TY - JOUR
T1 - Postoperative structural brain changes and cognitive dysfunction in patients with breast cancer
AU - Sato, Chiho
AU - Sekiguchi, Atsushi
AU - Kawai, Masaaki
AU - Kotozaki, Yuka
AU - Nouchi, Rui
AU - Tada, Hiroshi
AU - Takeuchi, Hikaru
AU - Ishida, Takanori
AU - Taki, Yasuyuki
AU - Kawashima, Ryuta
AU - Ohuchi, Noriaki
N1 - Funding Information:
This study was conducted using a grant (A Grant-in-Aid for Scientists (KAKENHI) from the Ministry of Education, Culture, Sports, Science and Technology etc.). Ryuta Kawashima, the principal investigator, receives royalty income from Nintendo Inc. "Nintendo 3DS", "ONI training", "Tetris" which are products of Nintendo Inc., which were planned to be used in an intervention study involved in the whole protocol of "Neurological underpinnings of cognitive dysfunction in breast cancer patients." However, this study did not employ intervention using these games. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.
Funding Information:
Financial support for this study was provided by a Grant for Special Project Research from the International Research Institute of Disaster Science, a Grant-in-Aid for Young Scientists (B) (KAKENHI 24790653) from the Ministry of Education, Culture, Sports, Science and Technology in Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2015 Sato et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2015/11/4
Y1 - 2015/11/4
N2 - Objective The primary purpose of this study was to clarify the influence of the early response to surgery on brain structure and cognitive function in patients with breast cancer. It was hypothesized that the structure of the thalamus would change during the early response after surgery due to the effects of anesthesia and would represent one aspect of an intermediate phenotype of postoperative cognitive dysfunction (POCD). Methods We examined 32 postmenopausal females with breast cancer and 20 age-matched controls. We assessed their cognitive function (attention, memory, and executive function), and performed brain structural MRI 1.5 ± 0.5 days before and 5.6 ± 1.2 days after surgery. Results We found a significant interaction between regional grey matter volume (rGMV) in the thalamus (P < 0.05, familywise error (FWE), small volume correction (SVC)) and one attention domain subtest (P = 0.001, Bonferroni correction) after surgery in the patient group compared with the control group. Furthermore, the changes in attention were significantly associated with sevoflurane anesthetic dose (r2 = 0.247, β = -0.471, P = 0.032) and marginally associated with rGMV changes in the thalamus (P = 0.07, FWE, SVC) in the Pt group. Conclusion Our findings suggest that alterations in brain structure, particularly in the thalamus, may occur shortly after surgery and may be associated with attentional dysfunction. This early postoperative response to anesthesia may represent an intermediate phenotype of POCD. It was assumed that patients experiencing other risk factors of POCD, such as the severity of surgery, the occurrence of complications, and pre-existing cognitive impairments, would develop clinical POCD with broad and multiple types of cognitive dysfunction.
AB - Objective The primary purpose of this study was to clarify the influence of the early response to surgery on brain structure and cognitive function in patients with breast cancer. It was hypothesized that the structure of the thalamus would change during the early response after surgery due to the effects of anesthesia and would represent one aspect of an intermediate phenotype of postoperative cognitive dysfunction (POCD). Methods We examined 32 postmenopausal females with breast cancer and 20 age-matched controls. We assessed their cognitive function (attention, memory, and executive function), and performed brain structural MRI 1.5 ± 0.5 days before and 5.6 ± 1.2 days after surgery. Results We found a significant interaction between regional grey matter volume (rGMV) in the thalamus (P < 0.05, familywise error (FWE), small volume correction (SVC)) and one attention domain subtest (P = 0.001, Bonferroni correction) after surgery in the patient group compared with the control group. Furthermore, the changes in attention were significantly associated with sevoflurane anesthetic dose (r2 = 0.247, β = -0.471, P = 0.032) and marginally associated with rGMV changes in the thalamus (P = 0.07, FWE, SVC) in the Pt group. Conclusion Our findings suggest that alterations in brain structure, particularly in the thalamus, may occur shortly after surgery and may be associated with attentional dysfunction. This early postoperative response to anesthesia may represent an intermediate phenotype of POCD. It was assumed that patients experiencing other risk factors of POCD, such as the severity of surgery, the occurrence of complications, and pre-existing cognitive impairments, would develop clinical POCD with broad and multiple types of cognitive dysfunction.
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U2 - 10.1371/journal.pone.0140655
DO - 10.1371/journal.pone.0140655
M3 - Article
C2 - 26536672
AN - SCOPUS:84950984171
VL - 10
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 11
M1 - 140655
ER -
