Unveiling the impact of chemotherapy in patients with breast cancer: A longitudinal study on peripheral inflammation, multimodal magnetic resonance imaging, and cognition

IF 5.1 2区医学 Q1 ONCOLOGY

Cancer Pub Date : 2025-09-19 DOI:10.1002/cncr.70095

Rob Colaes MSc, Gwen Schroyen PhD, Ahmed Radwan MD, PhD, Rebeca Alejandra Gavrila Laic PhD, Shannon Helsper PhD, Uwe Himmelreich PhD, Sigrid Hatse PhD, Ann Smeets MD, PhD, Karen Caeyenberghs PhD, Stefan Sunaert MD, PhD, Sabine Deprez PhD

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Abstract

Background

The pathophysiology of chemotherapy-induced cognitive impairment (CICI) remains unclear. Besides direct neurotoxicity, chemotherapy may trigger peripheral proinflammatory responses leading to neuroinflammation and neuronal injury. This longitudinal study investigated changes in peripheral inflammatory and neuronal markers, and multimodal magnetic resonance imaging measures from pre-to post-chemotherapy, and their potential role in CICI.

Methods

This study included 32 women receiving chemotherapy for early breast cancer (C+), 35 patients not exposed to chemotherapy (C–), and 46 healthy women (HC) age- and education-matched. Participants were assessed at diagnosis (T0), 3 months post-chemotherapy (T1), and 1 year post-chemotherapy (T2), or at matched intervals. Differences over time were assessed in cognitive outcomes, peripheral inflammatory and neuronal markers, and multimodal magnetic resonance imaging measures, reflecting white matter (WM) lesions, magnetic resonance spectroscopy metabolites, WM microstructure, and the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. To investigate changes in WM structure, the authors performed a longitudinal fixel-based analysis on multi-shell diffusion-weighted images. Associations between peripheral inflammation and WM microstructure were explored, as well as their relationship to both subjective and objective cognitive outcomes.

Results

This study observed alterations after chemotherapy in subjective and objective cognition, inflammatory profiles, neurofilament light chain, the DTI-ALPS index, and WM microstructure within the left inferior longitudinal fasciculus and in the genu of the prefrontal corpus callosum. Alterations in peripheral inflammatory profiles were associated with worse performance in objective cognition, but not with changes in WM microstructure.

Conclusion

Peripheral inflammatory responses and alterations in WM microstructure are potential key mechanisms underlying CICI.

Abstract Image

查看原文本刊更多论文

揭示化疗对乳腺癌患者的影响：外周炎症、多模态磁共振成像和认知的纵向研究。

背景：化疗诱导的认知障碍（CICI）的病理生理机制尚不清楚。除了直接的神经毒性外，化疗还可能引发外周促炎反应，导致神经炎症和神经元损伤。这项纵向研究调查了化疗前后外周炎症和神经元标志物的变化，以及多模态磁共振成像测量，以及它们在CICI中的潜在作用。方法：本研究纳入32名接受化疗的早期乳腺癌患者（C+）， 35名未接受化疗的患者（C-），以及46名年龄和教育程度相匹配的健康女性（HC）。在诊断（T0）、化疗后3个月（T1）和化疗后1年（T2）或匹配的时间间隔对参与者进行评估。评估认知结果、外周炎症和神经元标志物以及反映白质（WM）病变、磁共振波谱代谢物、WM微结构和沿血管周围空间弥散张量成像（DTI-ALPS）指数的多模态磁共振成像测量随时间的差异。为了研究WM结构的变化，作者对多壳扩散加权图像进行了纵向固定分析。研究人员还探讨了外周炎症与WM微观结构之间的关系，以及它们与主观和客观认知结果的关系。结果：本研究观察了化疗后主客观认知、炎症谱、神经丝轻链、DTI-ALPS指数、左下纵束和前额叶胼胝体膝内WM微结构的改变。外周炎症谱的改变与客观认知能力下降有关，但与WM微结构的改变无关。结论：外周炎症反应和WM微结构改变可能是CICI的关键机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research