cognitive deficits memory and concentration problems
Conditions
Interventions
None listed
Sponsors
Antoni van Leeuwenhoek Ziekenhuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: all groups: -female -sufficient proficiency in the Dutch language;cross-sectional part: -participation in previous neuropsychological study -having been treated with high-dose chemotherapy (CTC);prospective part, experimental group -newly diagnosed breast cancer patients without distant metastases that will receive chemotherapy (ACdd + T);prospective part, control group -newly diagnosed breast cancer patients without distant metastases that will not receive chemotherapy
Exclusion criteria
Exclusion criteria: -relapse and/or metastases -excessive use of alcohol or drugs -use of psychotropic medication -neurologic or psychiatric disorders that may influence cognitive functioning -conditions that preclude MRI examination
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| MR scanning will be performed using a Philips Intera 3.0 Tesla scanner with an eight channel Sense head coil. MRI imaging parameters: 1. 3-dimensional T1-weighted sequences followed by (automated) volumetric measurement, as a gross marker for tissue loss. 2. FLAIR sequence to determine presence and extent of demyelation. 3. MR Spectroscopy allows the safe in vivo measurement of brain neurochemistry. Compounds that can be identified are N-acetylaspartate (NAA), choline (Cho) and myo-inositol (MI). NAA is contained almost exclusively within neurons and is considered a neuronal marker for neuronal density and viability. MI reflects glial content. 4. Diffusion Tensor Imaging (DTI) will be used to study the (density of) fibers subserving well-defined functional networks and as such provide an index of damage in the normal appearing white matter. The outcome measures will be used to study correlations with specific functional deficits. 5. Functional MRI: EPI sequence, 35 slices/3.0 mm, TR * 2.0 s, axial sequential acquisition: We will use the following well-studied paradigms measuring executive functioning and memory to investigate changes in the blood oxygen level dependent (BOLD) response, reflecting neural activity. Tower of London Task: A task widely used to investigate executive/planning processes and known to robustly activate dorsolateral prefrontal cortex. The Flanker task (20): Previous studies from our group consistently show impaired performance on this task by patients treated with chemotherapy. It provides a means for examining interference control processes. Activation of the anterior cingulate cortex (viewed as a central component of the neural circuit for action monitoring) is reliably observed during this task. Paired associates task, measured both at encoding and retrieval. This memory paradigm has demonstrated to reliably activate medial temporal lobe (e.g., hippocampus). | — |
Secondary
| Measure | Time frame |
|---|---|
| In addition to the tests that are administrated while MRI scans are being acquired, the patients will also be tested with a neuropsychological examination after the scanning procedure. This examination will consist of the following classical neuropsychological tests, that were also included in the previous neuropsychological examinations conducted at the NKI-AvL: California Verbal Learning test, Stroop color-word naming, Trail making, Verbal Fluency, Digit symbol (WAIS), Wechsler memory scale (visual memory). These tests are included to obtain information on the current cognitive status of the participants. The following data will be collected for all participants: Age, educational status, smoking habits, alcohol intake, body mass index, age at menopause (if appropriate) and type of menopause (natural or artificial), use of hormone replacement therapy, psychological distress, self-reported cognitive problems, self-reported medical history and medication use. For the breast cancer patients previously treated with chemotherapy the following additional information will be obtained through the medical records: kind of cytotoxic treatment, radiotherapy yes/no, endocrine therapy yes/no. | — |
Countries
Netherlands
Outcome results
None listed