Brain Imaging and Behavior

, Volume 7, Issue 4, pp 491–500 | Cite as

Chemotherapy-induced amenorrhea: a prospective study of brain activation changes and neurocognitive correlates

  • Susan K. Conroy
  • Brenna C. McDonald
  • Tim A. Ahles
  • John D. West
  • Andrew J. Saykin
SI: Neuroimaging Studies of Cancer and Cancer Treatment


Chemotherapy-induced amenorrhea (CIA) often occurs in pre- and peri-menopausal BC patients, and while cancer/chemotherapy and abrupt estrogen loss have separately been shown to affect cognition and brain function, studies of the cognitive effects of CIA are equivocal, and its effects on brain function are unknown. Functional MRI (fMRI) during a working memory task was used to prospectively assess the pattern of brain activation and deactivation prior to and 1 month after chemotherapy in BC patients who experienced CIA (n = 9), post-menopausal BC patients undergoing chemotherapy (n = 9), and pre- and post-menopausal healthy controls (n = 6 each). Neurocognitive testing was also performed at both time points. Repeated measures general linear models were used to assess statistical significance, and age was a covariate in all analyses. We observed a group-by-time interaction in the combined magnitudes of brain activation and deactivation (p = 0.006): the CIA group increased in magnitude from baseline to post-treatment while other groups maintained similar levels over time. Further, the change in brain activity magnitude in CIA was strongly correlated with change in processing speed neurocognitive testing score (r = 0.837 p = 0.005), suggesting this increase in brain activity reflects effective cognitive compensation. Our results demonstrate prospectively that the pattern of change in brain activity from pre- to post-chemotherapy varies according to pre-treatment menopausal status. Cognitive correlates add to the potential clinical significance of these findings. These findings have implications for risk appraisal and development of prevention or treatment strategies for cognitive changes in CIA.


Breast cancer Chemotherapy Amenorrhea Functional MRI 


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Susan K. Conroy
    • 1
    • 2
  • Brenna C. McDonald
    • 1
    • 3
    • 4
  • Tim A. Ahles
    • 4
    • 5
  • John D. West
    • 1
  • Andrew J. Saykin
    • 1
    • 3
    • 4
  1. 1.Center for Neuroimaging, Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
  2. 2.Medical Scientist Training Program and Medical Neurosciences Graduate ProgramIndiana University School of MedicineIndianapolisUSA
  3. 3.Indiana University Melvin and Bren Simon Cancer CenterIndianapolisUSA
  4. 4.Department of Psychiatry and Norris Cotton Cancer CenterDartmouth Medical SchoolHanoverUSA
  5. 5.Department of Psychiatry and Behavioral SciencesMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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