Abstract
PurposeThis longitudinal study aimed to disentangle the impact of chemotherapy on fatigue and hypothetically associated functional brain network alterations.MethodsIn total, 34 breast cancer patients treated with chemotherapy (BCC +), 32 patients not treated with chemotherapy (BCC −), and 35 non-cancer controls (NC) were included. Fatigue was assessed using the EORTC QLQ-C30 fatigue subscale at two time points: baseline (T1) and six months after completion of chemotherapy or matched intervals (T2). Participants also underwent resting-state functional magnetic resonance imaging (rsfMRI). An atlas spanning 90 cortical and subcortical brain regions was used to extract time series, after which Pearson correlation coefficients were calculated to construct a brain network per participant per timepoint. Network measures of local segregation and global integration were compared between groups and timepoints and correlated with fatigue.ResultsAs expected, fatigue increased over time in the BCC + group (p = 0.025) leading to higher fatigue compared to NC at T2 (p = 0.023). Meanwhile, fatigue decreased from T1 to T2 in the BCC − group (p = 0.013). The BCC + group had significantly lower local efficiency than NC at T2 (p = 0.033), while a negative correlation was seen between fatigue and local efficiency across timepoints and all participants (T1 rho = − 0.274, p = 0.006; T2 rho = − 0.207, p = 0.039).ConclusionAlthough greater fatigue and lower local functional network segregation co-occur in breast cancer patients after chemotherapy, the relationship between the two generalized across participant subgroups, suggesting that local efficiency is a general neural correlate of fatigue.
Highlights
Breast cancer is the most prevalent cancer in women and the second most commonly occurring cancer overall [1]
At T1, no significant group difference was found in menopausal status, a significant difference was seen at T2, where post-hoc testing revealed more postmenopausal women in BCC + compared to BCC − and non-cancer controls (NC) [X2(2, N = 100) = 19.3, p < 0.001], as expected in women undergoing chemotherapeutic treatment
The present study examined fatigue and functional brain network topology of chemotherapy-treated breast cancer patients
Summary
Breast cancer is the most prevalent cancer in women and the second most commonly occurring cancer overall [1]. Studies have described the widespread abnormalities in restingstate networks of breast cancer survivors, highlighting chemotherapy-related functional changes in the brain [19, 20]. The breast cancer group had lower global and local efficiency compared with healthy controls Local alterations such as higher nodal degree and functional connectivity were seen in several prefrontal, occipital and parietal regions. Changes in network topology and fatigue from pre-treatment to posttreatment time points were compared between breast cancer patients who received chemotherapy, breast cancer patients who did not, and non-cancer controls Both graph measures of integration and segregation were used to allow a comprehensive overview and enable the comparison of our results with previous studies. We expected lower segregation and integration in those patients, and these network differences and changes to correlate with greater and increasing fatigue
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