Monday, April 4, 2005
Salon F & G (Hilton Cincinnati Netherland Plaza)
Session: 1207, Oncology: & Quality of Life, 9:15 AM

Assessing Cognitive Function Prior to Chemotherapy for Breast Cancer Using Functional Magnetic Resonance Imaging (fMRI)

Bernadine Cimprich, PhD, RN, FAAN, Associate Professor1, Barbara Therrien, PhD, Associate Professor1, Patricia Reuter-Lorenz, PhD, Professor2, Daniel Hayes, MD, Professor3, Douglas Noll, PhD, Professor4, Daniel Normolle, PhD, Biostatistician5, Robert Welsh, PhD, Research Analyst6, Patricia Clark, MS, Predoctoral Student1, Catherine Vincent, PhD, Post Doctoral Fellow1, and James Nelson, PhDc, Predoctoral Student7. (1) School of Nursing, University of Michigan, 400 N. Ingalls Room 2172, Ann Arbor, MI 48109, (2) Psychology, University of Michigan, East University Dr, Ann Arbor, MI 48109, (3) School of Medicine, University of Michigan, East Medical Center Drive, Ann Arbor, MI 48109, (4) College of Engineering, University of Michigan, Bonisteel Drive, Ann Arbor, MI 48109, (5) Biostatistics, University of Michigan, 300 N Ingalls, Ann Arbor, MI 48109, (6) Radiology, University of Michigan, East Medical Center Drive, Ann Arbor, MI 48109, (7) Department of Psychology, University of Michigan, 400 N Ingalls, Ann Arbor, MI 48109

Cognitive impairment is a common side effect of adjuvant chemotherapy for breast cancer having detrimental effects on daily functioning and the quality of survivorship. Despite the reported frequency of cognitive dysfunction associated with chemotherapy, the underlying brain mechanisms are not well understood. Two basic cognitive processes, attention and working memory, are considered important prerequisites for effective cognitive functioning in daily life. The purpose of this pilot study was to determine the feasibility of using functional magnetic resonance imaging (fMRI), a powerful noninvasive tool, to assess brain activation patterns related to attention and working memory in women newly diagnosed with breast cancer. Seven women (30 - 61 yrs old) with early stage (I or II) breast cancer were tested with an established Verbal Working Memory Task (VMT) during fMRI prior to the start of adjuvant chemotherapy, and seven healthy female controls (31 - 64 yrs old) were tested after a negative screening mammogram. Accuracy for the breast cancer group was 88% - 98%, and for controls, 92%-97%. The breast cancer group had significantly (p <. 05) slower reaction times in the demanding conditions of the task. Image analysis showed differences in brain activation patterns between the breast cancer and control groups. Controls showed expected activation in the medial frontal cortex (MFC). In contrast, the breast cancer group showed increased activity not only in the MFC but also in other components of the attention/working memory circuitry in both hemispheres, suggesting recruitment of additional brain areas in order to perform the task. These early behavioral and imaging findings show a trend of slowed performance and vulnerability in attention and working memory systems in middle age women with breast cancer prior to any adjuvant chemotherapy. Overall, the study demonstrates that fMRI can provide specific information about alterations in cognitive function in women diagnosed with breast cancer.

Session #1207 - Oncology: & Quality of Life

The 29th Annual MNRS Research Conference (April 1-4, 2005)