title: Multivariate analysis of brain metabolism reveals chemotherapy effects on prefrontal cerebellar system when related to dorsal attention network.
abstract: BACKGROUND
  Functional brain changes induced by chemotherapy are still not well characterized. We used a novel approach with a multivariate technique to analyze brain resting state [18 F]FDG-PET in patients with lymphoma, to explore differences on cerebral metabolic glucose rate between chemotherapy-treated and non-treated patients.
  
  
  METHODS
  PET/CT scan was performed on 28 patients, with 14 treated with systemic chemotherapy. We used a support vector machine (SVM) classification, extracting the mean metabolism from the metabolic patterns, or networks, that discriminate the two groups. We calculated the correct classifications of the two groups using the mean metabolic values extracted by the networks.
  
  
  RESULTS
  The SVM classification analysis gave clear-cut patterns that discriminate the two groups. The first, hypometabolic network in chemotherapy patients, included mostly prefrontal cortex and cerebellar areas (central executive network, CEN, and salience network, SN); the second, which is equal between groups, included mostly parietal areas and the frontal eye field (dorsal attention network, DAN). The correct classification membership to chemotherapy or not chemotherapy-treated patients, using only one network, was of 50% to 68%; however, when all the networks were used together, it reached 80%.
  
  
  CONCLUSIONS
  The evidenced networks were related to attention and executive functions, with CEN and SN more specialized in shifting, inhibition and monitoring, DAN in orienting attention. Only using DAN as a reference point, indicating the global frontal functioning before chemotherapy, we could better classify the subjects. The emerging concept consists in the importance of the investigation of brain intrinsic networks and their relations in chemotherapy cognitive induced changes.
authors.affiliation: Department of Neuroscience, AOU San Giovanni Battista, Turin, Italy. federico.dagata@unito.it.
authors.forename: Federico
authors.initials: F
authors.lastname: D'Agata
authors.forename: Tommaso
authors.initials: T
authors.lastname: Costa
authors.forename: Paola
authors.initials: P
authors.lastname: Caroppo
authors.forename: Bruno
authors.initials: B
authors.lastname: Baudino
authors.forename: Franco
authors.initials: F
authors.lastname: Cauda
authors.forename: Matteo
authors.initials: M
authors.lastname: Manfredi
authors.forename: Giuliano
authors.initials: G
authors.lastname: Geminiani
authors.forename: Paolo
authors.initials: P
authors.lastname: Mortara
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pinessi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Castellano
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisi
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