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Prefrontal cortex and executive function impairments in primary breast cancer
Shelli R Kesler1, Jamie S Kent, Ruth O'Hara
1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, MC5795, Stanford, CA 94305-5795, USA. skesler@stanford.edu
Archives of Neurology
|November 16, 2011
Summary
Breast cancer survivors show reduced brain activation, particularly in prefrontal cortex regions. Chemotherapy may worsen these executive function deficits, especially in older patients with lower education.
Area of Science:
- Neuroscience
- Oncology
- Psychology
Background:
- Breast cancer (BC) survivors may experience cognitive deficits.
- The impact of chemotherapy on prefrontal-executive function in BC survivors requires further investigation.
Purpose of the Study:
- To compare prefrontal-executive function in BC survivors with and without chemotherapy history to healthy controls.
- To identify associations between prefrontal cortex deficits, behavioral impairments, and demographic/disease variables.
Main Methods:
- Observational study conducted at a university-based research facility.
- Participants included 25 women with BC post-chemotherapy, 19 women with BC pre-chemotherapy, and 18 healthy female controls, matched for age and demographics.
Main Results:
- BC survivors exhibited reduced activation in the left middle dorsolateral prefrontal cortex and premotor cortex compared to controls.
- The chemotherapy group showed reduced left caudal lateral prefrontal cortex activation, increased perseverative errors, and slower processing speed.
- Reduced left caudal lateral prefrontal cortex activation correlated with higher disease severity and subjective executive dysfunction in chemotherapy-treated women.
Conclusions:
- Neurological impairment is evident in primary BC, independent of treatment history.
- The left caudal lateral prefrontal region appears vulnerable to chemotherapy and/or disease severity, potentially serving as a biomarker for executive dysfunction.
- Chemotherapy's negative effects on brain function may be amplified by older age and lower educational attainment.
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