Abstract
Cognitive complaints after chemotherapy are common in breast cancer patients, but the neural bases for these complaints remain unclear. This pilot study explored resting-state functional connectivity (FC) as a marker of subtle cognitive changes in breast cancer patients who experience cognitive complaints. Chemotherapy-treated (n = 20, at least 6 months off therapy) and untreated (n = 17, disease-control) female breast cancer patients with cognitive complaints and healthy controls (n = 20) were recruited. The FC of the right dorsolateral prefrontal cortex was calculated, and any correlations between this FC and neuropsychological assessments were determined. Chemotherapy-treated patients with cognitive complaints displayed increased FC between the right dorsolateral prefrontal cortex and both the contralateral cerebellar lobule VII and the cerebellar vermis XI, compared to the disease-control and healthy-control groups, despite unimpaired neuropsychological performance. The increased FC was negatively correlated with executive function and attention in breast cancer survivors with cognitive complaints. Our pilot study findings provide evidence that cerebellar-cortical FC changes may be a pathophysiological basis for chemotherapy-related cognitive complaints. In addition, the FC changes have the potential to reflect minor or compensated cognitive function impairment in breast cancer patients.
Highlights
Cognitive complaints after chemotherapy are common in breast cancer patients, but the neural bases for these complaints remain unclear
In the 36 breast cancer patients with cognitive complaints, lower attention/concentration values were correlated with depression (r = − 0.37, P = 0.030) and anxiety symptoms (r = − 0.41, P = 0.013), and lower executive function values were correlated with higher scores for anxiety (r = − 0.37, P = 0.031)
The neurocognitive performance of breast cancer patients treated with chemotherapy was not significantly different from that of the disease-control and healthy control groups
Summary
Cognitive complaints after chemotherapy are common in breast cancer patients, but the neural bases for these complaints remain unclear This pilot study explored resting-state functional connectivity (FC) as a marker of subtle cognitive changes in breast cancer patients who experience cognitive complaints. Chemotherapy-treated patients with cognitive complaints displayed increased FC between the right dorsolateral prefrontal cortex and both the contralateral cerebellar lobule VII and the cerebellar vermis XI, compared to the disease-control and healthy-control groups, despite unimpaired neuropsychological performance. Prior studies comparing chemotherapy treated breast cancer patients with healthy controls have shown alterations in the executive n etwork[15]; disrupted regional networks in the frontal, temporal, and striatal areas[16]; changes in the functional connectivity (FC) of the anterior cingulate cortex[17] or the anterior hippocampus[18]; and alterations in amplitude of low-frequency fluctuation[14]. The targeted investigation of patients with cognitive complaints in their daily lives may increase the understanding of compromised cognitive function and provide insight into the cognitive complaints themselves
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