Brain white matter microstructural changes in chemotherapy-treated older long-term breast cancer survivors

Ebenezer Daniel; Frank Deng; Sunita K Patel; Mina S Sedrak; Heeyoung Kim; Marianne Razavi; Can-Lan Sun; James C Root; Tim A Ahles; William Dale; Bihong T Chen

doi:10.1002/cam4.6881

Brain white matter microstructural changes in chemotherapy-treated older long-term breast cancer survivors

Cancer Med. 2023 Dec 28;13(1):e6881. doi: 10.1002/cam4.6881. Online ahead of print.

Authors

Ebenezer Daniel¹, Frank Deng¹, Sunita K Patel², Mina S Sedrak³, Heeyoung Kim⁴, Marianne Razavi⁵, Can-Lan Sun⁴, James C Root⁶, Tim A Ahles⁶, William Dale^{4

5}, Bihong T Chen^{1

4}

Affiliations

¹ Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, USA.
² Department of Population Science, City of Hope National Medical Center, Duarte, CA, USA.
³ Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA.
⁴ Center for Cancer and Aging, City of Hope National Medical Center, Duarte, CA, USA.
⁵ Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA.
⁶ Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Abstract

Purpose: To assess white matter microstructural changes in older long-term breast cancer survivors 5-15 years post-chemotherapy treatment.

Methods: Breast cancer survivors aged 65 years or older who underwent chemotherapy (C+) and who did not undergo chemotherapy (C-) and age- and sex-matched healthy controls (HC) were enrolled at time point 1 (TP1) and followed for 2 years for time point 2 (TP2). All participants underwent brain MRI with diffusion tensor images and neuropsychological (NP) testing with the NIH Toolbox Cognition Battery. Tract-based spatial statistics (TBSS) analysis was performed on the diffusion tensor images to assess white matter microstructural changes with the fractional anisotropy (FA) parameter.

Results: There were significant longitudinal alterations in FA within the C+ group over time. The C+ group showed diminished FA in the body and genu of corpus callosum, anterior corona radiate, and external capsule on both the whole brain and region of interest (ROI) based analyses after p < 0.05 family-wise error (FWE) correction. However, there were no significant group differences between the groups at TP1. Additionally, at TP1, a positive correlation (R = 0.58, p = 0.04) was observed between the FA value of the anterior corona radiata and the crystallized composite score in the C+ group.

Conclusions: Brain white matter microstructural alterations may be the underlying neural correlates of cognitive changes in older breast cancer survivors who had chemotherapy treatment years ago.

Keywords: breast cancer; cancer-related cognitive impairment; chemotherapy; diffusion tensor imaging; tract-based spatial statistics.

Abstract

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