Effects of chemotherapy on aging white matter microstructure: A longitudinal diffusion tensor imaging study

Area of Science:

• Neuroimaging
• Oncology
• Geriatrics

Background:

• Chemotherapy can cause cognitive impairment in older adults.
• White matter microstructure changes may underlie chemotherapy-induced cognitive dysfunction.

Purpose of the Study:

• To investigate white matter microstructural alterations using diffusion tensor imaging (DTI) in older women with breast cancer undergoing chemotherapy.
• To correlate DTI findings with neuropsychological (NP) test performance.

Main Methods:

• Recruited older women (≥60 years) with breast cancer receiving chemotherapy (CT group, n=19) and age/sex-matched healthy controls (HC, n=14).
• Performed brain MRI with DTI and NIH Toolbox Cognition Battery NP testing at baseline and post-chemotherapy.
• Calculated DTI parameters (FA, MD, AD, RD) and analyzed changes over time and correlations with NP scores.

Main Results:

• The CT group showed significant increases in mean diffusivity (MD) and radial diffusivity (RD) in the genu of the corpus callosum post-chemotherapy.
• Axial diffusivity (AD) increased in the CT group and decreased in the HC group, showing significant between-group differences.
• No significant correlations were found between DTI parameters and NP test scores.

Conclusions:

• Chemotherapy is associated with detectable alterations in white matter microstructure in older women with breast cancer.
• These DTI-based microstructural changes may serve as potential neuroimaging biomarkers for cognitive impairment in this population.