Abstract
Background
Chemotherapy related cognitive impairment (CRCI) has seriously affected the quality of life (QOL) of patients with breast cancer (BCs), thus the neurobiological mechanism of CRCI attracted widespread attention. Previous studies have found that chemotherapy causes CRCI through affecting brain structure, function, metabolism, and blood perfusion.
Findings
A variety of neuroimaging techniques such as functional magnetic resonance imaging (fMRI), event-related potential (ERP), near-infrared spectroscopy (NIRS) have been widely applied to explore the neurobiological mechanism of CRCI.
Conclusion
This review summarized the progress of neuroimaging research in BCs with CRCI, which provides a theoretical basis for further exploration of CRCI mechanism, disease diagnosis and symptom intervention in the future.
Graphical abstract
Multiple neuroimaging techniques for CRCI research.
Similar content being viewed by others
Data Availability
Not applicable.
References
Siegel RL, Miller KD, Wagle NS, Jemal A (2023) Cancer statistics, 2023. CA Cancer J Clin 73(1):17–48
Jassim GA, Doherty S, Whitford DL, Khashan AS (2023) Psychological interventions for women with non-metastatic breast cancer. Cochrane Database System Rev 1(1):CD008729
Zaheed M, Wilcken N, Willson ML, O’Connell DL, Goodwin A (2019) Sequencing of anthracyclines and taxanes in neoadjuvant and adjuvant therapy for early breast cancer. Cochrane Database System Rev 2(2):CD012873
Wefel JS, Kesler SR, Noll KR, Schagen SB (2015) Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. CA Cancer J Clin 65(2):123–138
Wagner LI, Gray RJ, Sparano JA, Whelan TJ, Garcia SF, Yanez B, Tevaarwerk AJ, Carlos RC, Albain KS, Olson JA Jr et al (2020) Patient-reported cognitive impairment among women with early breast cancer randomly assigned to endocrine therapy alone versus chemoendocrine therapy: results from TAILORx. J Clin Oncol 38(17):1875–1886
George RP, Semendric I, Hutchinson MR, Whittaker AL (2021) Neuroimmune reactivity marker expression in rodent models of chemotherapy-induced cognitive impairment: a systematic scoping review. Brain Behav Immun 94:392–409
Gutmann DH (2019) Clearing the fog surrounding chemobrain. Cell 176(1–2):2–4
Janelsins MC, Heckler CE, Peppone LJ, Ahles TA, Mohile SG, Mustian KM, Palesh O, O’Mara AM, Minasian LM, Williams AM et al (2018) Longitudinal trajectory and characterization of cancer-related cognitive impairment in a nationwide cohort study. J Clin Oncol 36(32):JCO2018786624
Wang XM, Walitt B, Saligan L, Tiwari AF, Cheung CW, Zhang ZJ (2015) Chemobrain: a critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy. Cytokine 72(1):86–96
Chiu GS, Maj MA, Rizvi S, Dantzer R, Vichaya EG, Laumet G, Kavelaars A, Heijnen CJ (2017) Pifithrin-μ prevents cisplatin-induced chemobrain by preserving neuronal mitochondrial function. Can Res 77(3):742–752
McDonald BC, Saykin AJ (2013) Alterations in brain structure related to breast cancer and its treatment: chemotherapy and other considerations. Brain Imaging Behav 7(4):374–387
Ahles TA, Saykin AJ (2007) Candidate mechanisms for chemotherapy-induced cognitive changes. Nat Rev Cancer 7(3):192–201
Mattsson N, Palmqvist S, Stomrud E, Vogel J, Hansson O (2019) Staging β-amyloid pathology with amyloid positron emission tomography. JAMA Neurol 76(11):1319–1329
Moore HC, Parsons MW, Yue GH, Rybicki LA, Siemionow W (2014) Electroencephalogram power changes as a correlate of chemotherapy-associated fatigue and cognitive dysfunction. Support Care Cancer 22(8):2127–2131
Schagen SB, Hamburger HL, Muller MJ, Boogerd W, van Dam FS (2001) Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function. J Neurooncol 51(2):159–165
Kam JWY, Brenner CA, Handy TC, Boyd LA, Liu-Ambrose T, Lim HJ, Hayden S, Campbell KL (2016) Sustained attention abnormalities in breast cancer survivors with cognitive deficits post chemotherapy: an electrophysiological study. Clin Neurophysiol 127(1):369–378
Li W, Lv Y, Duan X, Cheng G, Yao S, Yu S, Tang L, Cheng H (2022) The alterations in event-related potential responses to pain empathy in breast cancer survivors treated with chemotherapy. Front Psychol 13:942036
Swainston J, Louis C, Moser J, Derakshan N (2021) Neurocognitive efficiency in breast cancer survivorship: a performance monitoring ERP study. Int J Psychophysiol 168:9–20
Gascoyne LE, Mullinger KJ, Robson SE, Kumar J, O’Neill GC, Palaniyappan L, Morris PG, Liddle EB, Brookes MJ, Liddle PF (2018) Changes in electrophysiological markers of cognitive control after administration of galantamine. NeuroImage Clinical 20:228–235
