Study On The Changes Of Brain Function After Breast Cancer Chemotherapy Based On Resting Magnetic Resonance Imaging

PurposeTo explore the changes of cognitive function,neurological and psychological damage and corresponding brain function in patients with breast cancer before and after chemotherapy by resting state functional MRI(Resting-state Function MRI,RS-f MRI)technique,to find out the related factors of cognitive impairment(chemotherapy-related cognitive impairment,CRCI)and other neuropsychological function decrease caused by chemotherapy,and to further explore the hidden mechanism of brain function damage caused by chemotherapeutic drugs and corresponding neuropsychological changes in different brain regions.Materals and MethodsThis study included 25 female patients with breast cancer(stage Ⅰ ～ Ⅲ)diagnosed by pathology after breast surgery and received neoadjuvant chemotherapy after operation.the average age was(41.24 ± 8.00)years.Resting state functional magnetic resonance imaging(RS-f MRI)and neuropsychological tests were performed before postoperative chemotherapy(T1)and one month after the end of the total course of chemotherapy(T2).The neuropsychological test mainly includes four areas of neuropsychological cognitive test: Montreal Cognitive Assessment scale((Montreal Cognitive Assessment,Mo CA),Stroop color word test A,B,C(Stroop Colour-Word Test,SCWT),auditory word learning test(Auditory Verbal Learning Test,AVLT)immediate memory,delayed memory,digital symbol conversion test(Symbol Digit Modalities Test,SDMT).At the same time,the resting state functional MRI data were preprocessed with low frequency amplitude(Amplitude of Low Frequency Fluctuation,ALFF)and regional homogeneity(Regional Homogeneity,Re Ho)data by DPARSF(Data Processing Assistant for RS-f MRI)software package,and then statistically analyzed by REST,and the data were corrected by Alphasim multiple comparison.Using SPSS 25.0 statistical software package,the collected neuropsychological test score data were tested by paired t-test,and the correlation between neuropsychological test score and ALLF value,Reho value was statistically analyzed.ResultsIn the breast cancer chemotherapy group,in the neuropsychological cognitive test before chemotherapy(T1)and one month after chemotherapy(T2),Stroop color word test B test(41.20 ±3.66 s vs 48.00 ±8.65 s,Stroop color word test C test(106.00 ±10.25 s vs 127.4815.66 s,vs 5.737 score 0.00),auditory word learning test(AVLT)delayed memory test(9.28 ±0.93 vs 8.16 ±1.31).There was significant difference in the scores of(SDMT)(3.473 vs 0.01),digit symbol conversion test 56.76 ±1.71 vs and 4.1956 Pioneer 0.00)of the digit symbol conversion test.The difference was statistically significant(P < 0.01),and the difference was statistically significant(P <0.01),and the difference was statistically significant(P < 0.05).On the other hand,the Montreal Cognitive Assessment scale((Mo CA))scores(28.00 ±0.81)vs 27.52 ±1.00,Stroop Stroop color words test A(36.56 ± 2.46 s vs 38.16 ± 1.34 s,tcm2.847 pause 0.06),auditory word learning test(AVLT)immediate memory(4.44 ±0.96 vs 4.00 ±0.86),tactile color words test A(36.56 ±2.46 s color words 38.16 ±1.34 s,tours 2.847 ±0.06),auditory word learning test(AVLT)immediate memory(4.44 ± 0.96 vs 4.00 ± 0.86,tactile 1.701).There was no significant difference between the two time points of T1 and T2.The brain regions with increased ALLF values of breast cancer patients before and one month after chemotherapy included posterior cerebellar lobe,right middle temporal gyrus,right middle frontal gyrus,left middle frontal gyrus and middle right cingulate gyrus;the brain regions with decreased ALLF values of breast cancer patients before and one month after chemotherapy included right superior temporal gyrus,right postcentral gyrus and left supplementary active area.The areas in which the Reho value increased in breast cancer patients before chemotherapy(T1)and one month after chemotherapy(T2)included: left middle frontal gyrus;the areas of breast cancer patients with reduced Reho values before and one month after chemotherapy included left cerebellar peduncle 1,right cerebellar peduncle 2,right inferior temporal gyrus,left straight gyrus,left middle temporal gyrus,right anterior cingulate gyrus,right superior temporal gyrus and left postcentral gyrus.Pearson correlation analysis showed that there was no significant correlation between cognitive function test score and ALFF value and Reho value.ConclusionAlthough there is no significant difference in the overall cognitive ability of breast cancer patients after chemotherapy,the neuropsychological functions such as memory ability,executive ability,information processing and information processing speed are impaired correspondingly.At the same time,it is accompanied by changes in brain function activities in some brain regions,which further indicates that the use of chemotherapeutic drugs has a certain correlation with the damage of neurological function in cancer patients.At the same time,different aspects of neuropsychological impairment are associated with brain regions,which verifies the research prospect and application value of resting f MRI in the changes of brain function related to chemotherapy.