MRI scans show cause of chemobrain

INDIANA U. (US) — Researchers for first time have used brain imaging to study women with breast cancer before and after chemotherapy, showing that treatment can affect gray matter.

Findings are reported in the October issue of Breast Cancer Research and Treatment.

Andrew Saykin, a professor of radiology at Indiana University, says the analysis “suggest an anatomic basis for the cognitive complaints and performance changes seen in patients. Memory and executive functions like multi-tasking and processing speed are the most typically affected functions, and these are handled by the brain regions where we detected gray matter changes.”

Saykin and colleagues studied structural MRI brain scans of breast cancer patients and of healthy subjects. The scans were taken after surgery, but before radiation or chemotherapy, to give the researchers a baseline. Scans were then repeated one month and one year after chemotherapy was completed.

The researchers found gray matter changes were most prominent in areas consistent with cognitive dysfunction during and shortly after chemotherapy. Gray matter density in most women improved a year after chemotherapy ended.

The cognitive effects of chemotherapy, often referred to as “chemobrain,” have been known for years. For many patients, Saykin says, the effects are subtle. However, they can be more pronounced for others.

Although relatively rare, some patients—often middle-aged women—are so affected that they are never able to return to work. More commonly, women are able to work and multitask, but may find it more difficult to do so.

The study focused on 17 breast cancer patients treated with chemotherapy after surgery, 12 women with breast cancer who did not undergo chemotherapy after surgery, and 18 women without breast cancer.

“We hope there will be more prospective studies to follow so that the cause of these changes in cancer patients can be better understood,” Saykin says.

The study was supported by a grant from the Office of Cancer Survivorship of the National Cancer Institute, National Institutes of Health, and the Indiana Economic Development Corp.

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