Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy: A brain magnetic resonance imaging pilot study

Bihong T. Chen, Sean K. Sethi, Taihao Jin, Sunita K. Patel, Ningrong Ye, Can Lan Sun, Russell C. Rockne, E. Mark Haacke, James C. Root, Andrew Saykin, Tim A. Ahles, Andrei I. Holodny, Neal Prakash, Joanne Mortimer, James Waisman, Yuan Yuan, George Somlo, Daneng Li, Richard Yang, Heidi TanVani Katheria, Rachel Morrison, Arti Hurria

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Cognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy. Methods: Women aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models. Results: A total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for interaction = 0.07) and healthy controls (change = 0.09, p for interaction = 0.02). Conclusions: There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group; however, exploratory analyses demonstrated a reduction in both temporal lobe volume and oral reading recognition scores among patients on the TC regimen. These results suggest that different chemotherapy regimens may have differential effects on brain volume and cognition. Future, larger studies focusing on older adults with cancer on different treatment regimens are needed to confirm these findings.

Original languageEnglish (US)
Article number38
JournalBreast Cancer Research
Volume20
Issue number1
DOIs
StatePublished - May 2 2018

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Adjuvant Chemotherapy
Magnetic Resonance Imaging
Breast Neoplasms
Drug Therapy
Brain
Cognition
docetaxel
Temporal Lobe
Reading
Neoplasms
Control Groups
National Institutes of Health (U.S.)
Neuroimaging
Cyclophosphamide
Self Report
Linear Models
Software
Research

Keywords

  • Brain MRI
  • Brain volume
  • Breast cancer
  • Cancer-related cognitive impairment
  • Chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy : A brain magnetic resonance imaging pilot study. / Chen, Bihong T.; Sethi, Sean K.; Jin, Taihao; Patel, Sunita K.; Ye, Ningrong; Sun, Can Lan; Rockne, Russell C.; Haacke, E. Mark; Root, James C.; Saykin, Andrew; Ahles, Tim A.; Holodny, Andrei I.; Prakash, Neal; Mortimer, Joanne; Waisman, James; Yuan, Yuan; Somlo, George; Li, Daneng; Yang, Richard; Tan, Heidi; Katheria, Vani; Morrison, Rachel; Hurria, Arti.

In: Breast Cancer Research, Vol. 20, No. 1, 38, 02.05.2018.

Research output: Contribution to journalArticle

Chen, BT, Sethi, SK, Jin, T, Patel, SK, Ye, N, Sun, CL, Rockne, RC, Haacke, EM, Root, JC, Saykin, A, Ahles, TA, Holodny, AI, Prakash, N, Mortimer, J, Waisman, J, Yuan, Y, Somlo, G, Li, D, Yang, R, Tan, H, Katheria, V, Morrison, R & Hurria, A 2018, 'Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy: A brain magnetic resonance imaging pilot study', Breast Cancer Research, vol. 20, no. 1, 38. https://doi.org/10.1186/s13058-018-0965-3
Chen, Bihong T. ; Sethi, Sean K. ; Jin, Taihao ; Patel, Sunita K. ; Ye, Ningrong ; Sun, Can Lan ; Rockne, Russell C. ; Haacke, E. Mark ; Root, James C. ; Saykin, Andrew ; Ahles, Tim A. ; Holodny, Andrei I. ; Prakash, Neal ; Mortimer, Joanne ; Waisman, James ; Yuan, Yuan ; Somlo, George ; Li, Daneng ; Yang, Richard ; Tan, Heidi ; Katheria, Vani ; Morrison, Rachel ; Hurria, Arti. / Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy : A brain magnetic resonance imaging pilot study. In: Breast Cancer Research. 2018 ; Vol. 20, No. 1.
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title = "Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy: A brain magnetic resonance imaging pilot study",
abstract = "Background: Cognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy. Methods: Women aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models. Results: A total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for interaction = 0.07) and healthy controls (change = 0.09, p for interaction = 0.02). Conclusions: There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group; however, exploratory analyses demonstrated a reduction in both temporal lobe volume and oral reading recognition scores among patients on the TC regimen. These results suggest that different chemotherapy regimens may have differential effects on brain volume and cognition. Future, larger studies focusing on older adults with cancer on different treatment regimens are needed to confirm these findings.",
keywords = "Brain MRI, Brain volume, Breast cancer, Cancer-related cognitive impairment, Chemotherapy",
author = "Chen, {Bihong T.} and Sethi, {Sean K.} and Taihao Jin and Patel, {Sunita K.} and Ningrong Ye and Sun, {Can Lan} and Rockne, {Russell C.} and Haacke, {E. Mark} and Root, {James C.} and Andrew Saykin and Ahles, {Tim A.} and Holodny, {Andrei I.} and Neal Prakash and Joanne Mortimer and James Waisman and Yuan Yuan and George Somlo and Daneng Li and Richard Yang and Heidi Tan and Vani Katheria and Rachel Morrison and Arti Hurria",
year = "2018",
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TY - JOUR

T1 - Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy

T2 - A brain magnetic resonance imaging pilot study

AU - Chen, Bihong T.

AU - Sethi, Sean K.

AU - Jin, Taihao

AU - Patel, Sunita K.

AU - Ye, Ningrong

AU - Sun, Can Lan

AU - Rockne, Russell C.

AU - Haacke, E. Mark

AU - Root, James C.

AU - Saykin, Andrew

AU - Ahles, Tim A.

AU - Holodny, Andrei I.

AU - Prakash, Neal

AU - Mortimer, Joanne

AU - Waisman, James

AU - Yuan, Yuan

AU - Somlo, George

AU - Li, Daneng

AU - Yang, Richard

AU - Tan, Heidi

AU - Katheria, Vani

AU - Morrison, Rachel

AU - Hurria, Arti

PY - 2018/5/2

Y1 - 2018/5/2

N2 - Background: Cognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy. Methods: Women aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models. Results: A total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for interaction = 0.07) and healthy controls (change = 0.09, p for interaction = 0.02). Conclusions: There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group; however, exploratory analyses demonstrated a reduction in both temporal lobe volume and oral reading recognition scores among patients on the TC regimen. These results suggest that different chemotherapy regimens may have differential effects on brain volume and cognition. Future, larger studies focusing on older adults with cancer on different treatment regimens are needed to confirm these findings.

AB - Background: Cognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy. Methods: Women aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models. Results: A total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for interaction = 0.07) and healthy controls (change = 0.09, p for interaction = 0.02). Conclusions: There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group; however, exploratory analyses demonstrated a reduction in both temporal lobe volume and oral reading recognition scores among patients on the TC regimen. These results suggest that different chemotherapy regimens may have differential effects on brain volume and cognition. Future, larger studies focusing on older adults with cancer on different treatment regimens are needed to confirm these findings.

KW - Brain MRI

KW - Brain volume

KW - Breast cancer

KW - Cancer-related cognitive impairment

KW - Chemotherapy

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