Prechemotherapy alterations in brain function in women with breast cancer

Despite clinical reports of cognitive deficits associated with cancer chemotherapy, the underlying brain mechanisms are not clear. This research examined selective attention and working memory using functional magnetic resonance imaging (fMRI) in women before chemotherapy for localized breast cancer. Patients were tested with an established selective attention and working memory task during fMRI. Compared with healthy controls, patients showed (a) bilateral brain activation in high-demand task conditions with recruitment of additional components of attention/working memory circuitry, and (b) less accurate and slower task performance. Results indicate compromised cognitive functioning before any chemotherapy and raise key questions for further research.

[1]  J. Bernhard,et al.  Adjuvant breast cancer treatment and cognitive function: current knowledge and research directions. , 2003, Journal of the National Cancer Institute.

[2]  Robert A. Koeppe,et al.  Neurocognitive ageing of storage and executive processes , 2001 .

[3]  Neurocognitive ageing of storage and executive processes , 2001 .

[4]  A. W. M. van den Enden,et al.  Discrete Time Signal Processing , 1989 .

[5]  C. Meyers,et al.  Neuropsychological Sequelae of Non-Central Nervous System Cancer and Cancer Therapy , 2008, Neuropsychology Review.

[6]  C. Loprinzi,et al.  Novel approaches to preventing chemotherapy-induced cognitive dysfunction in breast cancer: the art of the possible. , 2002, Clinical breast cancer.

[7]  M. Wieneke,et al.  Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer , 1995 .

[8]  M Abdolell,et al.  Cognitive function in breast cancer patients receiving adjuvant chemotherapy. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[9]  R. Jung Neuropsychological Assessment, 4th ed. , 2005 .

[10]  M. Posner Attention in cognitive neuroscience: An overview. , 1995 .

[11]  B. Cimprich,et al.  Attentional fatigue following breast cancer surgery. , 1992, Research in nursing & health.

[12]  M. Corbetta,et al.  Selective and divided attention during visual discriminations of shape, color, and speed: functional anatomy by positron emission tomography , 1991, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[13]  Ian F Tannock,et al.  Cognitive impairment associated with chemotherapy for cancer: report of a workshop. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  C. Bielajew,et al.  A Meta-Analysis of the Neuropsychological Effects of Adjuvant Chemotherapy Treatment in Women Treated for Breast Cancer , 2006, The Clinical neuropsychologist.

[15]  M. Posner,et al.  Attentional networks , 1994, Trends in Neurosciences.

[16]  Bruce E Compas,et al.  Neuropsychological effects of treatments for adults with cancer: A meta-analysis and review of the literature , 2003, Journal of the International Neuropsychological Society.

[17]  I. Tannock,et al.  Cognitive function, fatigue, and menopausal symptoms in women receiving adjuvant chemotherapy for breast cancer. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  Stephen M Smith,et al.  Fast robust automated brain extraction , 2002, Human brain mapping.

[19]  M. Muller,et al.  Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma , 1999, Cancer.

[20]  R. Engle Working Memory Capacity as Executive Attention , 2002 .

[21]  Patricia A. Ganz,et al.  From cancer patient to cancer survivor : lost in transition , 2006 .

[22]  B. Cimprich,et al.  Pretreatment symptom distress in women newly diagnosed with breast cancer. , 1999, Cancer nursing.

[23]  P. Reuter-Lorenz New visions of the aging mind and brain , 2002, Trends in Cognitive Sciences.

[24]  S. Allan,et al.  A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer , 2006, British Journal of Cancer.

[25]  M. Mesulam Principles of Behavioral and Cognitive Neurology , 2000 .

[26]  M. D’Esposito Working memory. , 2008, Handbook of clinical neurology.

[27]  J. Jonides,et al.  Storage and executive processes in the frontal lobes. , 1999, Science.

[28]  V. Shilling,et al.  The effects of adjuvant chemotherapy on cognition in women with breast cancer--preliminary results of an observational longitudinal study. , 2005, Breast.

[29]  M. Posner,et al.  Attention and cognitive control. , 1975 .

[30]  T. Braver,et al.  Anterior Cingulate and the Monitoring of Response Conflict: Evidence from an fMRI Study of Overt Verb Generation , 2000, Journal of Cognitive Neuroscience.

