Differences in total cognition and cerebrovascular function in female breast cancer survivors and cancer-free women

Tahnee L Downs; Eliza J Whiteside; Gaye Foot; Dean E Mills; Edward S Bliss

doi:10.1016/j.breast.2023.03.018

Differences in total cognition and cerebrovascular function in female breast cancer survivors and cancer-free women

Breast. 2023 Jun:69:358-365. doi: 10.1016/j.breast.2023.03.018. Epub 2023 Mar 31.

Authors

Tahnee L Downs¹, Eliza J Whiteside², Gaye Foot³, Dean E Mills⁴, Edward S Bliss⁵

Affiliations

¹ School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Molecular Biomarkers Research Group, University of Southern Queensland, Toowoomba, Queensland, Australia.
² School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia; Molecular Biomarkers Research Group, University of Southern Queensland, Toowoomba, Queensland, Australia.
³ St. Andrew's Toowoomba Hospital, Toowoomba, Queensland, Australia; Blush Cancer Care Inc, St Andrew's Hospital Toowoomba, Toowoomba, Queensland, Australia.
⁴ School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia.
⁵ School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Queensland, Australia; Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia; Molecular Biomarkers Research Group, University of Southern Queensland, Toowoomba, Queensland, Australia. Electronic address: Edward.Bliss@usq.edu.au.

Abstract

Reduced cognition is often reported by breast cancer patients and survivors, but the mechanisms for this decline are yet to be determined. We compared the differences in cerebrovascular function and cognition in breast cancer survivors (n = 15) and cancer-free women (n = 15) matched by age and body mass index. Participants undertook anthropometric, mood, cardiovascular, exercise performance, strength, cerebrovascular, and cognitive measurements. Transcranial Doppler ultrasound was used to measure the cerebrovascular responsiveness (CVR) to physiological (hypercapnia; 5% carbon dioxide) and psychological stimuli. Breast cancer survivors had a lower CVR to hypercapnia (21.5 ± 12.8 vs 66.0 ± 20.9%, P < 0.001), CVR to cognitive stimuli (15.1 ± 1.5 vs 23.7 ± 9.0%, P < 0.001) and total composite cognitive score (100 ± 12 vs. 113 ± 7, P = 0.003) than cancer-free women. These parameters remained statistically different between the groups following adjustments for covariates using an analysis of co-variance. We observed significant correlations between multiple measures and exercise capacity the only variable positively correlated to all primary measures (CVR to hypercapnia, r = 0.492, P = 0.007; CVR to cognitive stimuli r = 0.555, P = 0.003; and total composite cognitive score, r = 0.625, P < 0.001). In this study, breast cancer survivors had lower cerebrovascular and cognitive function than age-matched cancer-free women, which may be attributable to the effects of cancer and cancer treatment on brain health.

Keywords: Breast cancer; Cerebral blood flow; Cerebrovascular function; Cognition; Survivor.

MeSH terms

Breast Neoplasms*
Cancer Survivors*
Cerebrovascular Circulation / physiology
Cognition
Female
Humans
Hypercapnia / etiology