Altered Brain Function in Chemotherapy for Breast Cancer

乳腺癌化疗改变脑功能

• 批准号: 7569290
• 负责人: BERNADINE E. CIMPRICH
• 金额: $ 52.82万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-15 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7569290
• 关键词: Acute; Address; Adjuvant Chemotherapy; Adjuvant Therapy; Adverse effects; Age; Attention; Biological; Brain; Brain imaging; Brain region; Breast Cancer Treatment; Cancer Survivor; Cerebrum; Classification; Cognitive; Cognitive deficits; Decision Making; Development; Distress; Education; Event; Fatigue; Foundations; Functional Magnetic Resonance Imaging; Image Analysis; Imaging technology; Impaired cognition; Impairment; Incidence; Intervention; Knowledge; Lead; Learning; Life; Link; Long-Term Effects; Longitudinal Studies; Measurement; Measures; Neurophysiology - biologic function; Neuropsychological Tests; Newly Diagnosed; Patient Self-Report; Patients; Pattern; Performance; Principal Investigator; Problem Solving; Process; Quality of life; Recovery; Reporting; Research; Research Personnel; Research Priority; Role; Severities; Short-Term Memory; Source; Staging; Symptoms; System; Technology; Testing; Time; Woman; Work; base; chemobrain; chemotherapy; cognitive function; daily functioning; design; improved; malignant breast neoplasm; physical state; programs; psychologic; relating to nervous system

DESCRIPTION (provided by applicant): Although cognitive impairment is a common, distressing side effect of adjuvant chemotherapy for breast cancer, the fundamental brain mechanisms have not been systematically examined. Previous research suggests that cognitive alterations in women treated for breast cancer may be related to basic cognitive processes, attention and working memory, that are prerequisites for effective functioning in daily life. Thus, the specific aims are to determine: (1) whether functional alterations occur in neural brain activation patterns on functional magnetic resonance imaging (fMRI) testing of attention and working memory and in cognitive performance in women treated with adjuvant chemotherapy for breast cancer over time; (2) whether systematic functional changes in neural brain activation patterns observed on fMRI testing of attention and working memory are associated with changes in objective and subjective indicators of cognitive functioning over time. A longitudinal study will be conducted with 105 women, including 70 patients newly diagnosed with Stage I or II breast cancer treated with adjuvant chemotherapy (n = 35) or without chemotherapy (n = 35), and 35 women as healthy controls. Three repeated measures will be obtained to evaluate acute and longer-term effects of adjuvant chemotherapy on attention and working memory over a one-year interval: pre-chemotherapy; one month post- chemotherapy; and seven months post-chemotherapy to permit optimal recovery from treatment. An established attention and verbal working memory task will be used during fMRI testing. The event- related fMRI analysis will evaluate neural function in brain regions underlying attention and working memory based on research and implicated in preliminary findings. Neuropsychological test performance and self-report assessments will be used to test hypothesized associations with brain activation patterns on fMRI testing. Covariates of age, education, psychological state, physical symptom distress, and selected biological functional indicators will be assessed and controlled. The study will provide new information about the role of basic processes of attention and working memory in the emergence of cognitive side effects of adjuvant chemotherapy for breast cancer and will establish a foundation for targeted interventions to improve cognitive functioning in breast cancer survivors.

描述（由申请人提供）：虽然认知障碍是乳腺癌辅助化疗的常见且令人痛苦的副作用，但基本的大脑机制尚未得到系统研究。先前的研究表明，接受乳腺癌治疗的女性的认知改变可能与基本认知过程、注意力和工作记忆有关，而这些是日常生活中有效运作的先决条件。因此，具体目标是确定：（1）随着时间的推移，接受乳腺癌辅助化疗的女性的注意力和工作记忆功能磁共振成像（fMRI）测试中的神经脑激活模式以及认知表现是否发生功能改变; (2)在注意力和工作记忆的功能磁共振成像测试中观察到的神经脑激活模式的系统功能变化是否与认知功能的客观和主观指标随时间的变化相关。一项纵向研究将对 105 名女性进行，其中包括 70 名新诊断为 I 期或 II 期乳腺癌的患者，接受辅助化疗 (n = 35) 或未接受化疗 (n = 35)，以及 35 名健康对照女性。将获得三个重复测量来评估辅助化疗在一年的时间间隔内对注意力和工作记忆的急性和长期影响：化疗前；化疗后1个月；化疗后七个月，以实现治疗的最佳恢复。在功能磁共振成像测试期间将使用既定的注意力和言语工作记忆任务。与事件相关的功能磁共振成像分析将基于研究并涉及初步发现，评估大脑区域中注意力和工作记忆的神经功能。神经心理学测试表现和自我报告评估将用于测试与功能磁共振成像测试中大脑激活模式的假设关联。将评估和控制年龄、教育程度、心理状态、身体症状困扰和选定的生物功能指标的协变量。该研究将提供关于注意力和工作记忆的基本过程在乳腺癌辅助化疗认知副作用出现中的作用的新信息，并将为改善乳腺癌幸存者认知功能的有针对性的干预措施奠定基础。