Daams M, Schuitema I, van Dijk BW, van Dulmen-den BE, Veerman AJ, van den Bos C, de Sonneville LM (2012) Long-term effects of cranial irradiation and intrathecal chemotherapy in treatment of childhood leukemia: a MEG study of power spectrum and correlated cognitive dysfunction. BMC Neurol 12:84
Sørensen PS, Jønsson A, Mathiesen HK, Blinkenberg M, Andresen J, Hanson LG, Ravnborg M (2006) The relationship between MRI and PET changes and cognitive disturbances in MS. J Neurol Sci 245(1–2):99–102
Kesler SR, Watson C, Koovakkattu D, Lee C, O’Hara R, Mahaffey ML, Wefel JS (2013) Elevated prefrontal myo-inositol and choline following breast cancer chemotherapy. Brain Imaging Behav 7(4):501–510
Tong T, Lu H, Zong J, Lv Q, Chu X (2020) Chemotherapy-related cognitive impairment in patients with breast cancer based on MRS and DTI analysis. Breast cancer (Tokyo, Japan) 27(5):893–902
Hu Y, Zhang Q, Cui C, Zhang Y (2022) Altered regional brain glucose metabolism in diffuse large B-cell lymphoma patients treated with cyclophosphamide, epirubicin, vincristine, and prednisone: an fluorodeoxyglucose positron emission tomography study of 205 cases. Front Neurosci 16:914556
Schroyen G, Sleurs C, Bartsoen E, Smeets D, van Weehaeghe D, Van Laere K, Smeets A, Deprez S, Sunaert S (2022) Neuroinflammation as potential precursor of leukoencephalopathy in early-stage breast cancer patients: a cross-sectional PET-MRI study. Breast (Edinburgh, Scotland) 62:61–68
Schroyen G, Blommaert J, van Weehaeghe D, Sleurs C, Vandenbulcke M, Dedoncker N, Hatse S, Goris A, Koole M, Smeets A, van Laere K, Sunaert S, Deprez S (2021) Neuroinflammation and its association with cognition, neuronal markers and peripheral inflammation after chemotherapy for breast cancer. Cancers (Basel). Aug 20;13(16):4198
Lim I, Joung HY, Yu AR, Shim I, Kim JS (2016) PET Evidence of the effect of donepezil on cognitive performance in an animal model of chemobrain. Biomed Res Int 2016:6945415
Chiaravalloti A, Filippi L, Pagani M, Schillaci O (2023) Functional imaging of chemo-brain: usefulness of Nuclear Medicine in the fog coming after cancer. J Nuclear Med
Chen L, Hua J, Ross CA, Cai S, van Zijl PCM, Li X (2019) Altered brain iron content and deposition rate in Huntington’s disease as indicated by quantitative susceptibility MRI. J Neurosci Res 97(4):467–479
Chen BT, Ghassaban K, Jin T, Patel SK, Ye N, Sun CL, Kim H, Rockne RC, Mark Haacke E, Root JC et al (2018) Subcortical brain iron deposition and cognitive performance in older women with breast cancer receiving adjuvant chemotherapy: a pilot MRI study. Magn Reson Imaging 54:218–224
Iuvone L, Mariotti P, Colosimo C, Guzzetta F, Ruggiero A, Riccardi R (2002) Long-term cognitive outcome, brain computed tomography scan, and magnetic resonance imaging in children cured for acute lymphoblastic leukemia. Cancer 95(12):2562–2570
Chen BT, Jin T, Patel SK, Ye N, Sun CL, Ma H, Rockne RC, Root JC, Saykin AJ, Ahles TA et al (2018) Gray matter density reduction associated with adjuvant chemotherapy in older women with breast cancer. Breast Cancer Res Treat 172(2):363–370
McDonald BC, Conroy SK, Ahles TA, West JD, Saykin AJ (2010) Gray matter reduction associated with systemic chemotherapy for breast cancer: a prospective MRI study. Breast Cancer Res Treat 123(3):819–828
McDonald BC, Conroy SK, Smith DJ, West JD, Saykin AJ (2013) Frontal gray matter reduction after breast cancer chemotherapy and association with executive symptoms: a replication and extension study. Brain Behav Immunity 30:S117-125
Mo C, Lin H, Fu F, Lin L, Zhang J, Huang M, Wang C, Xue Y, Duan Q, Lin W et al (2017) Chemotherapy-induced changes of cerebral activity in resting-state functional magnetic resonance imaging and cerebral white matter in diffusion tensor imaging. Oncotarget 8(46):81273–81284
Deprez S, Amant F, Yigit R, Porke K, Verhoeven J, Van den Stock J, Smeets A, Christiaens MR, Leemans A, Van Hecke W et al (2011) Chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning in breast cancer patients. Hum Brain Mapp 32(3):480–493
Mzayek Y, de Ruiter MB, Oldenburg HSA, Reneman L, Schagen SB (2021) Measuring decline in white matter integrity after systemic treatment for breast cancer: omitting skeletonization enhances sensitivity. Brain Imaging Behav 15(3):1191–1200
