{"title":"CALM干预改善乳腺癌幸存者CRCI的神经机制：一项基于fmri的研究","authors":"Chen Gan, Jian Xu, Senbang Yao, Xinyi Zheng, Longyu Hu, Meiwen Ling, Mingjun Zhang, Huaidong Cheng","doi":"10.62347/OOVH5568","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Managing Cancer and Living Meaningfully (CALM) intervention's impact on chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCs) was investigated through resting-state functional magnetic resonance imaging (rs-fMRI) to elucidate the underlying neural mechanisms involved.</p><p><strong>Methods: </strong>68 BCs were randomly assigned to either the CALM group (33 patients) or the care-as-usual (CAU) group (35 patients). Cognitive function was assessed before and after the intervention in both groups using the Mini Mental State Examination (MMSE) scale. Pre- and post-intervention rs-fMRI data were also collected for regional homogeneity (ReHo) and functional connectivity (FC) analyses in the CALM group. A total of 68 BCs were randomly assigned to either the CALM group (n = 33) or the care-as-usual (CAU) group (n = 35). Cognitive function was evaluated pre- and post-intervention using the Mini-Mental State Examination (MMSE). In the CALM group, rs-fMRI data were acquired before and after the intervention to assess alterations in regional homogeneity (ReHo) and functional connectivity (FC).</p><p><strong>Results: </strong>CALM intervention demonstrated a greater enhancement in cognitive function compared to CAU (<i>P</i> = 0.004). Following CALM, ReHo exhibited an increase in bilateral occipital and temporal regions, including the superior, middle, and inferior occipital gyri, lingual gyrus, as well as the middle and superior temporal gyri, while a decrease was observed in frontal and cingulate regions, including the bilateral middle, medial, and dorsolateral superior frontal gyri, anterior cingulate and paracingulate gyri, precuneus, posterior cingulate, and left angular gyrus. FC analysis revealed diminished connectivity between the middle frontal gyrus and occipital/calcarine regions, whereas connectivity strengthened with the left anterior cingulate/paracingulate and right orbital frontal regions. ΔMMSE exhibited a positive correlation with ReHo in the left middle frontal gyrus (<i>r</i> = 0.355, <i>P</i> = 0.042) and a reduction in middle frontal-occipital FC (left calcarine: <i>r</i> = 0.353, <i>P</i> = 0.044; right/left middle occipital: <i>r</i> = 0.388/0.423, <i>P</i> = 0.029/0.014).</p><p><strong>Conclusion: </strong>CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical.</p>","PeriodicalId":7437,"journal":{"name":"American journal of cancer research","volume":"15 4","pages":"1733-1746"},"PeriodicalIF":3.6000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070110/pdf/","citationCount":"0","resultStr":"{\"title\":\"Neural mechanisms of CALM intervention to improve CRCI in breast cancer survivors: an fMRI-based study.\",\"authors\":\"Chen Gan, Jian Xu, Senbang Yao, Xinyi Zheng, Longyu Hu, Meiwen Ling, Mingjun Zhang, Huaidong Cheng\",\"doi\":\"10.62347/OOVH5568\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Managing Cancer and Living Meaningfully (CALM) intervention's impact on chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCs) was investigated through resting-state functional magnetic resonance imaging (rs-fMRI) to elucidate the underlying neural mechanisms involved.</p><p><strong>Methods: </strong>68 BCs were randomly assigned to either the CALM group (33 patients) or the care-as-usual (CAU) group (35 patients). Cognitive function was assessed before and after the intervention in both groups using the Mini Mental State Examination (MMSE) scale. Pre- and post-intervention rs-fMRI data were also collected for regional homogeneity (ReHo) and functional connectivity (FC) analyses in the CALM group. A total of 68 BCs were randomly assigned to either the CALM group (n = 33) or the care-as-usual (CAU) group (n = 35). Cognitive function was evaluated pre- and post-intervention using the Mini-Mental State Examination (MMSE). In the CALM group, rs-fMRI data were acquired before and after the intervention to assess alterations in regional homogeneity (ReHo) and functional connectivity (FC).