Chemotherapy-induced grey matter abnormalities in cancer survivors: a voxel-wise neuroimaging meta-analysis

Brain Imaging Behav. 2021 Aug;15(4):2215-2227. doi: 10.1007/s11682-020-00402-7. Epub 2020 Oct 13.

Abstract

Background: Findings regarding chemotherapy-induced grey matter abnormalities are heterogeneous, and no meta-analysis has quantitatively assessed brain structural alterations in cancer survivors treated with chemotherapy.

Purpose: To investigate the grey matter abnormalities in non-CNS (central nervous system) cancer survivors treated with chemotherapy using Anisotropic Effect Size Signed Differential Mapping (AES-SDM) software.

Method: We identified studies published up to Sep 2018 that compared grey matter in non-CNS cancer survivors treated with chemotherapy (CT+, 10 data sets including 433 individuals) and cancer survivors not treated with chemotherapy (CT-, 7 data sets including 210 individuals) or healthy controls (HC, 3 data sets including 407 individuals) using whole-brain VBM. We used statistical maps from the studies included where available and reported peak coordinates otherwise.

Results: Compared with both CT- and HC, the CT + groups exhibited a reduced grey matter volume (GMV), mainly in the prefrontal and anterior cingulate cortex (ACC) and right fusiform gyrus (FG). A smaller GMV in the FG and prefrontal cortex were found in the CT + compared with the CT-groups and in the CT + groups with impaired cognition. GMV in two areas was positively associated with the time since chemotherapy.

Conclusions: The present results suggest that non-CNS cancer survivors treated with chemotherapy exhibit grey matter abnormalities in the brain, especially in the prefrontal and ACC cortex. Grey matter volume changes after chemotherapy may contribute to cognitive impairments in cancer survivors that can be observed after chemotherapy.

Keywords: Cancer survivors; Chemotherapy; Cognitive impairments; Magnetic resonance imaging; Meta-analysis; Voxel based morphometry.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Brain / diagnostic imaging
  • Cancer Survivors*
  • Gray Matter / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasms* / diagnostic imaging
  • Neoplasms* / drug therapy
  • Neuroimaging

Substances

  • Antineoplastic Agents