基于独立成分分析的乳腺癌化疗患者脑功能网络研究

A Study of Brain Function Networks in Patients with Breast Cancer after Chemotherapy Based on Independent Component Analysis

目的通过独立成分分析方法观察乳腺癌化疗患者大尺度静息态网络间功能连接变化,并分析其与认知评估及实验室指标的相关性。方法纳入50例术后化疗前的乳腺癌患者(C-组)和44例化疗后乳腺癌患者(C+组),两组分别进行了认知评估及静息态功能磁共振成像(rs-fMRI)检查。使用独立成分分析方法来评估脑功能网络成分,比较两组受试者功能网络连接性(FNC),并与认知测试结果及血液生化指标进行相关性分析。结果与C-组相比,C+组蒙特利尔认知评估(MoCA)、感知认知能力得分降低(P<0.05),数字连接实验A、认知疲劳、运动疲劳、感知认知障碍得分增高(P<0.05),同时C+组空腹血糖及甘油三酯水平较C-组高(P<0.05),两组在年龄、受教育年限差异无统计学意义。在脑网络水平,C+组听觉网络(AN)与背侧注意网络(DAN)、AN与感觉运动网络(SMN)、默认模式网络(DMN)内、DAN与腹侧注意网络(VAN)、左侧额顶网络(LFPN)与VAN间功能连接降低(Bonferroni校正,P<0.05)。相关性分析显示,AN与SMN功能连接强度与蒙特利尔认知评估(r=0.379,P=0.026,FDR校正)、简易精神量表(r=0.492,P=0.003,FDR校正)、感知认知能力(r=0.330,P=0.040,FDR校正)呈正相关。结论乳腺癌患者化疗后出现认知能力损伤、大尺度脑网络间功能连接性改变,且与认知测试相关,这提示静息态网络功能连接性可为诊断化疗相关认知功能损伤提供影像学依据。

Objective The objective of this study was to observe the functional connections between large-scale resting networks in patients with breast cancer after chemotherapy by independent component analysis,and to analyze their correlation with cognitive assessment and laboratory indicators.Methods A total of 50 patients with breast cancer without chemotherapy treatment(C-)and 44 patients with breast cancer after chemotherapy(C+)were enrolled in this study.Both groups underwent cognitive assessment and resting-state functional magnetic resonance imaging.Independent component analysis was used to assess brain functional network components.Functional network connectivity(FNC)were compared between the two groups,and its correlation with cognitive test results and blood biochemical indicators was analyzed.Results Compared with C-group,Montreal Cognitive Assessment(MoCA)and perceived cognitive abilities(CogPCA)scores in C+group were decreased,while Number Connection Test-A(NCT-A),the Fatigue Scale for Motor and Cognitive Functions-cognitive and motor(FSMC-C,FSMC-M),perceived cognitive impairments scores(CogPCI)were increased(P<0.05).The fasting blood glucose and triglyceride levels in the C+group were higher than those in the C-group(P<0.05).There was no significant difference in age and education level between the two groups.At the brain network level,the functional connections between the auditory network and the dorsal attention network,the auditory network and the sensorimotor network,the default mode inner-network,the dorsal attention network and the ventral attention network,and the left frontoparietal network and the ventral attention network were decreased in the C+group(Bonferroni correction,P<0.05).The correlation analysis showed that the functional connection strength between auditory network and sensorimotor network was positively correlated with MoCA(r=0.379,P=0.026,FDR correction),MMSE(r=0.492,P=0.003,FDR correction),and CogPCA(r=0.330,P=0.040,FDR correction).Conclusion Patients with breast cancer after chemotherapy showed cognitive impairment and large-scale functional connectivity changes between brain networks,which were correlated with cognitive tests,suggesting that the functional connectivity of resting state network could provide imaging basis for the diagnosis of chemotherapy-related cognitive impairment.