Surface-based morphological study on the relationship between cortical surface morphological changes and cancer-related fatigue changes in early chemotherapy for breast cancer
Objective:To study the early changes in cortical surface morphology in breast cancer patients in the early stage of chemotherapy and its relationship with cancer-related fatigue(CRF).Materials and Methods:Twenty-five first-diagnosed female breast cancer patients were taken for neuropsychological tests such as Brief Fatigue Inventory(BFI),Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)and cranial magnetic resonance 3D-T1-weighted data acquisition before(within one week before the start of chemotherapy)and during(within two weeks of the end of the second cycle of chemotherapy)postoperative chemotherapy,respectively.Age-matched healthy women were recruited as a control group during the same period,and clinical information and magnetic resonance data were collected using the same assessed approach during the matched time intervals.Surface-based morphometry(SBM)was used to analyze the surface morphology of the cerebral cortex of all subjects using the computational anatomy toolbox 12(CAT 12)in the statistical parametric mapping 12(SPM 12)software,and SPSS 26.0 was used to analyze the correlation between brain areas with altered surface morphology of the cortex and longitudinal changes in CRF during chemotherapy in breast cancer patients.Results:Compared with the pre-chemotherapy period,the differences in CRF,depression,and anxiety measurement scores of breast cancer patients in the early stage of chemotherapy were statistically significant(P<0.05).The values of cortical thickness,sulcal depth,fractal dimension,and gyrification index parameter of cortical surface morphology of breast cancer patients during chemotherapy changed compared with that of the pre-chemotherapy period.The differences were statistically significant(P<0.05):there was a reduction in cortical thickness in the parietal lobes(bilateral precuneus,right supramarginal,right postcentral)and occipital lobes(bilateral cuneus),a reduction in sulcus depth in the parietal lobes(bilateral inferiorparietal,right supramarginal and superiorparietal),the temporal lobes(right fusiform,superiortemporal and inferiortemporal),the occipital lobes(bilateral lateraloccipital,right cuneus,right pericalcarine),and a reduction in the number of fractal dimensions in the right frontal lobes(superiorfrontal,rostralmiddlefrontal and parsorbitalis),the right parietal lobes(supramarginal and inferiorparietal),and the left occipital lobes(lateraloccipital);The brain regions with increased parameter values were increased gyrification index in the left occipital lobe(lateraloccipital and cuneus),right parietal lobe(supramarginal,superiorparietal,and inferiorparietal),and right temporal lobe(middletemporal,inferiortemporal,and bankssts).Changes in the fractal dimension of the right rostralmiddlefrontal in the early phase of chemotherapy were negatively correlated with longitudinal changes in CRF compared with the pre-chemotherapy phase(r=-0.628,P=0.001).Conclusions:Cortical surface morphology in breast cancer patients can undergo early changes during chemotherapy and associated with changes in CRF.
breast cancerchemotherapycancer-related fatiguecerebral cortexmagnetic resonance imaging
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