Abstract
TPS240 Background: Cancer patients treated with chemotherapy frequently complain of cognitive deficits during treatment and often for some years thereafter. Many cytotoxic drugs commonly used in chemotherapy result in cognitive deficits via direct neurotoxicity to the cerebral parenchyma, neuronal axons, microglia, and/or oligodendrocytes. This chemotherapy-induced neurotoxicity may lead to changes in the levels of various brain metabolites. Previous studies using Magnetic Resonance Spectroscopy (MRS) suggest that cognitive impairment is accompanied by changes in specific brain metabolites such as N-acetyl aspartate (NAA), creatine, choline, and myo-inositol (Jung RE et al; 1999, Ross AJ et al; 2004). Because metabolic changes are likely to precede clinically detectable cognitive dysfunction, MRS may allow early identification of patients who will develop cognitive dysfunction associated with cancer treatments. Methods: The aims of this study are 1. to evaluate cognitive function using neuropsychological testing, 2. to collect MRS data from left thalamus, hippocampus, frontal and parietal lobes, 3. to characterize the temporal relationship between brain metabolite concentrations and cognitive functioning. Fifty newly diagnosed breast cancer patients, who are to receive adjuvant chemotherapy are evaluated with a battery of neuropsychological tests and MRS at three time points: before receiving chemotherapy (baseline), 4-8 weeks after completing their final treatment, and one year later. Patients also complete self-report questionnaires at all three time points. Exclusion criteria include CNS metastasis and depression. Neuropsychological tests are scored by standard procedures with adjustments for age, gender and education, and converted to Z-scores. Concentrations of NAA, creatine, choline, and myo-inositol are calculated from the MRS data for all time points by standard methods, with correction for the cerebrospinal fluid fraction in the voxel. Results of this study could lead to greater understanding of chemotherapy-induced cognitive impairment and improved prevention/treatment strategies in this population of cancer survivors.
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