Regional cerebral activity associated with self-perception of memory problems in brains of breast cancer patients soon after adjuvant chemotherapy

Objectives To examine relationships between self-reported cognitive complaints and regional cerebral activity in patients recently exposed to adjuvant chemotherapy.

Methods Subjects (n=30) recently diagnosed with breast cancer and not yet on endocrine therapy were prospectively recruited; 21 had completed adjuvant chemotherapy while 9 had none. Subjects assessed their memory problems and other cognitive difficulties, and underwent resting brain FDG-PET scans, which were analyzed by standard volume of interest (sVOI) and statistical parametric mapping (spm) methods.

Results Among the self-report subscales, perceived problems with memory differed the most between treatment groups, being significantly higher in subjects exposed to chemotherapy (ave±SEM, 2.05±0.06 vs. 0.03±0.2, respectively, on a 10-point scale; p=0.01). Memory complaints were negatively correlated with metabolism in brainstem (midbrain) by sVOI analysis (r=-0.6, p=0.007), and in bilateral inferior temporal cortex (sVOI p=0.004, spm p<0.0005), and positively correlated with metabolism of bilateral superior temporal and anterior cingulate cortex by both sVOI and spm analyses (cluster-corrected p≤0.04 with peak-voxel p<0.0005 for both areas). These correlations were not present in the untreated group.

Conclusions Self-reported memory complaints in recently treated breast cancer patients positively correlated with metabolism in superior temporal and anterior cingulate cortex, and negatively correlated with metabolism of inferior temporal cortex and midbrain, demonstrating objective support for specific neurological substrates of what are often regarded as “subjective” perceptions.

Research Support NCI R01-CA109650 & Breast Cancer Research Foundatio