Menning S, de Ruiter MB, Veltman DJ, Koppelmans V, Kirschbaum C, Boogerd W, Reneman L, Schagen SB (2015) Multimodal MRI and cognitive function in patients with breast cancer prior to adjuvant treatment–the role of fatigue. NeuroImage Clinical 7:547–554
Sporns O (2011) The human connectome: a complex network. Ann N Y Acad Sci 1224:109–125
Kesler SR (2014) Default mode network as a potential biomarker of chemotherapy-related brain injury. Neurobiol Aging 35(Suppl 2):S11-19
Wang L, Yan Y, Wang X, Tao L, Chen Q, Bian Y, He X, Liu Y, Ding W, Yu Y et al (2016) Executive function alternations of breast cancer patients after chemotherapy: evidence from resting-state functional MRI. Acad Radiol 23(10):1264–1270
Tao L, Wang L, Chen X, Liu F, Ruan F, Zhang J, Shen L, Yu Y (2020) Modulation of interhemispheric functional coordination in breast cancer patients receiving chemotherapy. Front Psychol 11:1689
Feng Y, Tuluhong D, Shi Z, Zheng LJ, Chen T, Lu GM, Wang S, Zhang LJ (2020) Postchemotherapy hippocampal functional connectivity patterns in patients with breast cancer: a longitudinal resting state functional MR imaging study. Brain Imaging Behav 14(5):1456–1467
Kesler SR, Blayney DW (2016) Neurotoxic effects of anthracycline- vs nonanthracycline-based chemotherapy on cognition in breast cancer survivors. JAMA Oncol 2(2):185–192
McDonald BC, Conroy SK, Ahles TA, West JD, Saykin AJ (2012) Alterations in brain activation during working memory processing associated with breast cancer and treatment: a prospective functional magnetic resonance imaging study. J Clin Oncol 30(20):2500–2508
Kam JW, Boyd LA, Hsu CL, Liu-Ambrose T, Handy TC, Lim HJ, Hayden S, Campbell KL (2016) Altered neural activation during prepotent response inhibition in breast cancer survivors treated with chemotherapy: an fMRI study. Brain Imaging Behav 10(3):840–848
Askren MK, Jung M, Berman MG, Zhang M, Therrien B, Peltier S, Ossher L, Hayes DF, Reuter-Lorenz PA, Cimprich B (2014) Neuromarkers of fatigue and cognitive complaints following chemotherapy for breast cancer: a prospective fMRI investigation. Breast Cancer Res Treat 147(2):445–455
Nudelman KN, McDonald BC, Wang Y, Smith DJ, West JD, O’Neill DP, Zanville NR, Champion VL, Schneider BP, Saykin AJ (2016) Cerebral perfusion and gray matter changes associated with chemotherapy-induced peripheral neuropathy. J Clin Oncol 34(7):677–683
Chen X, He X, Tao L, Cheng H, Li J, Zhang J, Qiu B, Yu Y, Wang K (2017) The attention network changes in breast cancer patients receiving neoadjuvant chemotherapy: evidence from an arterial spin labeling perfusion study. Sci Rep 7:42684
Chen WL, Wagner J, Heugel N, Sugar J, Lee YW, Conant L, Malloy M, Heffernan J, Quirk B, Zinos A et al (2020) Functional near-infrared spectroscopy and its clinical application in the field of neuroscience: advances and future directions. Front Neurosci 14:724
Jean-Pierre P (2014) Integrating functional near-infrared spectroscopy in the characterization, assessment, and monitoring of cancer and treatment-related neurocognitive dysfunction. Neuroimage 85(Pt 1):408–414
Durán-Gómez N, López-Jurado CF, Nadal-Delgado M, Pérez-Civantos D, Guerrero-Martín J, Cáceres MC. Chemotherapy-related cognitive impairment in patients with breast cancer based on functional assessment and nirs analysis. J Clin Med. 2022 Apr 23;11(9):2363
Acknowledgements
We thank the web of Pngkey and Pinclipart for providing the picture materials. We thank the authors for the creation of picture materials.
Funding
Funding was supplied by National Natural Science Foundation of China (No. 81872504; 81372487).
Author information
Authors and Affiliations
Contributions
HC contributed to the conception of the review. SY, QZ and XY were responsible for searching the literature and writing the manuscript. LP and XZ contributed scientific insights. XY created graphical illustrations. SY and HC contributed to manuscript revision and reviewed the submitted version. All authors contributed to the review and approved the submitted version.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no known competing financial interests and personal relationships that could have influence on the work reported in this review.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Yao, S., Zhang, Q., Yao, X. et al. Advances of neuroimaging in chemotherapy related cognitive impairment (CRCI) of patients with breast cancer. Breast Cancer Res Treat 201, 15–26 (2023). https://doi.org/10.1007/s10549-023-07005-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-023-07005-y