</p><p><strong>Results: </strong>CALM intervention demonstrated a greater enhancement in cognitive function compared to CAU (<i>P</i> = 0.004). Following CALM, ReHo exhibited an increase in bilateral occipital and temporal regions, including the superior, middle, and inferior occipital gyri, lingual gyrus, as well as the middle and superior temporal gyri, while a decrease was observed in frontal and cingulate regions, including the bilateral middle, medial, and dorsolateral superior frontal gyri, anterior cingulate and paracingulate gyri, precuneus, posterior cingulate, and left angular gyrus. FC analysis revealed diminished connectivity between the middle frontal gyrus and occipital/calcarine regions, whereas connectivity strengthened with the left anterior cingulate/paracingulate and right orbital frontal regions. ΔMMSE exhibited a positive correlation with ReHo in the left middle frontal gyrus (<i>r</i> = 0.355, <i>P</i> = 0.042) and a reduction in middle frontal-occipital FC (left calcarine: <i>r</i> = 0.353, <i>P</i> = 0.044; right/left middle occipital: <i>r</i> = 0.388/0.423, <i>P</i> = 0.029/0.014).</p><p><strong>Conclusion: </strong>CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical.</p>\",\"PeriodicalId\":7437,\"journal\":{\"name\":\"American journal of cancer research\",\"volume\":\"15 4\",\"pages\":\"1733-1746\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070110/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of cancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.62347/OOVH5568\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/OOVH5568","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：通过静息状态功能磁共振成像（rs-fMRI）研究管理癌症和有意义地生活（CALM）干预对乳腺癌幸存者化疗相关认知障碍（CRCI）的影响，以阐明其潜在的神经机制。方法：68例bc随机分为CALM组（33例）和CAU组（35例）。采用迷你精神状态检查（MMSE）量表评估两组患者干预前后的认知功能。还收集了CALM组干预前和干预后的rs-fMRI数据，用于区域均匀性（ReHo）和功能连通性（FC）分析。共有68例bc被随机分配到CALM组（n = 33）或照护组（n = 35）。认知功能在干预前和干预后使用简易精神状态检查（MMSE）进行评估。在CALM组，在干预前后获得rs-fMRI数据，以评估区域均匀性（ReHo）和功能连通性（FC）的变化。结果：与CAU相比，CALM干预对认知功能的改善更大（P = 0.004）。CALM后，ReHo显示双侧枕叶和颞叶区域，包括枕叶上、中、下回、舌回以及颞叶中、上回增加，而额叶和扣带区域，包括双侧额叶上回、内侧和背外侧、扣带前和副扣带回、楔前叶、扣带后和左角回减少。FC分析显示，中额回与枕部/脑钙区之间的连通性减弱，而与左前扣带/副扣带和右眶额区之间的连通性增强。ΔMMSE与左额中回ReHo呈正相关（r = 0.355, P = 0.042），额-枕中FC减少(左calcarine: r = 0.353, P = 0.044；右/左枕中部：r = 0.388/0.423, P = 0.029/0.014)。结论：CALM干预可减轻脑卒中患者的CRCI，其中额中回可能起关键作用。
Neural mechanisms of CALM intervention to improve CRCI in breast cancer survivors: an fMRI-based study.
Background: Managing Cancer and Living Meaningfully (CALM) intervention's impact on chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCs) was investigated through resting-state functional magnetic resonance imaging (rs-fMRI) to elucidate the underlying neural mechanisms involved.
Methods: 68 BCs were randomly assigned to either the CALM group (33 patients) or the care-as-usual (CAU) group (35 patients). Cognitive function was assessed before and after the intervention in both groups using the Mini Mental State Examination (MMSE) scale. Pre- and post-intervention rs-fMRI data were also collected for regional homogeneity (ReHo) and functional connectivity (FC) analyses in the CALM group. A total of 68 BCs were randomly assigned to either the CALM group (n = 33) or the care-as-usual (CAU) group (n = 35). Cognitive function was evaluated pre- and post-intervention using the Mini-Mental State Examination (MMSE). In the CALM group, rs-fMRI data were acquired before and after the intervention to assess alterations in regional homogeneity (ReHo) and functional connectivity (FC).
Results: CALM intervention demonstrated a greater enhancement in cognitive function compared to CAU (P = 0.004). Following CALM, ReHo exhibited an increase in bilateral occipital and temporal regions, including the superior, middle, and inferior occipital gyri, lingual gyrus, as well as the middle and superior temporal gyri, while a decrease was observed in frontal and cingulate regions, including the bilateral middle, medial, and dorsolateral superior frontal gyri, anterior cingulate and paracingulate gyri, precuneus, posterior cingulate, and left angular gyrus. FC analysis revealed diminished connectivity between the middle frontal gyrus and occipital/calcarine regions, whereas connectivity strengthened with the left anterior cingulate/paracingulate and right orbital frontal regions. ΔMMSE exhibited a positive correlation with ReHo in the left middle frontal gyrus (r = 0.355, P = 0.042) and a reduction in middle frontal-occipital FC (left calcarine: r = 0.353, P = 0.044; right/left middle occipital: r = 0.388/0.423, P = 0.029/0.014).
Conclusion: CALM intervention mitigates CRCI in BCs, with the middle frontal gyrus may play a critical.
期刊介绍：
The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.
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