Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: The impact of APOE and smoking

Tim A. Ahles, Yuelin Li, Brenna McDonald, Gary N. Schwartz, Peter A. Kaufman, Gregory J. Tsongalis, Jason H. Moore, Andrew Saykin

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: This study examined the association of post-treatment changes in cognitive performance, apolipoprotein E (APOE), and smoking in breast cancer patients treated with adjuvant therapy. Participants and Methods: Breast cancer patients treated with chemotherapy (N = 55, age = 51.9 ± 7.1, education = 15.7 ± 2.6) were evaluated with a battery of neuropsychological tests prior to chemotherapy and at 1, 6, and 18 months post-chemotherapy. Matched groups of breast cancer patients not exposed to chemotherapy (N = 68, age = 56.8 ± 8.3, education = 14.8 ± 2.2) and healthy controls (N = 43, age = 53.0 ± 10.1, education = 15.2 ± 2.6) were evaluated at similar intervals. APOE epsilon 4 carrier status (APOE4+) and smoking history were also evaluated. Results: The detrimental effect of APOE4+ genotype on post-treatment cognitive functioning was moderated by smoking history, that is, patients without a smoking history had significantly lower performance on measures of processing speed and working memory compared with those with a smoking history and healthy controls. Exploratory analyses revealed that APOE4+ patients without a smoking history who were exposed to chemotherapy showed a decline in performance in processing speed, compared with patients with a smoking history. A similar but less pronounced pattern was seen in the no chemotherapy group (primarily endocrine treatment). For working memory, the APOE4+ by smoking interaction was observed in the no chemotherapy group only. Conclusions: The association between APOE status, breast cancer treatment, and cognitive functioning was moderated by smoking history suggesting that both chemotherapy and endocrine therapy interact with APOE status and smoking to influence cognition. A putative mechanism is that smoking corrects a deficit in nicotinic receptor functioning and dopamine levels in APOE4+ individuals.

Original languageEnglish
Pages (from-to)1382-1390
Number of pages9
JournalPsycho-Oncology
Volume23
Issue number12
DOIs
StatePublished - Dec 1 2014

Fingerprint

Apolipoproteins E
Smoking
Breast Neoplasms
History
Drug Therapy
Therapeutics
Short-Term Memory
Education
Apolipoprotein E4
Neuropsychological Tests
Nicotinic Receptors
Cognition
Dopamine
Research Design
Genotype

Keywords

  • APOE
  • Breast cancer
  • Chemotherapy
  • Cognition
  • Smoking

ASJC Scopus subject areas

  • Oncology
  • Psychiatry and Mental health
  • Experimental and Cognitive Psychology

Cite this

Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer : The impact of APOE and smoking. / Ahles, Tim A.; Li, Yuelin; McDonald, Brenna; Schwartz, Gary N.; Kaufman, Peter A.; Tsongalis, Gregory J.; Moore, Jason H.; Saykin, Andrew.

In: Psycho-Oncology, Vol. 23, No. 12, 01.12.2014, p. 1382-1390.

Research output: Contribution to journalArticle

Ahles, Tim A. ; Li, Yuelin ; McDonald, Brenna ; Schwartz, Gary N. ; Kaufman, Peter A. ; Tsongalis, Gregory J. ; Moore, Jason H. ; Saykin, Andrew. / Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer : The impact of APOE and smoking. In: Psycho-Oncology. 2014 ; Vol. 23, No. 12. pp. 1382-1390.
@article{ea5ed25fa1ce49ffbe531d997405d850,
title = "Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: The impact of APOE and smoking",
abstract = "Purpose: This study examined the association of post-treatment changes in cognitive performance, apolipoprotein E (APOE), and smoking in breast cancer patients treated with adjuvant therapy. Participants and Methods: Breast cancer patients treated with chemotherapy (N = 55, age = 51.9 ± 7.1, education = 15.7 ± 2.6) were evaluated with a battery of neuropsychological tests prior to chemotherapy and at 1, 6, and 18 months post-chemotherapy. Matched groups of breast cancer patients not exposed to chemotherapy (N = 68, age = 56.8 ± 8.3, education = 14.8 ± 2.2) and healthy controls (N = 43, age = 53.0 ± 10.1, education = 15.2 ± 2.6) were evaluated at similar intervals. APOE epsilon 4 carrier status (APOE4+) and smoking history were also evaluated. Results: The detrimental effect of APOE4+ genotype on post-treatment cognitive functioning was moderated by smoking history, that is, patients without a smoking history had significantly lower performance on measures of processing speed and working memory compared with those with a smoking history and healthy controls. Exploratory analyses revealed that APOE4+ patients without a smoking history who were exposed to chemotherapy showed a decline in performance in processing speed, compared with patients with a smoking history. A similar but less pronounced pattern was seen in the no chemotherapy group (primarily endocrine treatment). For working memory, the APOE4+ by smoking interaction was observed in the no chemotherapy group only. Conclusions: The association between APOE status, breast cancer treatment, and cognitive functioning was moderated by smoking history suggesting that both chemotherapy and endocrine therapy interact with APOE status and smoking to influence cognition. A putative mechanism is that smoking corrects a deficit in nicotinic receptor functioning and dopamine levels in APOE4+ individuals.",
keywords = "APOE, Breast cancer, Chemotherapy, Cognition, Smoking",
author = "Ahles, {Tim A.} and Yuelin Li and Brenna McDonald and Schwartz, {Gary N.} and Kaufman, {Peter A.} and Tsongalis, {Gregory J.} and Moore, {Jason H.} and Andrew Saykin",
year = "2014",
month = "12",
day = "1",
doi = "10.1002/pon.3545",
language = "English",
volume = "23",
pages = "1382--1390",
journal = "Psycho-Oncology",
issn = "1057-9249",
publisher = "John Wiley and Sons Ltd",
number = "12",

