TY - JOUR
T1 - Cognitive and brain structural changes in a lung cancer population
AU - Simó, Marta
AU - Root, James C.
AU - Vaquero, Lucía
AU - Ripollés, Pablo
AU - Jové, Josep
AU - Ahles, Tim
AU - Navarro, Arturo
AU - Cardenal, Felipe
AU - Bruna, Jordi
AU - Rodríguez-Fornells, Antoni
N1 - Funding Information:
This work was supported by la Fundació Marató-TV3 (Acquired Spinal Cord and Brain Injuries Program [2012–2015] awarded to ARF) and the Catalan Government [Generalitat de Catalunya, 2009 SGR 93 to ARF]. Marta Simó was a recipient of a Rio Hortega research contract (code: CM11/00256) from the Carlos III National Health Institute (Spanish Government).
Publisher Copyright:
Copyright © 2014 by the International Association for the Study of Lung Cancer.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - Chemotherapy
KW - Cognitive impairment
KW - Diffusion tensor imaging
KW - Lung cancer
KW - Neuroimaging
KW - Voxel-based morphometry
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U2 - 10.1097/JTO.0000000000000345
DO - 10.1097/JTO.0000000000000345
M3 - Article
C2 - 25325778
AN - SCOPUS:84926420820
SN - 1556-0864
VL - 10
SP - 38
EP - 45
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 1
ER -