Frontal gray matter reduction after breast cancer chemotherapy and association with executive symptoms

A replication and extension study

Brenna McDonald, Susan K. Conroy, Dori J. Smith, John D. West, Andrew Saykin

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Cognitive changes related to cancer and its treatment have been intensely studied, and neuroimaging has begun to demonstrate brain correlates. In the first prospective longitudinal neuroimaging study of breast cancer (BC) patients we recently reported decreased gray matter density one month after chemotherapy completion, particularly in frontal regions. These findings helped confirm a neural basis for previously reported cognitive symptoms, which most commonly involve executive and memory processes in which the frontal lobes are a critical component of underlying neural circuitry. Here we present data from an independent, larger, more demographically diverse cohort that is more generalizable to the BC population. BC patients treated with (. N=. 27) and without (. N=. 28) chemotherapy and matched healthy controls (. N=. 24) were scanned at baseline (prior to systemic treatment) and one month following chemotherapy completion (or yoked intervals for non-chemotherapy and control groups) and APOE-genotyped. Voxel-based morphometry (VBM) showed decreased frontal gray matter density after chemotherapy, as observed in the prior cohort, which was accompanied by self-reported difficulties in executive functioning. Gray matter and executive symptom changes were not related to APOE ε4 status, though a somewhat greater percentage of BC patients who received chemotherapy were ε4 allele carriers than patients not treated with chemotherapy or healthy controls. These findings provide confirmatory evidence of frontal morphometric changes that may be a pathophysiological basis for cancer and treatment-related cognitive dysfunction. Further research into individual risk factors for such changes will be critical for development of treatment and prevention strategies.

Original languageEnglish
JournalBrain, Behavior, and Immunity
Volume30
Issue numberSUPPL.
DOIs
StatePublished - Mar 15 2013

Fingerprint

Breast Neoplasms
Drug Therapy
Neuroimaging
Neurobehavioral Manifestations
Second Primary Neoplasms
Frontal Lobe
Longitudinal Studies
Gray Matter
Therapeutics
Alleles
Control Groups
Brain
Research
Population
Neoplasms

Keywords

  • Adjuvant chemotherapy
  • APOE genotype
  • Brain
  • Breast cancer
  • BRIEF-A
  • Executive function
  • Frontal lobes
  • Magnetic resonance imaging
  • Neuroimaging
  • Voxel-based morphometry

ASJC Scopus subject areas

  • Immunology
  • Behavioral Neuroscience
  • Endocrine and Autonomic Systems

Cite this

Frontal gray matter reduction after breast cancer chemotherapy and association with executive symptoms : A replication and extension study. / McDonald, Brenna; Conroy, Susan K.; Smith, Dori J.; West, John D.; Saykin, Andrew.

In: Brain, Behavior, and Immunity, Vol. 30, No. SUPPL., 15.03.2013.

Research output: Contribution to journalArticle

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