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Increased posterior cingulate cortex blood flow in cancer-related fatigue
David Raizen1,2,3, Rupal Bhavsar1,3, Brendan T Keenan2,3
1Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Frontiers in Neurology
|August 14, 2023
Summary
Cancer patients undergoing radiation therapy exhibit altered brain blood flow in the posterior cingulate cortex, a key part of the default mode network. This change may indicate unique mechanisms driving cancer-related fatigue progression.
Area of Science:
- Neuroscience
- Oncology
- Medical Imaging
Background:
- Cancer-related fatigue (CRF) is a prevalent and debilitating symptom following cancer treatments.
- The brain mechanisms and progression of CRF remain poorly understood.
- Previous research implicates the default mode network (DMN) in fatigue.
Purpose of the Study:
- To investigate cerebral blood flow (CBF) differences in the posterior cingulate cortex (PCC), a DMN hub, in cancer patients undergoing radiation therapy (RAT) compared to healthy controls (HC).
- To explore the relationship between PCC CBF, fatigue, and cognitive task performance in CRF.
- To assess changes in PCC CBF during CRF progression and recovery post-therapy.
Main Methods:
- Arterial spin labeling (ASL) perfusion functional magnetic resonance imaging (fMRI) was employed.
- Resting-state CBF in the PCC was compared between 16 cancer patients (prostate/breast) and 18 HC.
- CBF was measured before and after a fatiguing psychomotor vigilance task (PVT).
Main Results:
- Cancer patients exhibited significantly increased resting CBF in the PCC compared to HC.
- Elevated PCC CBF persisted in patients during a follow-up period post-RAT.
- Post-PVT PCC CBF changes correlated with fatigue changes, suggesting a link to CRF recovery.
Conclusions:
- Cancer patients treated with RAT show distinct alterations in PCC resting CBF.
- These PCC CBF changes are associated with cancer-related fatigue and may persist post-treatment.
- PCC CBF following a cognitive challenge could serve as a potential biomarker for CRF recovery.
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