A Prospective Study About Chemotherapy Related Cognitive Disorder Based On Resting‐state Functional Magnetic Resonance Imaging And Diffusion Tensor Imaging In Patients With Breast Cancer

Purpose: The purpose of our study is to uncover chemotherapy related cognitive disorder by using resting-state functioning magnetic resonance imaging(RS-fMRI) and magnetic resonance diffusion tensor imaging(DTI). Experimental Design: Nineteen women with early breast cancer who underwent chemotherapy received neuropsychologic, RS-fMRI, and DTI assessments before and after the chemotherapy. For the patients who received adjuvant chemotherapy and the controls, the first neuropsychologic assessment(t1) was two to three weeks after the operation and before chemotherapy. For the patients who received neoadjuvant chemotherapy, the first assessment was just before chemotherapy. The second assessment(t2) was two to three weeks after the chemotherapy for the patients receiving adjuvant therapy, and the second assessment was two to three weeks after the operation for the patients receiving neoadjuvant therapy. Eleven age-matched controls with breast benign masses underwent the same assessments at matched intervals. We used regional homogeneity(ReHo) to reflect cerebral activity in RS-fMRI, and used fractional anisotropy(FA) to reflect white matter(WM) tissue integrity in DTI. Paired t tests were used to study changes of neuropsychologic tests, ReHo and FA. We correlated changes of neuropsychologic tests that survived the paired t tests with the changes of ReHo and FA in patients receiving chemotherapy. Results: The chemotherapy-treated group performed worse on memory and self-reported cognition at t2 compared with t1(P <0.05). We found increases of ReHo in the posterior and anterior lobe of the cerebellum, and decreases in the right orbitofrontal area, right middle and superior temporal gyrus, right subcentral area, left dorsolateral prefrontal cortex, and precentral gyrus. We found increases of FA in the fornix and superior fronto-occipital fasciculus. ReHo and FA were the same between t1 and t2 in the healthy control group. There was a correlation between some cognitive function and MRI measurements in the correlation analysis, but not significant after false discovery rate(FDR) multiple testing corrections. Conclusion: This prospective study combined resting state functional magnetic resonance imaging and diffusion tensor imaging to study chemotherapy related cognitive disorder in patients with breast cancer, and confirmed the existence of "chemo-brain". Chemotherapy induces longitudinal changes in memory, cerebral activity and cerebral white matter integrity. The results indicate that RS- fMRI and DTI have the application prospect in assessing chemotherapy related cognitive disorder.