Temporal evolution of brain structural changes associated with anxiety sensitivity in patients with breast cancer: A...

Anxiety sensitivity (AS) significantly impacts treatment outcomes and quality of life in breast cancer patients, yet the neural mechanisms underlying AS-related brain structural changes remain poorly understood.

To investigate brain structural alterations associated with AS and their temporal evolution in patients with breast cancer.

Eighty-five patients with breast cancer (42 with high AS and 43 with low AS) and 42 healthy controls (HCs) were recruited. Voxel-based morphometry analysis was conducted to examine gray matter volume (GMV) differences between the high and low AS patient groups and the HCs. Causal structural covariance network (CaSCN) analysis was employed to investigate the inferred temporal evolution of GMV alterations in relation to AS levels and disease duration using cross-sectional data.

AS levels showed a marked decline within the first two months post-diagnosis before stabilizing. Both patient groups exhibited GMV reduction compared with HCs, with low AS patients showing more widespread atrophy. The left middle cingulum (MCC.L) GMV negatively correlated with AS scores in high AS patients (r = -0.448, P = 0.0029). CaSCN analysis revealed a directional influence pathway from the MCC.L to the right thalamus (THA.R), with the THA.R showing positive self-feedback. Conjunction analysis identified shared effects of decreasing AS and increasing illness duration mediated by the THA.R, resulting in concordant atrophy in regions such as the left cerebellum (lobule VI) and discordant changes in temporal, parietal, and limbic areas.

THA.R plays a central role in mediating AS-related brain structural alterations in breast cancer patients, offering potential therapeutic targets for managing AS.