Brain connectivity tracks effects of chemotherapy separately from behavioral measures

• Main Authors: Omid Kardan, Patricia A. Reuter-Lorenz, Scott Peltier, Nathan W. Churchill, Bratislav Misic, Mary K. Askren, Mi Sook Jung, Bernadine Cimprich, Marc G. Berman
• Format: Article
• Language: English
• Published: Elsevier 2019-01-01
• Series: NeuroImage: Clinical
• Online Access: http://www.sciencedirect.com/science/article/pii/S221315821930004X

Several studies in cancer research have suggested that cognitive dysfunction following chemotherapy, referred to in lay terms as “chemobrain”, is a serious problem. At present, the changes in integrative brain function that underlie such dysfunction remain poorly understood. Recent developments in neuroimaging suggest that patterns of functional connectivity can provide a broadly applicable neuromarker of cognitive performance and other psychometric measures. The current study used multivariate analysis methods to identify patterns of disruption in resting state functional connectivity of the brain due to chemotherapy and the degree to which the disruptions can be linked to behavioral measures of distress and cognitive performance. Sixty two women (22 healthy control, 18 patients treated with adjuvant chemotherapy, and 22 treated without chemotherapy) were evaluated with neurocognitive measures followed by self-report questionnaires and open eyes resting-state fMRI scanning at three time points: diagnosis (M0, pre-adjuvant treatment), 1 month (M1), and 7 months (M7) after treatment. The results indicated deficits in cognitive health of breast cancer patients immediately after chemotherapy that improved over time. This psychological trajectory was paralleled by a disruption and later recovery of resting-state functional connectivity, mostly in the parietal and frontal brain regions. Mediation analysis showed that the functional connectivity alteration pattern is a separable treatment symptom from the decreased cognitive health. Current study indicates that more targeted support for patients should be developed to ameliorate these multi-faceted side effects of chemotherapy treatment on neural functioning and cognitive health. Keywords: Breast cancer, Chemobrain, Functional connectivity, Resting-state BOLD