brain changes associated w chemo induced cognitive dysfunction identified

[Lani]

on my way looking for the original article I came across this other article, also pretty hot off the press:


Front Hum Neurosci. 2011;5:122. Epub 2011 Nov 1.
Pre-chemotherapy differences in visuospatial working memory in breast cancer patients compared to controls: an FMRI study.
Scherling C, Collins B, Mackenzie J, Bielajew C, Smith A.
Source
School of Psychology, University of Ottawa Ottawa, ON, Canada.
Abstract
Introduction: Cognitive deficits are a side-effect of chemotherapy, however pre-treatment research is limited. This study examines neurofunctional differences during working memory between breast cancer (BC) patients and controls, prior to chemotherapy. Methods: Early stage BC females (23), scanned after surgery but before chemotherapy, were individually matched to non-cancer controls. Participants underwent functional magnetic resonance imaging (fMRI) while performing a Visuospatial N-back task and data was analyzed by multiple group comparisons. fMRI task performance, neuropsychological tests, hospital records, and salivary biomarkers were also collected. Results: There were no significant group differences on neuropsychological tests, estrogen, or cortisol. Patients made significantly fewer commission errors but had less overall correct responses and were slower than controls during the task. Significant group differences were observed for the fMRI data, yet results depended on the type of analysis. BC patients presented with increased activations during working memory compared to controls in areas such as the inferior frontal gyrus, insula, thalamus, and midbrain. Individual group regressions revealed a reverse relationship between brain activity and commission errors. Conclusion: This is the first fMRI investigation to reveal neurophysiological differences during visuospatial working memory between BC patients pre-chemotherapy and controls. These results also increase the knowledge about the effects of BC and related factors on the working memory network. Significance: This highlights the need to better understand the pre-chemotherapy BC patient and the effects of associated confounding variables.

PMID: 22053153 [PubMed] PMCID: PMC3205481 Free PMC Article

[SoCalGal]

It seems like a very small sampling of women.

[StephN]

Hopefully this is just the start of such studies. With such a small sample, it would be hard to cover all treatment modalities.

[Lani]

I looked at the article.

It did NOT test them before surgery and then after surgery but before chemo or hormonal and then after chemo/hormonal and then periodically thereafter as you would need to to draw more meaningful conclusions

It just matched the numbers of those who got chemo and those who did not for hormonal therapy NOT EVEN CONSIDERING IT could be the antihormonal therapy that was responsible (not even in the discussion of possible confounders at the end of the article) and didn't reflect on the fact that one of the mechanisms of action/results of chemotherapy is to put patients in premature menopause ie, it might be the time course of estrogen deprivation which is important. It just matched the patients with and without chemo and without bc for age and menopausal status.

Lot of work left to be done!