The attention network changes in breast cancer patients receiving neoadjuvant chemotherapy: Evidence from an arterial spin labeling perfusion study

Abstract

To investigate the neural mechanisms underlying attention deficits that are related to neoadjuvant chemotherapy in combination with cerebral perfusion. Thirty one patients with breast cancer who were scheduled to receive neoadjuvant chemotherapy and 34 healthy control subjects were included. The patients completed two assessments of the attention network tasks (ANT), neuropsychological background tests, and the arterial spin labeling scan, which were performed before neoadjuvant chemotherapy and after completing chemotherapy. After neoadjuvant chemotherapy, the patients exhibited reduced performance in the alerting and executive control attention networks but not the orienting network (p < 0.05) and showed significant increases in cerebral blood flow (CBF) in the left posterior cingulate gyrus, left middle occipital gyrus, bilateral precentral gyrus, inferior parietal gyrus, supramarginal gyrus, angular gyrus, precuneus, cuneus, superior occipital gyrus, calcarine cortex, and temporal gyrus (p < 0.01 corrected) when compared with patients before chemotherapy and healthy controls. A significant correlation was found between the decrease performance of ANT and the increase in CBF changes in some brain regions of the patients with breast cancer. The results demonstrated that neoadjuvant chemotherapy influences hemodynamic activity in different brain areas through increasing cerebral perfusion, which reduces the attention abilities in breast cancer patients.

Functional and Structural Connectome Features for Machine Learning Chemo-Brain Prediction in Women Treated for Breast Cancer with Chemotherapy

“…We found higher absolute values of the functional connection weighted coefficients in the LR model over the frontoparietal and occipital lobes in the cancer patients compared with the healthy controls. The altered brain regions may be associated with the dorsal attention network, and the results were consistent with previous functional neuroimaging studies [ 43 , 44 ]. In Figure 2 , higher absolute values of the structural connection weighted coefficients in the LR model over the parietal and occipital lobes were also found in the cancer patients compared with the healthy controls, and the results were consistent with previous structural neuroimaging studies [ 45 ].…”

The association of genetic polymorphisms with neuroconnectivity in breast cancer patients

“…We previously observed significant hyper-activation in left (and right) cuneus among chemotherapy-treated breast cancer survivors compared to healthy controls during a verbal memory task 74 . Increased perfusion in the left cuneus and left calcarine has been demonstrated in patients with breast cancer exposed to chemotherapy compared to both healthy and chemotherapy-naïve controls, a finding also correlated with dysfunction changes in executive control network scores 75 . Our analysis suggests dysfunction in these regions may be influenced by the presence of at-risk alleles, a finding that warrants further exploration.…”

Association of functional dorsal attention network alterations with breast cancer and chemotherapy

“…Moreover, dorsal and ventral systems have flexible interactions with each other 58 . A recent study using arterial spin labeling perfusion evaluated breast cancer patients 1 month after chemotherapy and compared their findings with those of both patients with breast cancer before chemotherapy and healthy controls; the results showed significant increases in cerebral blood flow due to overcompensatory mechanisms in multiple brain areas associated with altered attention networks 59 . Another longitudinal study used task-based fMRI and found decreased functional connectivity in the DAN 1 month after chemotherapy, suggesting that changes in connectivity in the DAN have implications for understanding the effect of chemotherapy on cognitive performance 32 .…”