Abstract
Colorectal cancer (CRC) survivors report significant long-term physical and cognitive declines post-treatment. Our purpose was to combine task-evoked Event-Related Potential (ERP) and resting state functional magnetic resonance imaging (rsf/MRI) methodologies to characterize the physiological underpinnings and cognitive sequelae of chemotherapy-related cognitive impairment, including changes in Quality-Of-Life (QOL) in patients with CRC, as compared to healthy control (HC) participants. This descriptive study recruited and obtained baseline data from patients with CRC at medical and surgical oncology visits four to six weeks post-op and followed them at 12- and 24-weeks. Procedures employed ERP, pencil and paper neuropsychological testing (N-P), structural/functional rsf/MRI, and self-report QOL methodologies. Data analyses included correlations, one-way ANOVA, Chi-square tests, and linear mixed models. Study participants (n=40) across groups (n=15, 11, 14) were balanced on age, sex, education, and race, but not marital status Several significant associations were found between changes in Dorsal Attention Network (DAN)-related ERP measures (P2, N2, N2P2, N2pc amplitudes), with QOL measures between baseline and last visits (p<0.05-0.001). Additionally, rsf/MRI findings showed increased network activity in a single node of the DAN post-treatment, which was associated with poorer performance on N-P tests of attention and working memory, as well as a focal decline in grey matter volume in the area. Our methodology revealed structural and functional changes within the DAN associated with altered spatial attention, working memory, and ability to inhibit. These disruptions may be responsible for decreased QOL ratings in patients with CRC. This study provides a putative mechanism of understanding how altered brain structural/functional relationships impact cognition, QOL, and nursing care in patients with CRC. NCI-2020-05952, University of Nebraska Medical Center, Clinical Trials.gov ID NCT03683004.
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