Functional Network Connectivity Reveals the Brain Functional Alterations in Breast Cancer Survivors.

Tatyana Bukkieva,Aleksandr Efimtsev,Maxim Shevtsov,Maria Pospelova,Gennadiy Trufanov,Albina Makhanova,Stephanie Combs,Varvara Krasnikova,Olga Fionik,Tatyana Alekseeva,Konstantin Samochernych,Elena Gorbunova,Anatoliy Levchuk

doi:10.3390/jcm11030617

Abstract

Different neurological and psychiatric disorders such as vertebrobasilar insufficiency, chronic pain syndrome, anxiety, and depression are observed in more than 90% of patients after treatment for breast cancer and may cause alterations in the functional connectivity of the default mode network. The purpose of the present study is to assess changes in the functional connectivity of the default mode network in patients after breast cancer treatment using resting state functional magnetic resonance imaging (rs-fMRI). Rs-fMRI was performed using a 3.0T MR-scanner on patients (N = 46, women) with neurological disorders (chronic pain, dizziness, headaches, and/or tinnitus) in the late postoperative period (>12 months) after Patey radical mastectomy for breast cancer. According to the intergroup statistical analysis, there were differences in the functional connectivity of the default mode network in all 46 patients after breast cancer treatment compared to the control group (p < 0.01). The use of rs-fMRI in in breast cancer survivors allowed us to identify changes in the functional connectivity in the brain caused by neurological disorders, which correlated with a decreased quality of life in these patients. The results indicate the necessity to improve treatment and rehabilitation methods in this group of patients.

Highlights

Breast cancer is the most common cancer among women worldwide— according to GLOBOCAN, 2.26 million new cases of breast cancer were detected in 2020, which accounted for 11.7% of all cancers [1]
Different neurological and psychiatric disorders such as vertebrobasilar insufficiency, chronic pain syndrome, anxiety, and depression are observed in more than 90% of patients after treatment for breast cancer and may cause alterations in the functional connectivity of the default mode network
When analyzing the resting state functional magnetic resonance imaging (rs-functional MRI (fMRI)) data in patients after breast cancer treatment compared to the control group, there was a change in the functional connectivity between the medial prefrontal cortex (MPFC) and a number of significant areas of the brain

Summary

Introduction

Breast cancer is the most common cancer among women worldwide— according to GLOBOCAN, 2.26 million new cases of breast cancer were detected in 2020, which accounted for 11.7% of all cancers [1]. After treatment for breast cancer, a complex of symptoms occurs, including disorders of the lymphatic, cardiovascular, musculoskeletal, and nervous systems [3,4]. Peripheral neurological disorders after breast cancer treatment are associated with persistent pain syndrome and impaired sensitivity and muscle strength of the upper limb on the side of surgical treatment [5,6]. These changes are primarily caused by disorders of the peripheral nervous system due to local fibrous-atrophic postoperative and post-radiation changes [7,8]. All of the above changes can lead to structural and functional changes in the brain, which worsens the long-term prognosis of rehabilitation and the quality of life of patients [15]

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