Detecting microstructural alterations of cerebral white matter associated with breast cancer and chemotherapy revealed by generalized q-sampling MRI

Vincent Chin-Hung Chen; Wei Chuang; Chien-Wei Chen; Yuan-Hsiung Tsai; Roger S McIntyre; Jun-Cheng Weng

doi:10.3389/fpsyt.2023.1161246

Detecting microstructural alterations of cerebral white matter associated with breast cancer and chemotherapy revealed by generalized q-sampling MRI

Front Psychiatry. 2023 Jun 9:14:1161246. doi: 10.3389/fpsyt.2023.1161246. eCollection 2023.

Authors

Vincent Chin-Hung Chen^{1

2}, Wei Chuang³, Chien-Wei Chen^{1

4}, Yuan-Hsiung Tsai^{1

4}, Roger S McIntyre^{5

6

7}, Jun-Cheng Weng^{2

3

8}

Affiliations

¹ School of Medicine, Chang Gung University, Taoyuan, Taiwan.
² Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.
³ Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁵ Mood Disorder Psychopharmacology Unit, Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, Canada.
⁶ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
⁷ Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada.
⁸ Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan.

Abstract

Objective: Previous studies have discussed the impact of chemotherapy on the brain microstructure. There is no evidence of the impact regarding cancer-related psychiatric comorbidity on cancer survivors. We aimed to evaluate the impact of both chemotherapy and mental health problem on brain microstructural alterations and consequent cognitive dysfunction in breast cancer survivors.

Methods: In this cross-sectional study conducted in a tertiary center, data from 125 female breast cancer survivors who had not received chemotherapy (BB = 65; 49.86 ± 8.23 years) and had received chemotherapy (BA = 60; 49.82 ± 7.89 years) as well as from 71 age-matched healthy controls (47.18 ± 8.08 years) was collected. Chemotherapeutic agents used were docetaxel and epirubicin. We used neuropsychological testing and questionnaire to evaluate psychiatric comorbidity, cognitive dysfunction as well as generalized sampling imaging (GQI) and graph theoretical analysis (GTA) to detect microstructural alterations in the brain.

Findings: Cross-comparison between groups revealed that neurotoxicity caused by chemotherapy and cancer-related psychiatric comorbidity may affect the corpus callosum and middle frontal gyrus. In addition, GQI indices were correlated with the testing scores of cognitive function, quality of life, anxiety, and depression. Furthermore, weaker connections between brain regions and lower segregated ability were found in the post-treatment group.

Conclusion: This study suggests that chemotherapy and cancer-related mental health problem both play an important role in the development of white matter alterations and cognitive dysfunction.

Keywords: breast cancer; chemotherapy; generalized q-sampling imaging; graph theoretical analysis; psychiatric comorbidity.