Structural Neuroimaging Findings Related to Adult Non-CNS Cancer and Treatment: Review, Integration, and Implications for Treatment of Cognitive Dysfunction

Abstract

Cancer-and treatment-related cognitive dysfunction (CRCD) is a common challenge faced by patients diagnosed with noncentral nervous system (CNS) cancer. It has become increasingly recognized that multiple factors likely play a role in these symptoms, including the cancer disease process, systemic treatments (e.g., chemotherapy and endocrine therapies), and risk factors that may predispose an individual to both cancer and cognitive dysfunction. As the field has evolved, advanced neuroimaging techniques have been applied to better understand the neural correlates of CRCD. This review focuses on structural neuroimaging findings related to CRCD in adult non-CNS cancer populations, including examination of gray matter volume/density and white matter integrity differences between cancer patients and comparison groups, as well as emerging findings regarding structural network abnormalities. Overall, this literature has demonstrated consistent findings of reduced gray matter volume/density and white matter integrity in cancer patients relative to comparison groups. These are most prominent in individuals treated with chemotherapy, though alterations have also been noted in those treated with anti-estrogen and androgen-deprivation therapies. Alterations in gray and white matter structural network connectivity have also been identified. These structural abnormalities have been observed most prominently in frontal and temporal brain regions, and have been shown to correlate with subjective and objective cognitive function, as well as with physiological and clinical variables, helping to inform understanding of CRCD mechanisms. To date, however, structural neuroimaging techniques have not been utilized in systematic studies of potential CRCD treatments, suggesting a potentially fruitful avenue for future research.

Data Analysis for Modeling the Effect of Acupuncture on Postchemotherapy Cancer Fatigue in Gynecologic Oncology Patients

“…Although the mechanism of the effect of acupuncture in the treatment of this disease is not clear, some studies have shown that acupuncture and its related therapies (such as auricular acupuncture and warm acupuncture) have great potential as an adjuvant therapy to alleviate CRF in patients and improve the quality of survival of patients, and the clinical studies of acupuncture and its related therapies in recent years are summarized, analyzed, and summarized as follows. A randomized double-blind controlled trial was conducted by [ 12 ], which included 28 patients with CRF of lung cancer, with acupoints selected as 45 min/time, 2 times/week, and continued treatment for 4 weeks with a 2-week follow-up, while the sham acupuncture group took the same acupoints but without needles into the skin [ 13 ].…”

Multimodal MRI examination of structural and functional brain changes in older women with breast cancer in the first year of antiestrogen hormonal therapy

“…HT exposure over the recommended 5-10 years has the potential to interact with other risks for cognitive decline (e.g., medical comorbidities, cognitive aging, dementia). Furthermore, while we only examined women who did not receive chemotherapy, HT and chemotherapy effects may be additive, especially as similar frontal and temporal regions appear vulnerable to effects of both types of treatment [26][27][28][29][30].…”

“…While extensively used to examine structural and functional brain changes after breast cancer chemotherapy [26][27][28][29][30], neuroimaging has not been widely applied to examine the impact of HT. Lower hippocampal volume and resting hippocampal-prefrontal functional connectivity have been reported in women with breast cancer taking tamoxifen [31,32], and Hurria and colleagues found metabolic changes on FDG-PET in post-menopausal women with breast cancer taking an aromatase inhibitor, notably in regions relevant to aging [33].…”

Pre-Surgery Demographic, Clinical, and Symptom Characteristics Associated with Different Self-Reported Cognitive Processes in Patients with Breast Cancer

“…Brain imaging studies provide information on changes in brain structure and patterns of neural activities that individuals use when they engage in various cognitive processes that underlie tasks of daily life [66][67][68]. The brain region most associated with executive functions and inhibitory control processes is the prefrontal cortex (PFC) [69,70].…”