基于前扣带回功能连接探究乳腺癌患者化疗相关认知障碍及脑功能异常的研究OA

Objective:To investigate cognitive impairments and abnormalities in brain function associated with chemotherapy in breast cancer patients based on functional connectivity of the anterior cingulate cortex(ACC).Materials and Methods:A patient group consisting of 26 individuals with breast cancer who had undergone surgery,had pathologically confirmed infiltrative ductal carcinoma,and received standard chemotherapy was included.Neuropsychological assessment scales and magnetic resonance imaging of the brain were performed for all patients at the time of surgery,before chemotherapy(T0),and after chemotherapy(T1).26 patients with breast cancer who were pathologically confirmed as invasive ductal carcinoma and received standardized chemotherapy were included into the patient group.All patients were evaluated with neuropsychological scale and brain MRI after surgery,before chemotherapy(T0 point)and after chemotherapy(T1 point).At T0,26 healthy volunteers matched in age and education level were included to form a control group.Compare the cognitive function and differences in functional connectivity based on the ACC between the patient group and the control group at T0,as well as the longitudinal changes in cognitive function and functional connectivity based on the ACC between breast cancer patients at T0 and T1,and perform correlation analysis to explore the relationship between abnormal functional connectivity of the ACC and cognitive function.The differences of cognitive function and ACC based functional connectivity between the patient group and the control group at T0 were compared,and the longitudinal changes of cognitive function and ACC based functional connectivity between T0 and T1 in breast cancer patients were compared,and the correlation analysis was conducted to explore the relationship between abnormal ACC functional connectivity and cognitive function.Results:At T0,there was no statistically significant difference in neuropsychological scale scores and ACC functional connectivity between the patient group and the control group(P＞0.05);Compared with T0,the scores of short-term delayed recall,long-term delayed recall and word learning of breast cancer patients at T1 decreased(P＜0.05);The results of the functional connectivity analysis based on ACC as a seed point indicate that after chemotherapy,breast cancer patients exhibited reduced functional connectivity between ACC and the left middle cingulate gyrus,the left inferior frontal gyrus,and the left middle frontal gyrus(P＜0.001);Pearson correlation analysis revealed a positive correlation(r=0.514,P＜0.05;r=0.441,P＜0.05)between the degree of decline in ACC function connectivity with the left medial dorsal anterior cingulate cortex following chemotherapy and changes in scores for word learning and short-term delayed memory.Conclusions:Chemotherapy may have impaired the functional coordination between the ACC and related brain regions in breast cancer patients,manifesting as a general decrease in connectivity strength,and can also lead to cognitive dysfunction in many aspects,such as reduced memory and learning ability.The functional connectivity between ACC and the left middle cingulate gyrus may participate in the regulation of related functions.