Associations of cognition, mood symptoms, and brain regional homogeneity in patients with breast cancer with or without chemotherapy and healthy controls

Abstract

Abstract Background Cognitive impairments have long been a complaint from patients with BC. We hypothesized that presentations on Regional homogeneity (ReHo) from fMRI may be associated with relevant cognitive changes in patients with or without breast cancer and/or chemotherapy. Methods Neuropsychological assessments of cognitive functions, levels of depression, fatigue, and anxiety, as well as whole-brain MRI scans were administered in patients with newly diagnosed BC prior to and 3~9 months after receiving chemotherapy, as well as healthy controls without cancer. ReHo was calculated from fMRI data to determine synchronizations of local brain activity. Multivariate regression models adjusting for intelligence quotient (IQ), menopause, and mood symptoms, as well as mediation analyses using generalized structural equation modeling, were performed. Results In all, 51 participants (19 noncancer controls, 11 patients with BC before chemotherapy, and 21 patients with BC who finished chemotherapy) completed the neuropsychological assessments and MRI. Significant differences in IQ and ReHo from several brain areas were observed in the three subgroups. Predictors for each domain of neurocognitive testing differed among the subgroups. Brain synchronization from the right middle frontal area was found to have significant mediating effect between chemotherapy status and the first part of Color Trails Test (CTT1) in the pre-C/T subgroup. Conclusion Differing from our expectations, the effects that the status of chemotherapy had on neurocognitive function assessed by CTT1 was mediated by ReHo in the right middle frontal area individually and not in sequential order with any mood symptoms.