title: Postoperative Structural Brain Changes and Cognitive Dysfunction in Patients with Breast Cancer.
abstract: OBJECTIVE
  The primary purpose of this study was to clarify the influence of the early response to surgery on brain structure and cognitive function in patients with breast cancer. It was hypothesized that the structure of the thalamus would change during the early response after surgery due to the effects of anesthesia and would represent one aspect of an intermediate phenotype of postoperative cognitive dysfunction (POCD).
  
  
  METHODS
  We examined 32 postmenopausal females with breast cancer and 20 age-matched controls. We assessed their cognitive function (attention, memory, and executive function), and performed brain structural MRI 1.5 ± 0.5 days before and 5.6 ± 1.2 days after surgery.
  
  
  RESULTS
  We found a significant interaction between regional grey matter volume (rGMV) in the thalamus (P < 0.05, familywise error (FWE), small volume correction (SVC)) and one attention domain subtest (P = 0.001, Bonferroni correction) after surgery in the patient group compared with the control group. Furthermore, the changes in attention were significantly associated with sevoflurane anesthetic dose (r2 = 0.247, β = ‒0.471, P = 0.032) and marginally associated with rGMV changes in the thalamus (P = 0.07, FWE, SVC) in the Pt group.
  
  
  CONCLUSIONS
  Our findings suggest that alterations in brain structure, particularly in the thalamus, may occur shortly after surgery and may be associated with attentional dysfunction. This early postoperative response to anesthesia may represent an intermediate phenotype of POCD. It was assumed that patients experiencing other risk factors of POCD, such as the severity of surgery, the occurrence of complications, and pre-existing cognitive impairments, would develop clinical POCD with broad and multiple types of cognitive dysfunction.
authors.affiliation: Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.|Division of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Sato
authors.affiliation: Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.|Division of Medical Neuroimage Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.|Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sekiguchi
authors.affiliation: Department of Breast Oncology, Miyagi Cancer Center Hospital, Miyagi, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawai
authors.affiliation: Division of Clinical Research, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kotozaki
authors.affiliation: Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science, Tohoku University, Sendai, Japan.|Department of Advanced Brain Science, Smart Ageing International Research Center, IDAC, Tohoku University, Sendai, Japan.|Human and Social Response Research Division, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
authors.forename: Rui
authors.initials: R
authors.lastname: Nouchi
authors.affiliation: Division of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.affiliation: Division of Developmental Cognitive Neuroscience, IDAC, Tohoku University, Sendai, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: Division of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Division of Medical Neuroimage Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.|Division of Developmental Cognitive Neuroscience, IDAC, Tohoku University, Sendai, Japan.|Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Taki
authors.affiliation: Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.|Department of Advanced Brain Science, Smart Ageing International Research Center, IDAC, Tohoku University, Sendai, Japan.|Division of Developmental Cognitive Neuroscience, IDAC, Tohoku University, Sendai, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Kawashima
authors.affiliation: Division of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
mesh_terms: D000758:Anesthesia / Q000009:adverse effects*; D001288:Attention / Q000502:physiology; D001943:Breast Neoplasms / Q000601:surgery*; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D066128:Gray Matter / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology*; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology; D013788:Thalamus / Q000033:anatomy & histology / Q000503:physiopathology*