Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: Converging results from multimodal magnetic resonance imaging

Michiel B. de Ruiter, Liesbeth Reneman, Willem Boogerd, Dick J. Veltman, Matthan Caan, Gwenaëlle Douaud, Cristina Lavini, Sabine C. Linn, Epie Boven, Frits S.A.M. van Dam, Sanne B. Schagen
2011 Human Brain Mapping  
The neural substrate underlying cognitive impairments after chemotherapy is largely unknown. Here, we investigated very late (>9 years) effects of adjuvant high-dose chemotherapy on brain white and gray matter in primary breast cancer survivors (n ¼ 17) with multimodal magnetic resonance imaging (MRI). A group of breast cancer survivors who did not receive chemotherapy was scanned for comparison (n ¼ 15). Neuropsychological tests demonstrated cognitive impairments in the chemotherapy group.
more » ... usion tensor imaging (DTI) with tract-based spatial statistics showed that chemotherapy was associated with focal changes in DTI values indicative for reduced white matter integrity. Single voxel proton MR spectroscopy (1H-MRS) in the left centrum semiovale (white matter) showed a reduction of N-acetylasparate/creatine indicative of axonal injury. Voxel-based morphometry demonstrated a reduction of gray matter volume that overlapped with fMRI hypoactivation (as reported in a previous publication) in posterior parietal areas and colocalized with DTI abnormalities. Also, DTI correlated with 1H-MRS only in the chemotherapy group. These results converge to suggest Additional Supporting Information may be found in the online version of this article.
doi:10.1002/hbm.21422 pmid:22095746 fatcat:r23r7kfhd5akzdds6d3jyk7pkq