treated with anti-estrogen and androgen-deprivation therapies. Alterations in gray and white matter structural network connectivity have also been identified. These structural abnormalities have been observed most prominently in frontal and temporal brain regions, and have been shown to correlate with subjective and objective cognitive function, as well as with physiological and clinical variables, helping to inform understanding of CRCD mechanisms. To date, however, structural neuroimaging techniques have not been utilized in systematic studies of potential CRCD treatments, suggesting a potentially fruitful avenue for future research.
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Affiliation(s)
- Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, 355 W. 16th St., GH Suite 4100, Indianapolis, IN, 46202, USA.
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