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Sci Rep. 2018 Sep 14;8(1):13801. doi: 10.1038/s41598-018-32257-w.

Diminished gray matter density mediates chemotherapy dosage-related cognitive impairment in breast cancer patients.

Author information

1
Department of Oncology, People's Hospital of Yuxi City, the Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, 653100, China.
2
Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.
3
Cancer Center, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
4
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA.
5
Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
6
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA.
7
Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China. chd1975ay@126.com.
8
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA. chd1975ay@126.com.

Abstract

To investigate chemotherapy dosage-related cognitive impairment and its neural mechanisms in breast cancer (BC) patients. Twenty-eight breast cancer patients after each chemotherapy cycle and matched 29 healthy control subjects underwent structural magnetic resonance imaging. Voxel-based morphometry analysis was performed to compare group differences in the gray matter for the whole brain. Furthermore, mediation analysis was conducted to explore the role of brain structures in chemotherapy dosage-related cognitive impairment. Voxel-based morphometry analysis was performed in gray matter for the whole brain of BC patients after chemotherapy. The results revealed that the gray matter density in the left inferior frontal gyrus, right middle frontal gyrus, right fusiform area, and bilateral cerebellum was decreased in the BC patients compared to controls. The number of chemotherapy cycles was negatively associated with general cognitive capacity, verbal fluency and digit span performance in the BC patients. In addition, decreased gray matter density in the right middle frontal gyrus could mediate the chemotherapy dosage effects on verbal fluency performance. These findings indicate that the dose-response relationship between chemotherapy and cognitive impairment may depend on the decreases in gray matter density of the frontal cortical structures.

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