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Can Brain White Matter Microstructure Cause Cognitive Decline in Patients With Breast Cancer?

By: Victoria Kuhr, BA
Posted: Monday, January 3, 2022

Low fractional anisotropy (FA) before chemotherapy appears to be a risk factor for early and late cognitive decline after chemotherapy for patients with breast cancer. Michiel B. de Ruiter, PhD, of the Netherlands Cancer Institute Amsterdam, and colleagues proposed that white matter microstructures in brain regions before chemotherapy may be critically involved in several cognitive functions. A detailed report of their study was published in the Journal of Clinical Oncology.

“The finding that a low baseline FA is a risk factor for cognitive decline after chemotherapy in patients with breast cancer has potential clinical implications. A low FA might represent a low brain white matter reserve,” said the authors.

Recruited patients were enrolled into one of the three following groups: patients with breast cancer who received systemic therapy (n = 49), patients with breast cancer who did not receive systemic therapy (n = 39), and controls without cancer (n = 37). Researchers used FA to measure white matter microstructures before and after chemotherapy in specific nerve tracts, in addition to baseline age, fatigue, cognitive complaints, and premorbid intelligence quotient.

Low FA independently predicted cognitive decline at 6 months (P = .013) and at 3 years (P < .001) after chemotherapy. For the continuous outcome measure of cognitive decline, no significant group differences were apparent from baseline to follow-up 1 and 2 (on average 7.1 and 27.4 months after chemotherapy). For follow-up 3 (on average 40.4 months after chemotherapy), performance was worse for those with breast cancer who had chemotherapy than for those with breast cancer who did not. FA did not predict cognitive decline in patients with breast cancer who did not receive systemic therapy nor in control patients without cancer.

Disclosure: The study authors reported no conflicts of interest.

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