Cognitive and brain structural changes in a lung cancer population

Marta Simó, James C. Root, Lucía Vaquero, Pablo Ripollés, Josep Jové, Tim Ahles, Arturo Navarro, Felipe Cardenal, Jordi Bruna, Antoni Rodríguez-Fornells

Research output: Contribution to journalArticlepeer-review


Introduction: No study has examined structural brain changes specifically associated with chemotherapy in a lung cancer population. The aim of this cross-sectional study was to assess differences in brain structure between small-cell lung cancer patients (C+) following chemotherapy, non-small-cell lung cancer patients (C-) before chemotherapy and healthy controls (HC). Methods: Twenty-eight small-cell lung cancer patients underwent a neuropsychological assessment and a structural magnetic resonance imaging, including T1-weighted and diffusion tensor imaging to examine gray matter density and white matter (WM) integrity, respectively, 1 month following completion of platinum-based chemotherapy. This group was compared with 20 age and education-matched non-small-cell lung cancer patients before receiving chemotherapy and 20 HC. Results: Both C+ and C- groups exhibited cognitive impairment compared with the HC group. The C+ group performed significantly worse than HC in verbal fluency and visuospatial subtests; C- performed significantly worse than both C+ and HC in verbal memory. Voxel-based morphometry analysis revealed lower gray matter density in the insula and parahippocampal gyrus bilaterally, and left anterior cingulate cortex in C+ compared with HC. Diffusion tensor imaging indices showed focal decreased WM integrity in left cingulum and bilateral inferior longitudinal fasciculus in the C+ group and more widespread decreased integrity in the C- group compared with the HC group. Conclusion: This study demonstrates that lung cancer patients exhibit cognitive impairment before and after chemotherapy. Before the treatment, C- showed verbal memory deficits as well as a widespread WM damage. Following treatment, the C+ group performed exhibited lower visuospatial and verbal fluency abilities, together with structural gray matter and WM differences in bilateral regions integrating the paralimbic system.

Original languageEnglish (US)
Pages (from-to)38-45
Number of pages8
JournalJournal of Thoracic Oncology
Issue number1
StatePublished - Jan 1 2015


  • Chemotherapy
  • Cognitive impairment
  • Diffusion tensor imaging
  • Lung cancer
  • Neuroimaging
  • Voxel-based morphometry

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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