Longitudinal Trajectory of Spontaneous Brain Activity Changes in Breast Cancer Patients Following One Circle and the Completion of Neoadjuvant Chemotherapy-a preliminary prospective study

Abstract

Abstract There is growing evidence that brain activity changes in breast cancer patients after chemotherapy. However, the longitudinal changes in brain function during chemotherapy are unclear and not studied before. To assess trajectory of brain activity changes during chemotherapy, we prospectively enrolled 36 breast cancer patients and longitudinally compared amplitude of low-frequency fluctuation (ALFF) and neuropsychological tests at three time points including before neoadjuvant chemotherapy (NAC) (time point 0, TP0), before the second cycle of NAC (time point 1, TP1), and after NAC (pre-operation, time point 2, TP2). Compared with TP0, ALFF values of right orbital part of inferior frontal gyrus, left medial orbital part of the superior frontal gyrus, right insula, left medial part of superior frontal gyrus and right middle frontal gyrus decreased significantly at TP1 and TP2. Besides, the score of Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) decreased significantly at both TP1 and TP2. The scores of Self-Rating Anxiety Scale and Perceived Cognitive Abilities have a significant decrease at TP1 and TP2, respectively. There was no statistically significant difference found between the scores on the neuropsychological tests at TP1 and TP2. And aberrant ALFF values were correlated with neuropsychological tests scores at TP0. We conclude that brain activity of breast cancer patients treated with NAC changed significantly after the first cycle of NAC and lasted until the end of chemotherapy, along with the cognitive function deterioration. Most brain regions with ALFF changes were located in the frontal lobe, which is involved in the higher-order of cognitive function.