title: Magnetic resonance spectroscopic imaging and volumetric measurements of the brain in patients with postcancer fatigue: a randomized controlled trial.
abstract: BACKGROUND
  Postcancer fatigue is a frequently occurring problem, impairing quality of life. Until now, little is known about (neuro) physiological factors determining postcancer fatigue. For non-cancer patients with chronic fatigue syndrome, certain characteristics of brain morphology and metabolism have been identified in previous studies. We investigated whether these volumetric and metabolic traits are a reflection of fatigue in general and thus also of importance for postcancer fatigue.
  
  
  METHODS
  Fatigued patients were randomly assigned to either the intervention condition (cognitive behavior therapy) or the waiting list condition. Twenty-five patients in the intervention condition and fourteen patients in the waiting list condition were assessed twice, at baseline and six months later. Baseline measurements of 20 fatigued patients were compared with 20 matched non-fatigued controls. All participants had completed treatment of a malignant, solid tumor minimal one year earlier. Global brain volumes, subcortical brain volumes, metabolite tissue concentrations, and metabolite ratios were primary outcome measures.
  
  
  RESULTS
  Volumetric and metabolic parameters were not significantly different between fatigued and non-fatigued patients. Change scores of volumetric and metabolic parameters from baseline to follow-up were not significantly different between patients in the therapy and the waiting list group. Patients in the therapy group reported a significant larger decrease in fatigue scores than patients in the waiting list group.
  
  
  CONCLUSIONS
  No relation was found between postcancer fatigue and the studied volumetric and metabolic markers. This may suggest that, although postcancer fatigue and chronic fatigue syndrome show strong resemblances as a clinical syndrome, the underlying physiology is different.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01096641.
authors.affiliation: Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, The Netherlands.
authors.forename: Hetty
authors.initials: H
authors.lastname: Prinsen
authors.forename: Arend
authors.initials: A
authors.lastname: Heerschap
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
authors.forename: Machiel J
authors.initials: MJ
authors.lastname: Zwarts
authors.forename: Jan Willem H
authors.initials: JW
authors.lastname: Leer
authors.forename: Jack J
authors.initials: JJ
authors.lastname: van Asten
authors.forename: Marinette
authors.initials: M
authors.lastname: van der Graaf
authors.forename: Mark
authors.initials: M
authors.lastname: Rijpkema
authors.forename: Hanneke W M
authors.initials: HW
authors.lastname: van Laarhoven
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D015928:Cognitive Behavioral Therapy; D005221:Fatigue / Q000628:therapy*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
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