Duygu HEREK, Gamze GÖKÖZ DOĞU, Mehmet Bülent ÖZDEMİR, Burcu YAPAR TAŞKÖYLÜ, Umut ÇAKIROĞLU, Yurdaer DOĞU, Arzu YAREN

Hippocampal volume reduction after chemotherapy assessed by brain MRI: a cause of chemobrain in cancer patients

Purpose:Cancer treatment (chemotherapy) affects various neural parts of the brain which results in cognitive impairments as problems in working memory, concentration, speed of processing and responding, and speech. This condition is called “chemobrain”. The aim of this study is to establish whether any change exists in the volume of certain brain parts before and after chemotherapy that might play a role in chemobrain by means of magnetic resonance imaging (MRI). Materials and methods: Eleven patients with various cancers underwent cranial MRI before and after chemotherapy. 3-dimensional reconstruction from coronal 2 dimensional images were obtained by SURFDriver program. Volume calculations of cerebrum, cerebellum, ventricles, right and left hippocampus were done by Cavalieri method. Results:According to measurements there was a statistically significant difference only in the volumes of right and left hippocampus before and after chemotherapy (p

Kemoterapi sonrası hipokampüs hacmindeki azalmanın beyin MRG ile değerlendirilmesi:kanser hastalarında kemobeyinin bir sebebi

Amaç:Kanser tedavisi (kemoterapi) beyinin çeşitli nöral parçalarını etkileyerek hafıza, konsantrasyon, işleme ve karşılık verme hızı ve konuşma gibi alanlarda bilişsel bozukluklara neden olur. Bu duruma “kemobeyin” adı verilir. Bu çalışmanın amacı manyetik rezonans görüntüleme (MRG) aracılığıyla kemoterapi öncesi ve sonrası bazı beyin kısımlarında kemobeyin oluşmasına neden olabilecek herhangi bir hacim değişikliği olup olmadığını ortaya koymaktır. Gereç ve yöntem:Farklı kanser tanıları olan 11 hastaya kemoterapi öncesi ve sonrası kraniyal MRG tetkiki yapıldı. Koronal 2-boyutlu görüntülerden SURFDriver programı kullanılarak 3-boyutlu rekonstrüksiyonlar elde edildi. Serebrum, serebellum, ventriküller, sağ ve sol hipokampüsün hacim ölçümleri Cavalieri yöntemi kullanılarak elde edildi. Bulgular:Ölçümler sonucunda kemoterapi öncesi ve sonrası sadece hipokampüs hacimlerinde anlamlı farklılık vardı (p

PDF

___

Schagen SB, Muller MJ, Boogerd W, Millenbergh GJ, van Dam FS. Change in cognitive function after chemotherapy:a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst 2006;98:1742-1745.

Schagen SB, Muller MJ, Boogerd W, et al. Late effects of adjuvant chemotherapy on cognitive function: a follow-up study in breast cancer patients. Ann Oncol 2002;13:1387-1397.

Koppelmans V, Breteler MM, Boogerd W,et al. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol 2012;30:1080-1086.

Conroy SK, McDonald BC, Smith, DJ,et al. Alterations in brain structure and function in breast cancer survivors: effect of post-chemotherapy interval and relation to oxidative DNA damage. Breast Cancer Res Treat 2013;137:493-501.

Inagaki M, Yoshikawa E, Matsuoka Y,et al. Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer 2007;109:146-156.

Dutta V. Psychostimulants for chemotherapy induced cognitive changes in cancer, Ockham’s razor, anyone? J Cancer Res Ther 2012;8:326-329.

Bender CM, Sereika SM, Berga SL,et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology 2006;15:422-430.

Jansen CE, Cooper BA, Dodd MJ, Miaskowski CA. A prospective longitudinal study of chemotherapyinduced cognitive changes in breast cancer patients. Support Care Cancer 2011;19:1647-1656.

Schagen SB, van Dam FS, Muller MJ, Boogerd W, Lindeboom J, Bruning PF. Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 1999;85:640-650.

Cheung YT, Shwe M, Tan YP, Fan G, Ng R, Chan A. Cognitive changes in multiethnic Asian breast cancer patients: a focus group study. Ann Oncol 2012;23:2547-2552.

Kesler SR. Default mode network as a potential biomarker of chemotherapy-related brain injury. Neurobiol Aging 2014;35:11-19.

Hede K. Chemobrain is real but may need new name. J Natl Cancer Inst 2008;100:162-163,169.

Moore HC. An overview of chemotherapy-related cognitive dysfunction, or ‘chemobrain’. Oncology (Williston Park) 2014;28:797-804. 11. Scherling CS, Smith A. Opening up the window into “chemobrain”: a neuroimaging review. Sensors (Basel) 2013;13:3169-3203.

Selamat MH, Loh SY, Mackenzie L et al. Chemobrain experienced by breast cancer survivors: a metaethnography study investigating research and care implications. PLoS One 2014;9:e108002.

Rolls ET. Theory of hippocampal function in memory. Hippocampus 1996;6:601-620.

SURFdriver. [Online]. Available at:http://www.surfdriver. com. Accessed March 3, 2016.

Monje M, Dietrich J. Cognitive side effects of cancer therapy demonstrate a functional role for adult neurogenesis. Behav Brain Res 2012;227:376-379.

Nokia MS, Anderson ML, Shors TJ. Chemotherapy disrupts learning, neurogenesis and theta activity in the adult brain. Eur J Neurosci 2012;36:3521-3530.

Boykoff N, Moieni M, Subramanian SK. Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 2009;3:223-232.

Holmes D. Trying to unravel the mysteries of chemobrain. Lancet Neurol 2013;12:533-534.

Patel SK, Hurria A, Mandelblatt JS. Chemobrain: is it time to initiate guidelines for assessment and management? Oncology (Williston Park) 2014;28:797-804.

Cheung YT, Ng T, Shwe M et al. Association of proinflammatory cytokines and chemotherapyassociated cognitive impairment in breast cancer patients: a multi-centered, prospective, cohort study. Ann Oncol 2015;26:1446-1451.