Brain structural alterations and cognitive dysfunction in lung cancer patients without brain metastasis

This study explored the relationship between cognitive function and brain structure in lung cancer (LCs) patients without brain metastases and healthy controls (HCs). A cohort of 75 chemotherapy-naive LCs without brain metastases and 29 age-, sex-, and education-matched HCs underwent cognitive assessments and structural MRI. The MRI focused on cortical thickness, surface area, and volume of subcortical structures. We examined the relationships among these parameters. The volume of twelve subcortical structures was significantly reduced in patients with advanced-stage lung cancer (aLCs) compared to HCs (p < 0.05). In aLCs, cortical thickness decreased in one brain region and surface area in five regions (p < 0.05). Patients with early-stage lung cancer (eLCs) exhibited increased cortical thickness in three regions. When comparing eLCs to aLCs, there was a notable decrease in cortical thickness and surface area (p < 0.05). Visuospatial/executive and delayed memory functions were impaired in aLCs and worsened with disease progression. These impairments correlated positively with the thickness of several cerebral cortices and the surface area and volume of subcortical structures (p < 0.05). Structural brain changes and cognitive dysfunction are evident in aLC patients, independent of metastasis. Since none of the patients received chemotherapy, the observed abnormalities in aLCs, absent in eLCs, are likely attributable to the disease itself rather than chemotherapy effects.