摘要
目的 使用基于后扣带回(PCC)的功能连接分析,探索乳腺癌化疗相关认知障碍的脑功能异常。方法 选取经手术病理证实并接受全部化疗周期的乳腺浸润性导管癌患者20例,在术后、化疗前(T0点)及化疗后(T1点)分别进行一系列神经认知评估及MRI检查。比较乳腺癌患者T0及T1时间点神经认知功能变化及基于PCC功能连接的纵向变化。使用相关性分析探索PCC功能连接异常与认知功能的联系。结果 乳腺癌患者在T1点与T0点相比,即刻回忆、短时延迟回忆、长时延迟回忆及数字倒背任务的评分降低,CTT-1、CTT-2用时增加,差异均有统计学意义(P<0.05)。基于PCC为种子点的功能连接分析结果显示,乳腺癌患者化疗后出现了PCC与右侧额上回、右侧角回以及右侧楔前叶的功能连接降低(P<0.001)。Pearson相关性分析结果显示,乳腺癌患者化疗后相比化疗前,PCC与右侧楔前叶的FC差值分别与即刻回忆评分的差值和短时延迟回忆评分的差值呈显著正相关(P<0.05)。结论 化疗会造成乳腺癌患者大脑PCC与多发脑区功能连接的异常减低,同时会造成多个领域的认知功能障碍,并且PCC与右侧楔前叶功能连接参与了记忆功能的调节。
Objective In this study,Posterior cingulate cortex(PCC)functional connectivity analysis was used to explore the brain dysfunction of chemotherapy-related cognitive impairment in breast cancer.Methods 20 cases of invasive ductal car⁃cinoma of the breast confirmed by surgery and pathology and receiving all chemotherapy cycles were selected,and a series of neurocognitive assessments and magnetic resonance imaging examinations were performed after surgery,before chemotherapy(T0 point),and after chemotherapy(T1 point).We compared the changes of neurocognitive function at T0 and T1 time points and the longitudinal changes based on PCC functional connectivity in breast cancer patients and used correlation analysis to ex⁃plore the relationship between PCC functional connectivity abnormalities and cognitive function.Results Compared with those before chemotherapy,the scores of immediate recall,short-term delayed recall,long-term delayed recall,and digit reverse task of breast cancer patients,who received all chemotherapy cycles,decreased,and the duration of CTT-1 and CTT-2 increased,with a statistically significant difference(P<0.05).The results of functional connectivity analysis based on PCC as seed point showed that the functional connectivity between PCC and right superior frontal gyrus,right angular gyrus and right anterior cunei⁃form lobe in breast cancer patients after chemotherapy was reduced(P<0.001,uncorrected).The results of correlation analysis showed that the functional connectivity(FC)difference between PCC and right anterior cuneiform lobe of breast cancer patients after chemotherapy was significantly positively correlated with the difference of immediate recall score and the difference of shortterm delayed recall score(P<0.05).Conclusion Chemotherapy can cause abnormal reduction of functional connectivity be⁃tween PCC and multiple brain regions in breast cancer patients and,also,cause cognitive dysfunction in multiple fields.The functional connectivity between PCC and the right anterior cuneiform lobe is involved in the regulation of memory function.
作者
刘同辉
李朋
张华文
冯伟
王雪原
陈瑞
魏恒阳
LIU Tonghui;LI Peng;ZHANG Huawen;FENG Wei;WANG Xueyuan;CHEN Rui;WEI Hengyang(Department of Medical Imaging,Nuclear Industry 215 Hospital of Shaanxi Province,Xianyang 712000,China)
出处
《医学影像学杂志》
2024年第5期5-8,14,共5页
Journal of Medical Imaging
基金
陕西省重点研发计划项目(编号:2019SF-209)
陕西省咸阳市重点研发计划项目(编号:L2022ZDYFSF026)
陕西省咸阳市秦都区科技计划项目(编号:2021QKJ-021)
中陕核工业集团有限公司科技攻关项目(编号:61230302)。
关键词
乳腺癌
认知障碍
磁共振成像
功能连接
后扣带回
Breast cancer
Cognitive impairment
Magnetic resonance imaging
Functional connectivity
Posterior cingu⁃late cortex
