title: A prospective study of grey matter and cognitive function alterations in chemotherapy-treated breast cancer patients.
abstract: OBJECTIVE
  Subsequent to chemotherapy treatment, breast cancer patients often report a decline in cognitive functioning that can adversely impact many aspects of their lives. Evidence has mounted in recent years indicating that a portion of breast cancer survivors who have undergone chemotherapy display reduced performance on objective measures of cognitive functioning relative to comparison groups. Neurophysiological support for chemotherapy-related cognitive impairment has been accumulating due to an increase in neuroimaging studies in this field; however, longitudinal studies are limited and have not examined the relationship between structural grey matter alterations and neuropsychological performance. The aim of this study was to extend the cancer-cognition literature by investigating the association between grey matter attenuation and objectively measured cognitive functioning in chemotherapy-treated breast cancer patients.
  
  
  METHODS
  Female breast cancer patients (n = 19) underwent magnetic resonance imaging after surgery but before commencing chemotherapy, one month following treatment, and one year after treatment completion. Individually matched controls (n = 19) underwent imaging at similar intervals. All participants underwent a comprehensive neuropsychological battery comprising four cognitive domains at these same time points. Longitudinal grey matter changes were investigated using voxel-based morphometry.
  
  
  RESULTS
  One month following chemotherapy, patients had distributed grey matter volume reductions. One year after treatment, a partial recovery was observed with alterations persisting predominantly in frontal and temporal regions. This course was not observed in the healthy comparison group. Processing speed followed a similar trajectory within the patient group, with poorest scores obtained one month following treatment and some improvement evident one year post-treatment.
  
  
  CONCLUSIONS
  This study provides further credence to patient claims of altered cognitive functioning subsequent to chemotherapy treatment.
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Lepage
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada.
authors.forename: Andra M
authors.initials: AM
authors.lastname: Smith
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Moreau
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Barlow-Krelina
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Wallis
authors.affiliation: School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier, Ottawa, ON K1N 6 N5 Canada ; Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9 Canada.
authors.forename: Barbara
authors.initials: B
authors.lastname: Collins
authors.affiliation: Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9 Canada.
authors.forename: Joyce
authors.initials: J
authors.lastname: MacKenzie
authors.affiliation: Memory and Aging Center, Neurology, UCSF, Sandler Neuroscience Center, 675 Nelson Rising Lane, San Francisco, CA 94158 USA.
authors.forename: Carole
authors.initials: C
authors.lastname: Scherling
keywords: Breast cancer; Chemotherapy; Cognition; MRI; Neuroimaging; Voxel-based morphometry