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Multimodal MRI Biomarker of Mild Cognitive Impairment in Breast Cancer Study

Jeffrey S. Wefel, PhD, and Shelli Kesler, PhD, University of Texas MD Anderson Cancer Center, Houston, TX
Study abstract

Women with breast cancer, particularly those who are older and who receive adjuvant chemotherapy, are at significantly increased risk for mild cognitive impairment (MCI). Our previous research shows persistent and progressive MCI long after cancer treatment has ended. This cognitive impairment tends to involve difficulties with memory and executive function (e.g. multi-tasking, problem solving, thinking) that interfere with daily living skills and reduce quality of life. The default mode network (DMN) is a brain circuit important for several cognitive processes. The connections between the DMN brain regions tend to naturally decrease in strength as we age. Accordingly, DMN functional connectivity is a highly promising neuroimaging biomarker of MCI in non-cancer populations. Disruption of DMN functional connectivity is strongly associated with conversion to dementia and has even been show to precede other biomarkers of neurodegeneration. Previous studies, including our own, show atrophy of DMN regions and damage to the white matter pathways that connect these regions following breast cancer chemotherapy. We believe that chemotherapy treatment accelerates DMN decline resulting in increased frequency of MCI following breast cancer. However, no studies to date have directly assessed the DMN or its relationship to MCI in breast cancer. The specific aims of the proposed study are therefore to 1) determine the frequency of MCI in older breast cancer subjects who receive chemotherapy, 2) identify DMN neuroimaging biomarkers in older breast cancer subjects treated with chemotherapy, and 3) develop models that predict vulnerability to MCI in this population.

Study review

In this study researchers investigated changes in brain function in women with breast cancer. The researchers wanted to enroll up to 55 volunteers and used the Army of Women (AOW) as one of their recruitment sources. The Call to Action for this study was sent to AOW members on September 30, 2015. The researchers closed enrollment on March 10, 2017. The AOW provided them with 127 women who were interested in enrolling in the study.