title: Longitudinal assessment of chemotherapy-induced alterations in brain activation during multitasking and its relation with cognitive complaints.
abstract: OBJECTIVE
  To examine whether cognitive complaints after treatment for breast cancer are associated with detectable changes in brain activity during multitasking.
  
  
  METHODS
  Eighteen patients who were scheduled to receive chemotherapy performed a functional magnetic resonance imaging multitasking task in the scanner before the start of treatment (t1) and 4 to 6 months after finishing treatment (t2). Sixteen patients who were not scheduled to receive chemotherapy and 17 matched healthy controls performed the same task at matched intervals. Task difficulty level was adjusted individually to match performance across participants. Statistical Parametric Mapping 8 (SPM8) software was used for within-group, between-group, and group-by-time interaction image analyses.
  
  
  RESULTS
  Voxel-based paired t tests revealed significantly decreased activation (P < .05) from t1 to t2 at matched performance in the multitasking network of chemotherapy-treated patients, whereas no changes were noted in either of the control groups. At baseline, there were no differences between the groups. Furthermore, in contrast to controls, the chemotherapy-treated patients reported a significant increase in cognitive complaints (P < .05) at t2. Significant (P < .05) correlations were found between these increases and decreases in multitasking-related brain activation. Moreover, a significant group-by-time interaction (P < .05) was found whereby chemotherapy-treated patients showed decreased activation and healthy controls did not.
  
  
  CONCLUSIONS
  These results suggest that changes in brain activity may underlie chemotherapy-induced cognitive complaints. The observed changes might be related to chemotherapy-induced damage to the brain or reduced connectivity between brain regions rather than to changes in effort or changes in functional strategy. To the best of our knowledge, this is the first longitudinal study providing evidence for a relationship between longitudinal changes in cognitive complaints and changes in brain activation after chemotherapy.
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium. sabine.deprez@uzleuven.be.
authors.forename: Sabine
authors.initials: S
authors.lastname: Deprez
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Vandenbulcke
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Ronald
authors.initials: R
authors.lastname: Peeters
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Louise
authors.initials: L
authors.lastname: Emsell
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Smeets
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Marie-Rose
authors.initials: MR
authors.lastname: Christiaens
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Frederic
authors.initials: F
authors.lastname: Amant
authors.affiliation: All authors: Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D001943:Breast Neoplasms / Q000188:drug therapy*; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects*; D060825:Cognitive Dysfunction / Q000139:chemically induced* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000187:drug effects; D013647:Task Performance and Analysis