title: Subtle hippocampal deformities in breast cancer survivors with reduced episodic memory and self-reported cognitive concerns.
abstract: Cancer survivors have lingering cognitive problems, however the anatomical basis for these problems has yet to be fully elucidated. Clinical studies as well as animal models of chemotherapy have pinpointed cell and volume loss to the hippocampus, however, few studies have performed shape analysis of the hippocampus on cancer survivors. This study used high-dimensional deformation mapping analysis to test whether localized hippocampal deformation differs in breast cancer survivors who received adjuvant chemotherapy coupled with hormone blockade therapy, and if deformation was related to subjective self-reported concerns and cognitive performance. 3 T MRI images were acquired from 16 pre-menopausal breast cancer survivors and 18 healthy controls without a history of cancer. Breast cancer survivors had undergone chemotherapy within the eighteen months prior to the study, and were receiving estrogen-blockade therapy at the time of the study. Automated high-dimensional deformation mapping was used to compare localized hippocampal deformation differences between groups. Self-reported subjective concerns were assessed using Neuro-QOL Cognitive Function assessment, whereas cognitive performance was evaluated using the NIH Toolbox Cognition Battery. Relative to healthy controls, cancer survivors showed significantly more inward hippocampal deformation, worse self-reported cognitive functioning, and inferior episodic memory test score. This study is the first of its kind to examine the relationship between hippocampal deformity and cognitive impairment in cancer survivors.
authors.affiliation: Division of Clinical Psychology, Northwestern University Feinberg School of Medicine, United States; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Apple
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Ryals
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Alpert
authors.affiliation: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, United States.
authors.forename: Lynne I
authors.initials: LI
authors.lastname: Wagner
authors.affiliation: Department of Psychiatry, University of California, San Diego, United States.
authors.forename: Pei-An
authors.initials: PA
authors.lastname: Shih
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dokucu
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States; Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, United States.
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Penedo
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States; Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Joel L
authors.initials: JL
authors.lastname: Voss
authors.affiliation: Division of Clinical Psychology, Northwestern University Feinberg School of Medicine, United States; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, United States; Department of Radiology, Northwestern University Feinberg School of Medicine, United States.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001931:Brain Mapping; D001943:Breast Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008569:Memory Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D057566:Self Report; D017741:Survivors; D055815:Young Adult
keywords: Cancer-related cognitive impairment (CRCI); Hippocampus; NIH toolbox; Neurocognitive