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Longitudinal Trajectories of Memory Performance in Patients with Early-Stage Breast Cancer
Alexandra C Apple1, Cutter A Lindbergh1,2, Susan M Landau3,4
1University of California San Francisco, Department of Neurology, Memory and Aging Center, San Francisco, CA, USA.
Journal of Oncology
|April 26, 2022
Summary
Patients receiving chemotherapy for breast cancer show less memory improvement over time compared to controls. This reduced practice effect may indicate cognitive difficulties post-treatment.
Area of Science:
- Neuroscience
- Oncology
- Cognitive Psychology
Background:
- Breast cancer treatments can impact cognition, but long-term cognitive changes across different treatment types are not well understood.
- The integrity of the hippocampal-prefrontal cortex network is implicated in cognition, yet its predictive role in longitudinal cognitive performance requires further investigation.
Purpose of the Study:
- To investigate longitudinal cognitive trajectories in early-stage breast cancer patients undergoing adjuvant therapy compared to healthy controls.
- To examine how different adjuvant cancer treatments influence cognitive performance over time.
- To explore the relationship between baseline brain structure (hippocampal and prefrontal volumes) and longitudinal cognitive changes.
Main Methods:
- A prospective trial involving 69 early-stage breast cancer patients and 12 controls.
- Longitudinal cognitive assessments (episodic memory, executive functioning, processing speed) at four time points over 24 months.
- Baseline structural MRI to measure hippocampal and prefrontal cortex volumes in a subset of participants.
Main Results:
- Significant group-by-time interactions were observed for memory performance, with patients receiving chemotherapy or chemotherapy plus hormone therapy showing the least improvement.
- No significant effects of treatment group on the relationship between time and processing speed or executive functioning.
- No differences in baseline hippocampal or prefrontal volumes between groups, and no significant interaction effects involving baseline regional volumes on cognition.
Conclusions:
- Early-stage breast cancer patients treated with chemotherapy or chemotherapy plus hormone therapy exhibit diminished benefits from practice effects on memory tests compared to controls.
- The loss of longitudinal practice effect in memory performance may serve as a novel and clinically significant indicator of cognitive challenges experienced by patients post-treatment.
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