Cognitive and brain structural changes in a lung cancer population Journal Article


Authors: Simo, M.; Root, J. C.; Vaquero, L.; Ripolles, P.; Jove, J.; Ahles, T.; Navarro, A.; Cardenal, F.; Bruna, J.; Rodriguez-Fornells, A.
Article Title: Cognitive and brain structural changes in a lung cancer population
Abstract: Introduction: No study has examined structural brain changes specifically associated with chemotherapy in a lung cancer population. The aim of this cross-sectional study was to assess differences in brain structure between small-cell lung cancer patients (C+) following chemotherapy, non-small-cell lung cancer patients (C-) before chemotherapy and healthy controls (HC). Methods: Twenty-eight small-cell lung cancer patients underwent a neuropsychological assessment and a structural magnetic resonance imaging, including T1-weighted and diffusion tensor imaging to examine gray matter density and white matter (WM) integrity, respectively, 1 month following completion of platinum-based chemotherapy. This group was compared with 20 age and education-matched non-small-cell lung cancer patients before receiving chemotherapy and 20 HC. Results: Both C+ and C-groups exhibited cognitive impairment compared with the HC group. The C+ group performed significantly worse than HC in verbal fluency and visuospatial subtests; C- performed significantly worse than both C+ and HC in verbal memory. Voxel-based morphometry analysis revealed lower gray matter density in the insula and parahippocampal gyrus bilaterally, and left anterior cingulate cortex in C+ compared with HC. Diffusion tensor imaging indices showed focal decreased WM integrity in left cingulum and bilateral inferior longitudinal fasciculus in the C+ group and more widespread decreased integrity in the C-group compared with the HC group. Conclusion: This study demonstrates that lung cancer patients exhibit cognitive impairment before and after chemotherapy. Before the treatment, C- showed verbal memory deficits as well as a widespread WM damage. Following treatment, the C+ group performed exhibited lower visuospatial and verbal fluency abilities, together with structural gray matter and WM differences in bilateral regions integrating the paralimbic system.
Keywords: chemotherapy; neuroimaging; diffusion; lung cancer; survivors; adjuvant chemotherapy; trial; breast-cancer; women; systemic chemotherapy; white-matter; voxel-based morphometry; cognitive impairment; prophylactic cranial irradiation; tensor imaging; gray
Journal Title: Journal of Thoracic Oncology
Volume: 10
Issue: 1
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2015-01-01
Start Page: 38
End Page: 45
Language: English
ACCESSION: WOS:000346986500007
DOI: 10.1097/jto.0000000000000345
PROVIDER: wos
PUBMED: 25325778
PMCID: PMC5657249
Notes: Article -- Source: Wos
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  1. Tim A Ahles
    146 Ahles
  2. James Charles Root
    76 Root