title: Brain network alterations and vulnerability to simulated neurodegeneration in breast cancer.
abstract: Breast cancer and its treatments are associated with mild cognitive impairment and brain changes that could indicate an altered or accelerated brain aging process. We applied diffusion tensor imaging and graph theory to measure white matter organization and connectivity in 34 breast cancer survivors compared with 36 matched healthy female controls. We also investigated how brain networks (connectomes) in each group responded to simulated neurodegeneration based on network attack analysis. Compared with controls, the breast cancer group demonstrated significantly lower fractional anisotropy, altered small-world connectome properties, lower brain network tolerance to systematic region (node), and connection (edge) attacks and significant cognitive impairment. Lower tolerance to network attack was associated with cognitive impairment in the breast cancer group. These findings provide further evidence of diffuse white matter pathology after breast cancer and extend the literature in this area with unique data demonstrating increased vulnerability of the post-breast cancer brain network to future neurodegenerative processes.
authors.affiliation: Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: skesler@mdanderson.org.
authors.forename: Shelli R
authors.initials: SR
authors.lastname: Kesler
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California at San Francisco, San Francisco, CA, USA.
authors.forename: Christa L
authors.initials: CL
authors.lastname: Watson
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Blayney
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology*; D016880:Anisotropy; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000209:etiology* / Q000473:pathology*; D063132:Connectome; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D009410:Nerve Degeneration / Q000473:pathology; D009415:Nerve Net / Q000473:pathology*; D066127:White Matter / Q000473:pathology*
keywords: Brain network; Breast cancer; Connectome; DTI; Graph theory; Network attack; Neurodegeneration