Perfusion Imaging of Time-on-Task effects in Cancer related Fatigue
Poster No:
1664
Submission Type:
Abstract Submission
Authors:
Jing Xu1, Patrick Liu2, Rupal Bhavsar2, David Raizen2, Hengyi Rao1
Institutions:
1Shanghai International studies university, Shanghai, Shanghai, 2University of Pennsylvania, Philadelphia, PA
First Author:
Co-Author(s):
Introduction:
The majority of cancer patients, including patients with prostate or breast cancer (Chao et al., 2018; Arya et al., 2021), experience cancer-related fatigue (CRF). CRF is a common, distressing symptom that negatively affects health-related quality of life in cancer patients, yet it's neural mechanisms remain poorly understood. Understanding the neural mechanism of CRF is critical to develop therapies to reduce CRF burden. To study this, we used arterial spin labeling (ASL) perfusion fMRI to study changes in regional cerebral blood flow in prostate or breast cancer patients engaged in a psychomotor vigilance test (PVT) to assess cognitive fatigability. Patients were also asked to self-report fatigue metrics. Through this, we sought to demonstrate whether cancer patients would demonstrate time-on-task cognitive fatigability on a PVT, whether objective performance correlated with subjective fatigue reports, and the neural substrates involved in objective cognitive fatigue.
Methods:
A total of 15 radiation therapy patients (8 males and 7 females; age range was 34-75 years) treated for either non-metastatic breast or non-metastatic prostate cancer participated in this study. The PVT was used as a 20-minute sustained attention task in this study. Patients rated their subjective mental fatigue score on the 9-point Visual Analog Scale (VAS). BFI Brief Fatigue Inventory (BFI) was used to assess the severity and impact of cancer related fatigue. Perfusion imaging data were acquired on a Siemens Magnetom 3.0 T Prisma scanner. A 2-shot spiral 3D pseudo-continuous arterial spin labeling sequence was used for the perfusion scan. The perfusion scanning protocol of PVT performance lasted 20 minutes. An additional two 4-minute perfusion scanning protocols were collected while subjects were at rest before and after the PVT to assess resting baseline CBF levels. To assess time-on-task effects and performance fatigability, the 20-min PVT was divided into five 4-min quintiles and compared the median RT in the first quintile to that of the last quintile for each subject.
Results:
Figure 1a showed an increase in RT over 20 min of the PVT with median RT increasing from 357 to 440 ms, which is consistent with our previous founding on PD patients. Large individual difference was also observed (Figure 1b). Figure 1c showed that subjective fatigue rating after PVT task significantly increased compare to pre-PVT (p<0.05); self-reported fatigue rating change and RT change are both significantly correlated with global BFI (Figure 1e and 1f). However, there is no correlation between RT change and self-reported fatigue rating change (Figure 1d).
Figure 2 and shows the perfusion imaging results. when comparing PVT task condition to the pre-PVT baseline (Figure 2a), Increased CBF was found in Inferior Parietal Lobe (IPL), Inferior parietal gyrus (IFG), Supplementary motor area (SMA) and insula. CBF in IFG was also increased when comparing post-PVT baseline and pre-PVT baseline (Figure 2b).
Figure 2 and shows the perfusion imaging results. when comparing PVT task condition to the pre-PVT baseline (Figure 2a), Increased CBF was found in Inferior Parietal Lobe (IPL), Inferior parietal gyrus (IFG), Supplementary motor area (SMA) and insula. CBF in IFG was also increased when comparing post-PVT baseline and pre-PVT baseline (Figure 2b).
Conclusions:
Cancer patients showed significant TOT effects, evidenced by progressively slower reaction times and significantly higher mental fatigue ratings during the task and higher fatigue ratings after the PVT compared to before the task, which is consistent with previous findings in healthy individuals and PD patients (Lim et al., 2010; Liu et al., 2022). In addition, there were significant positive correlations of patients' fatigue severity with their performance declines during the PVT task, as well as a trend of negative correlation with their self-reported mental fatigue changes assessed immediately before and after the task. In conclusion, we investigated the brain mechanisms of CRF, using behavioral, psychological, and brain imaging measurements. The results show that the sustained mental workload paradigm effectively induced both subjective fatigue and performance decrements.
Modeling and Analysis Methods:
Task-Independent and Resting-State Analysis 1
Novel Imaging Acquisition Methods:
Non-BOLD fMRI 2
Keywords:
Cerebral Blood Flow
MRI
Other - Cancer related fatigue
1|2Indicates the priority used for review
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Provide references using APA citation style.
Arya, N., Vaish, A., Zhao, K., & Rao, H. (2021). Neural Mechanisms Underlying Breast Cancer Related Fatigue: A Systematic Review of Neuroimaging Studies. Frontiers in neuroscience, 15, 735945. https://doi.org/10.3389/fnins.2021.735945
Lim, J., Wu, W. C., Wang, J., Detre, J. A., Dinges, D. F., & Rao, H. (2010). Imaging brain fatigue from sustained mental workload: an ASL perfusion study of the time-on-task effect. NeuroImage, 49(4), 3426–3435. https://doi.org/10.1016/j.neuroimage.2009.11.020
Liu, W., Liu, J., Bhavsar, R., Mao, T., Mamikonyan, E., Raizen, D., Detre, J. A., Weintraub, D., & Rao, H. (2022). Perfusion Imaging of Fatigue and Time-on-Task Effects in Patients With Parkinson's Disease. Frontiers in aging neuroscience, 14, 901203. https://doi.org/10.3389/fnagi.2022.901203