Dysfunction of the neural network associated with sustained attention in cancer patients with clinically significant depressive symptoms.
BACKGROUND
A breast cancer diagnosis is a major stressor in women that might mediate disabling depressive symptoms. Dysfunction of the neural network associated with attentive processing of emotional information has been considered an important pathophysiologic mechanism of depression. Attention deficit and related brain abnormalities in patients with clinically significant depressive symptoms were investigated by comparing patients without clinically significant depressive symptoms when they were diagnosed with breast cancer.


METHODS
Twelve breast cancer patients with clinically significant depressive symptoms and 12 breast cancer patients without clinically significant depressive symptoms participated in this study. A psychiatric assessment and attention task were performed during a positron-emission tomography (PET) scan. Independent-samples t-tests, Pearson correlation, and statistical parametric mapping analyses were performed.


RESULTS
The performance during the sustained attention task was worse in the depressed group than in the nondepressed group, with the behavioral performance being negatively correlated with the severity of depressive symptoms. The regional glucose metabolism during the task was markedly reduced in four brain regions, including bilateral dorsolateral prefrontal cortices. Regional [F-18] fluoro-2-deoxyglucose uptake in the right dorsolateral prefrontal cortex was significantly correlated with behavioral performance.


CONCLUSIONS
Deficit in sustained attention and related brain abnormalities were found in breast cancer patients with significant depressive symptoms in this study. As a reactive change to a psychosocial stressor, depressive symptoms might be associated with brain dysfunction after a cancer diagnosis. Prefrontal dysfunction may play an important role in the pathophysiology of attention deficit in depressive disorder.
Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
Lee Su
LS
Kim
Hee Sung
HS
Hwang
Duk-In
DI
Jon
Byoung-Joo
BJ
Ham
Jeong-Ho
JH
Seok
D000328:Adult; D001288:Attention / Q000502:physiology*; D001931:Brain Mapping; D001943:Breast Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D003863:Depression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography / Q000379:methods; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index
D019788:Fluorodeoxyglucose F18