乳腺癌化疗患者认知功能与度中心性的相关性研究

Correlation between Cognitive Function and Degree Centrality in Patients with Breast Cancer After Chemotherapy

目的该研究的目的是通过度中心性(degree centrality,DC)来分析乳腺癌化疗患者是否存在持续性脑区功能损伤,并探讨其与神经心理学量表的相关性。方法该研究一共纳入了29名化疗后的乳腺癌患者(chem otherapy treatment group,C+)和28名未经放化疗的同龄乳腺癌患者(without chemotherapy treatment group,C-),两组均进行了静息态功能磁共振检查和神经心理学量表测试。结果与C-组相比,C+组运动疲劳、认知疲劳、感知认知障碍、他人的评价、对生活质量的影响得分明显增高,感知认知能力得分明显降低,差异有统计学意义(P<0.05)。C+组右侧颞上回、左侧中央后回zDC值升高(FWE校正,P<0.01),左侧尾状核zDC值降低(FWE校正,P<0.01)。多元回归分析提示数字符号实验得分与右侧颞上回(r=0.709,P<0.001)呈正相关,与右侧角回(r=-0.784,P<0.001)、左侧顶上回(r=-0.739,P<0.001)呈负相关。结论化疗导致乳腺癌患者出现脑功能活动异常和认知功能下降,且这种影响将持续存在,DC可作为化疗相关认知功能障碍的影像学标志物。

Objective The purpose of this study was to analyze whether there was persistent brain functional impairment in patients with breast cancer after chemotherapy by degree centrality(DC),and to explore its correlation with neuropsychological scales.Methods A total of 29 post-chemotherapy patients with breast cancer(chemotherapy group,C+)and 28 same-age patients with breast cancer(without chemotherapy group,C-)were enrolled in this study.Both groups underwent resting-state functional magnetic resonance(rs-fMRI)examination and neuropsychological scale tests.Results Compared with the C-group,the scores of the fatigue scale for motor,the fatigue scale for cognitive,perceived cognitive impairments,comments for others,impact on quality of life in the C+group were significantly higher,perceived cognitive abilities were significantly lower(P<0.05).In the C+group,the zDC values of the right superior temporal gyrus and left posterior central gyrus increased(FWE corrected,P<0.01),while the zDC values of the left caudate nucleus decreased(FWE corrected,P<0.01).Multiple regression analysis showed that digital symbol test score was positively correlated with the right superior temporal gyrus(r=0.709,P<0.001),and negatively correlated with the right angular gyrus(r=-0.784,P<0.001)and the left parietal gyrus(r=-0.739,P<0.001).Conclusion Chemotherapy leads to abnormal brain functional activity and cognitive decline in patients with breast cancer,and this effect will persist.DC can be used as an imaging marker of chemotherapy-related cognitive dysfunction.