1. Cerebral Perfusion and Gray Matter Changes Associated With Chemotherapy-Induced Peripheral Neuropathy
- Author
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Andrew J. Saykin, Brenna C. McDonald, Yang Wang, Victoria L. Champion, Darren P. O'Neill, John D. West, Kelly N.H. Nudelman, Noah R. Zanville, Bryan P. Schneider, and Dori J. Smith
- Subjects
Cancer Research ,Perfusion scanning ,Breast Neoplasms ,Neuroimaging ,Gynecologic oncology ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Cerebral perfusion pressure ,Gray Matter ,medicine.diagnostic_test ,business.industry ,Peripheral Nervous System Diseases ,Magnetic resonance imaging ,ORIGINAL REPORTS ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Neoadjuvant Therapy ,Peripheral neuropathy ,Oncology ,Chemotherapy-induced peripheral neuropathy ,030220 oncology & carcinogenesis ,Cerebrovascular Circulation ,Female ,Neurotoxicity Syndromes ,Spin Labels ,Nuclear medicine ,business ,Perfusion ,030217 neurology & neurosurgery - Abstract
Purpose To investigate the longitudinal relationship between chemotherapy-induced peripheral neuropathy (CIPN) symptoms (sx) and brain perfusion changes in patients with breast cancer. Interaction of CIPN-sx perfusion effects with known chemotherapy-associated gray matter density decrease was also assessed to elucidate the relationship between CIPN and previously reported cancer treatment–related brain structural changes. Methods Patients with breast cancer treated with (n = 24) or without (n = 23) chemotherapy underwent clinical examination and brain magnetic resonance imaging at the following three time points: before treatment (baseline), 1 month after treatment completion, and 1 year after the 1-month assessment. CIPN-sx were evaluated with the self-reported Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity four-item sensory-specific scale. Perfusion and gray matter density were assessed using voxel-based pulsed arterial spin labeling and morphometric analyses and tested for association with CIPN-sx in the patients who received chemotherapy. Results Patients who received chemotherapy reported significantly increased CIPN-sx from baseline to 1 month, with partial recovery by 1 year (P < .001). CIPN-sx increase from baseline to 1 month was significantly greater for patients who received chemotherapy compared with those who did not (P = .001). At 1 month, neuroimaging showed that for the group that received chemotherapy, CIPN-sx were positively associated with cerebral perfusion in the right superior frontal gyrus and cingulate gyrus, regions associated with pain processing (P < .001). Longitudinal magnetic resonance imaging analysis in the group receiving chemotherapy indicated that CIPN-sx and associated perfusion changes from baseline to 1 month were also positively correlated with gray matter density change (P < .005). Conclusion Peripheral neuropathy symptoms after systemic chemotherapy for breast cancer are associated with changes in cerebral perfusion and gray matter. The specific mechanisms warrant further investigation given the potential diagnostic and therapeutic implications.
- Published
- 2015