[31]  Bart Rypma,et al.  Prefrontal modulation of working memory performance in brain injury and disease , 2006, Human brain mapping.

[32]  J. Jonides,et al.  Inhibition in verbal working memory revealed by brain activation. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[33]  A. Saykin,et al.  Cognitive Effects of Standard-Dose Chemotherapy in Patients with Cancer , 2001, Cancer investigation.

[34]  N. Cohen,et al.  The relative involvement of anterior cingulate and prefrontal cortex in attentional control depends on nature of conflict. , 2001, Brain research. Cognitive brain research.

[35]  M. Lux,et al.  Cognitive function during neoadjuvant chemotherapy for breast cancer , 2007, Cancer.

[36]  Robert T. Knight,et al.  Effects of frontal lobe damage on interference effects in working memory , 2002, Cognitive, affective & behavioral neuroscience.

[37]  B. Cimprich Age and extent of surgery affect attention in women treated for breast cancer. , 1998, Research in nursing & health.

[38]  David L Ronis,et al.  An Environmental Intervention to Restore Attention in Women With Newly Diagnosed Breast Cancer , 2003, Cancer nursing.

[39]  Andrew J Saykin,et al.  Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[40]  H. Rugo,et al.  The impact of adjuvant therapy for breast cancer on cognitive function: current evidence and directions for research. , 2003, Seminars in oncology.

[41]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[42]  John Jonides,et al.  Dissociable neural mechanisms underlying response-based and familiarity-based conflict in working memory , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[43]  P. Reuter-Lorenz,et al.  Neurocognitive Aging and the Compensation Hypothesis , 2008 .

[44]  B. Cimprich,et al.  Development of an intervention to restore attention in cancer patients , 1993, Cancer nursing.

[45]  Howard S. Kirsnher Principles of Behavioral and Cognitive Neurology, 2nd Ed. , 2002 .

[46]  Andrew J Saykin,et al.  Mild cognitive impairment: conceptual issues and structural and functional brain correlates. , 2003, Seminars in clinical neuropsychiatry.

[47]  A. Saykin,et al.  Brain structure and function differences in monozygotic twins: possible effects of breast cancer chemotherapy. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[48]  A. Saykin,et al.  Cognitive effects of cytotoxic cancer chemotherapy: Predisposing risk factors and potential treatments , 2004, Current psychiatry reports.

[49]  Edward E. Smith,et al.  Temporal dynamics of brain activation during a working memory task , 1997, Nature.

[50]  Robert A. Koeppe,et al.  Age Differences in Behavior and PET Activation Reveal Differences in Interference Resolution in Verbal Working Memory , 2000, Journal of Cognitive Neuroscience.

[51]  D. Ronis,et al.  Attention and symptom distress in women with and without breast cancer. , 2001, Nursing research.

[52]  S E Petersen,et al.  A positron emission tomography study of the short-term maintenance of verbal information , 1996, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[53]  Edward E. Smith,et al.  Age Differences in the Frontal Lateralization of Verbal and Spatial Working Memory Revealed by PET , 2000, Journal of Cognitive Neuroscience.

[54]  S. Rodenhuis,et al.  Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. , 1998, Journal of the National Cancer Institute.

[55]  Jonathan D. Cohen,et al.  Anterior cingulate and prefrontal cortex: who's in control? , 2000, Nature Neuroscience.

[56]  Andrew J. Saykin,et al.  Cognitive function in breast cancer patients prior to adjuvant treatment , 2008, Breast Cancer Research and Treatment.

[57]  M. D’Esposito,et al.  The neural basis of the central executive system of working memory , 1995, Nature.

[58]  W. H. Ittelson Environment and cognition , 1974 .

[59]  Andrew J Saykin,et al.  Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. , 2003, Seminars in clinical neuropsychiatry.

[60]  R. Theriault,et al.  The cognitive sequelae of standard‐dose adjuvant chemotherapy in women with breast carcinoma , 2004, Cancer.

[61]  J. Holland,et al.  Cognitive Function of Older Patients Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Prospective Longitudinal Study , 2006, Journal of the American Geriatrics Society.

[62]  R. Passingham,et al.  Active maintenance in prefrontal area 46 creates distractor-resistant memory , 2002, Nature Neuroscience.