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Postoperative Structural Brain Changes and Cognitive Dysfunction in Patients with Breast Cancer.
Chiho Sato1,2, Atsushi Sekiguchi1,3,4, Masaaki Kawai5
1Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.
Plos One
|November 5, 2015
Summary
Early surgery response impacts brain structure and attention in breast cancer patients. Thalamus grey matter changes and attentional deficits are linked to anesthesia, potentially indicating early signs of postoperative cognitive dysfunction (POCD).
Area of Science:
- Neuroscience
- Oncology
- Anesthesiology
Background:
- Postoperative cognitive dysfunction (POCD) is a concern for surgical patients.
- The early effects of surgery and anesthesia on brain structure and function remain incompletely understood.
- Breast cancer surgery, involving anesthesia, may influence cognitive outcomes.
Purpose of the Study:
- To investigate the early influence of surgery on brain structure and cognitive function in breast cancer patients.
- To determine if thalamic structural changes after surgery correlate with cognitive deficits.
- To explore the hypothesis that early postoperative brain changes represent an intermediate phenotype of POCD.
Main Methods:
- Structural MRI was used to assess brain structure (regional grey matter volume - rGMV) in 32 breast cancer patients and 20 controls.
- Cognitive function, including attention, memory, and executive function, was evaluated before and after surgery.
- The study analyzed changes in rGMV and cognitive performance, correlating them with anesthetic dose.
Main Results:
- A significant interaction was found between thalamic rGMV and attention performance post-surgery in breast cancer patients compared to controls.
- Changes in attention were significantly associated with the dose of sevoflurane anesthesia.
- A marginal association was observed between attentional changes and thalamic rGMV alterations.
Conclusions:
- Alterations in thalamic structure occur early after surgery and are linked to attentional dysfunction in breast cancer patients.
- The early postoperative response to anesthesia may serve as an intermediate phenotype for POCD.
- Further research is needed to understand how other risk factors contribute to the development of clinical POCD.
