A prospective cohort study investigating contemporaneous changes in cytokines and cognitive function during chemotherapy in patients with breast cancer

Abstract

Background We aimed to investigate whether changes in levels of chosen cytokines were associated with contemporaneous changes in cognitive function from before to after chemotherapy, adjusting for baseline characteristics such as body mass index, age, or education years, and changes in anxiety, depression, or fatigue into consideration. Methods Adult patients with breast cancer stages I to III without brain metastasis were invited to participate in this longitudinal follow up study. A multidimensional neuropsychological examination was administered at two timepoints evaluating multiple subjective and objective cognitive domains, depression, anxiety, or fatigue before and at least 3 months after chemotherapy, and baseline demographic information. Cytokine levels were taken at the same times. Stepwise multivariate Generalized Linear Mixed Model was used to examine changes in cytokines and associations with changes in cognitive function. Results Over a mean interval of 10.5 months Event-based prospective memory (p < 0.001), Word list immediate (p < 0.001) or delayed recall (p = 0.024), and self- perceived cognitive impairment (p = 0.026) significantly improved following chemotherapy. Unit changes in log values of IL-2 (Estimates (SE) = 1.22(0.59), p = 0.04) and IL-12p70 (1.05(0.19), p = 0.03) were positively associated with improvements in Event-based prospective memory over that period. Discussion Improvements in Event-based prospective memory were positively associated with changes in IL-2 and IL-12p70. Our finding may not only reduce BC patients’ concerns about chemotherapy-related cognitive adverse effects, but also exhibit the possible roles or interactions of systemic cytokines and inflammation and cognitions.