Structural Changes in Brain Networks and Depression Severity in Chemotherapy-Treated Breast Cancer
Poster No:
1724
Submission Type:
Abstract Submission
Authors:
Sahil Bajaj1, C Quarles1, Rania Mohamed1, Kyle Noll1, Catherine Sullaway1, Jeffrey Wefel1
Institutions:
1MD Anderson Cancer Center, Houston, TX
First Author:
Co-Author(s):
Introduction:
Chemotherapy for breast cancer (BC) has been linked to mental health issues, including elevated levels of anxiety and depression [1]. The underlying neural mechanisms driving these issues remain insufficiently studied, particularly from a network-based perspective that examines the brain's interconnected regions rather than isolated areas. This study employed longitudinal MRI to track changes in cortical thickness (CT) across key brain networks in women with BC who underwent chemotherapy.
Methods:
This study (participant age range: 50-84 years) involved 22 women with BC who received chemotherapy (Chemo+), 28 women with BC who did not receive chemotherapy (Chemo-), and 48 healthy control women (HC). Brain MRI scans were acquired at three time points (TPs) for the Chemo+ group: pre-chemotherapy (TP1), one-month post-chemotherapy (TP2), and six months post-chemotherapy (TP3). The Chemo- and HC groups were scanned at matched intervals. Anxiety and depression severity were assessed using the Hospital Anxiety and Depression Scale [2]. Network-specific CT was assessed following whole-brain parcellation into seven bilateral networks: the visual network, somatomotor network, dorsal attention network, salience network, limbic network (LN), frontoparietal network, and default mode network (DMN) [3,4]. Repeated measures analysis of covariance followed by pairwise comparisons was conducted to examine the effects of group and time on CT, with age and education level included as covariates. A subsequent Group×Time interaction analysis was performed on all the regions within the identified networks. A third analysis assessed the Group×Time interaction on anxiety and depression severity scores. Stepwise regression analysis across the combined sample of all three groups was performed to quantify the association between changes in CT across identified networks and regions and changes in anxiety and depression severity levels, with Group included as covariate.
Results:
There were significant Group×Time interactions for the right LN and right DMN (ps<.002, corrected for multiple comparisons) [see Figs 1 and 2], and for specific brain regions: the temporal pole and inferior frontal cortex of the right LN, and the prefrontal cortex, temporal cortex, and inferior parietal cortex (IPC) of the right DMN (ps<.05), indicating that changes in CT over time in these networks and regions differ between groups. Pairwise comparisons indicated a significant reduction in CT from TP1 to TP2 and TP1 to TP3 for the right LN, right DMN, and all the identified regions within both the networks for the Chemo+ group (ps<.05), but not for the Chemo- and HC groups. There were significant Group×Time interactions for anxiety and depression severity levels (ps<.05). At baseline (TP1), there were no significant differences in anxiety and depression severity scores for Chemo+ group relative to Chemo- and HC groups. There was a significant decrease in anxiety levels from TP1 to TP2 but an increase in depression severity from TP1 to TP2 and TP1 to TP3 for the Chemo+ group (p<.05), but not for the Chemo- or HC groups. Regression analyses revealed a significant negative association between changes in depression severity scores and changes in CT in the right IPC (p=.03) [for both from TP1 to TP2 and TP1 to TP3], indicating that as the depression severity increases, there is a corresponding decrease in CT in the right IPC. Group type did not significantly contribute to the regression model.
·Anatomical Locations of the right LN and right DMN
·Significant Group×Time interactions for the right LN and right DMN
Conclusions:
Chemotherapy may uniquely impact neural circuits involved in emotion regulation and self-referential processing. The significant association between increased depression severity and cortical thinning in the right IPC highlights potential biomarkers for vulnerability to mood disturbances following cancer treatment. These results emphasize shared structural brain biomarkers of depression severity across BC and HC groups, albeit potentially driven by different underlying mechanisms.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia)
Modeling and Analysis Methods:
Image Registration and Computational Anatomy
Multivariate Approaches
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping 1
Novel Imaging Acquisition Methods:
Anatomical MRI 2
Keywords:
Anxiety
Cortex
Emotions
Morphometrics
MRI
Multivariate
Psychiatric
Psychiatric Disorders
STRUCTURAL MRI
1|2Indicates the priority used for review
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Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Was this research conducted in the United States?
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Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.
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2 Zigmond, A. S. & Snaith, R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand 67, 361-370 (1983). https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
3 Laboratory for Computational Neuroimaging - Martinos Center for Biomedical Imaging. FreeSurfer,
4 Yeo, B. T. et al. The organization of the human cerebral cortex estimated by intrinsic functional connectivity. J Neurophysiol 106, 1125-1165 (2011). https://doi.org/10.1152/jn.00338.2011