Abstract
BackgroundBreast cancer survivors, particularly those treated with chemotherapy, are at significantly increased risk for long-term cognitive and neurobiologic impairments. These deficits tend to involve skills that are subserved by distributed brain networks. Additionally, neuroimaging studies have shown a diffuse pattern of brain structure changes in chemotherapy-treated breast cancer survivors that might impact large-scale brain networks.MethodsWe therefore applied graph theoretical analysis to compare the gray matter structural networks of female breast cancer survivors with a history of chemotherapy treatment and healthy age and education matched female controls.ResultsResults revealed reduced clustering coefficient and small-world index in the brain network of the breast cancer patients across a range of network densities. In addition, the network of the breast cancer group had less highly interactive nodes and reduced degree/centrality in the frontotemporal regions compared to controls, which may help explain the common impairments of memory and executive functioning among these patients.ConclusionsThese results suggest that breast cancer and chemotherapy may decrease regional connectivity as well as global network organization and integration, reducing efficiency of the network. To our knowledge, this is the first report of altered large-scale brain networks associated with breast cancer and chemotherapy.
Highlights
Breast cancer survivors, those treated with chemotherapy, are at significantly increased risk for long-term cognitive and neurobiologic impairments
We found an alteration in small-world characteristics of the brain structural network in the breast cancer survivors (BC) group; an observation that confirms our hypothesis suggesting changes in largescale brain network properties in BC survivors treated with chemotherapy
The present findings indicate that the network of BC patients does not show expected prefrontal and temporal hubs suggesting network alterations involving these regions, again which are critical for the executive function and memory skills commonly disrupted in BC
Summary
Those treated with chemotherapy, are at significantly increased risk for long-term cognitive and neurobiologic impairments These deficits tend to involve skills that are subserved by distributed brain networks. Several neuropsychological studies have shown the negative influence of breast cancer and chemotherapy on various cognitive skills with executive function and memory impairments being the most common [2,3] These deficits have been reported both prior and following chemotherapy with evidence showing increased and/or more severe cognitive changes in breast cancer patients treated with chemotherapy [4,5,6,7,8,9]. We investigated whether breast cancer and chemotherapy are associated with alterations in large-scale structural brain networks
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