Alterations in brain activation during working memory processing associated with breast cancer and treatment: A prospective functional magnetic resonance imaging study Journal Article


Authors: McDonald, B. C.; Conroy, S. K.; Ahles, T. A.; West, J. D.; Saykin, A. J.
Article Title: Alterations in brain activation during working memory processing associated with breast cancer and treatment: A prospective functional magnetic resonance imaging study
Abstract: Purpose: To prospectively examine alterations in working memory (WM) -associated brain activation related to breast cancer and treatment by using functional magnetic resonance imaging. Patients and Methods: Patients treated with chemotherapy (CTx+; n = 16) or without chemotherapy (CTx-; n = 12) and healthy controls (n = 15) were scanned during an n-back task at baseline (after surgery but before radiation, chemotherapy, and/or antiestrogen treatment), 1 month after completion of chemotherapy (M1), and 1 year later (Y1), or at yoked intervals for CTx- and controls. SPM5 was used for all image analyses, which included cross-sectional between-group and group-by-time interaction and longitudinal within-group analyses, all using a statistical threshold of 0.001. Results: At baseline, patients with cancer showed increased bifrontal and decreased left parietal activation compared with controls. At M1, both cancer groups showed decreased frontal hyperactivation compared with controls, with increased hyperactivation at Y1. These cross-sectional findings were confirmed by group-by-time interaction analyses, which showed frontal activation decreases from baseline to M1 in patients compared with controls. Within-group analyses showed different patterns of longitudinal activation change by treatment group (CTx+ or CTx-), with prominent alterations in the frontal lobes bilaterally. Conclusion: Significant frontal lobe hyperactivation to support WM was found in patients with breast cancer. Superimposed on this background, patients showed decreased frontal activation at M1, with partial return to the previously abnormal baseline at Y1. These functional changes correspond to frontal lobe regions where we previously reported structural changes in this cohort and provide prospective, longitudinal data that further elucidate mechanisms underlying cognitive effects related to breast cancer and its treatment. © 2012 by American Society of Clinical Oncology.
Keywords: adult; clinical article; controlled study; middle aged; doxorubicin; cancer combination chemotherapy; paclitaxel; magnetic resonance imaging; prospective study; prospective studies; breast cancer; cyclophosphamide; breast neoplasms; docetaxel; cancer hormone therapy; psychological rating scale; cognition; frontal lobe; functional magnetic resonance imaging; left hemisphere; task performance; antiestrogen; parietal lobe; nuclear magnetic resonance scanner; working memory; task performance and analysis; memory, short-term; center for epidemiologic studies depression scale; state trait anxiety inventory; fatigue symptom inventory; functional neuroimaging
Journal Title: Journal of Clinical Oncology
Volume: 30
Issue: 20
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2012-07-10
Start Page: 2500
End Page: 2508
Language: English
DOI: 10.1200/jco.2011.38.5674
PROVIDER: scopus
PMCID: PMC3397784
PUBMED: 22665542
DOI/URL:
Notes: --- - "Export Date: 1 August 2012" - "CODEN: JCOND" - "Source: Scopus"
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  1. Tim A Ahles
    95 Ahles