}

TY - JOUR

T1 - Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer

T2 - The impact of APOE and smoking

AU - Ahles, Tim A.

AU - Li, Yuelin

AU - McDonald, Brenna

AU - Schwartz, Gary N.

AU - Kaufman, Peter A.

AU - Tsongalis, Gregory J.

AU - Moore, Jason H.

AU - Saykin, Andrew

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Purpose: This study examined the association of post-treatment changes in cognitive performance, apolipoprotein E (APOE), and smoking in breast cancer patients treated with adjuvant therapy. Participants and Methods: Breast cancer patients treated with chemotherapy (N = 55, age = 51.9 ± 7.1, education = 15.7 ± 2.6) were evaluated with a battery of neuropsychological tests prior to chemotherapy and at 1, 6, and 18 months post-chemotherapy. Matched groups of breast cancer patients not exposed to chemotherapy (N = 68, age = 56.8 ± 8.3, education = 14.8 ± 2.2) and healthy controls (N = 43, age = 53.0 ± 10.1, education = 15.2 ± 2.6) were evaluated at similar intervals. APOE epsilon 4 carrier status (APOE4+) and smoking history were also evaluated. Results: The detrimental effect of APOE4+ genotype on post-treatment cognitive functioning was moderated by smoking history, that is, patients without a smoking history had significantly lower performance on measures of processing speed and working memory compared with those with a smoking history and healthy controls. Exploratory analyses revealed that APOE4+ patients without a smoking history who were exposed to chemotherapy showed a decline in performance in processing speed, compared with patients with a smoking history. A similar but less pronounced pattern was seen in the no chemotherapy group (primarily endocrine treatment). For working memory, the APOE4+ by smoking interaction was observed in the no chemotherapy group only. Conclusions: The association between APOE status, breast cancer treatment, and cognitive functioning was moderated by smoking history suggesting that both chemotherapy and endocrine therapy interact with APOE status and smoking to influence cognition. A putative mechanism is that smoking corrects a deficit in nicotinic receptor functioning and dopamine levels in APOE4+ individuals.

AB - Purpose: This study examined the association of post-treatment changes in cognitive performance, apolipoprotein E (APOE), and smoking in breast cancer patients treated with adjuvant therapy. Participants and Methods: Breast cancer patients treated with chemotherapy (N = 55, age = 51.9 ± 7.1, education = 15.7 ± 2.6) were evaluated with a battery of neuropsychological tests prior to chemotherapy and at 1, 6, and 18 months post-chemotherapy. Matched groups of breast cancer patients not exposed to chemotherapy (N = 68, age = 56.8 ± 8.3, education = 14.8 ± 2.2) and healthy controls (N = 43, age = 53.0 ± 10.1, education = 15.2 ± 2.6) were evaluated at similar intervals. APOE epsilon 4 carrier status (APOE4+) and smoking history were also evaluated. Results: The detrimental effect of APOE4+ genotype on post-treatment cognitive functioning was moderated by smoking history, that is, patients without a smoking history had significantly lower performance on measures of processing speed and working memory compared with those with a smoking history and healthy controls. Exploratory analyses revealed that APOE4+ patients without a smoking history who were exposed to chemotherapy showed a decline in performance in processing speed, compared with patients with a smoking history. A similar but less pronounced pattern was seen in the no chemotherapy group (primarily endocrine treatment). For working memory, the APOE4+ by smoking interaction was observed in the no chemotherapy group only. Conclusions: The association between APOE status, breast cancer treatment, and cognitive functioning was moderated by smoking history suggesting that both chemotherapy and endocrine therapy interact with APOE status and smoking to influence cognition. A putative mechanism is that smoking corrects a deficit in nicotinic receptor functioning and dopamine levels in APOE4+ individuals.

KW - APOE

KW - Breast cancer

KW - Chemotherapy

KW - Cognition

KW - Smoking

UR - http://www.scopus.com/inward/record.url?scp=84915731609&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84915731609&partnerID=8YFLogxK

U2 - 10.1002/pon.3545

DO - 10.1002/pon.3545

M3 - Article

C2 - 24789331

AN - SCOPUS:84915731609

VL - 23

SP - 1382

EP - 1390

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 12

ER -