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, independent of menopausal status -age under 70 years (to allow use of the same neuropsychological test battery) -sufficient proficiency in the Dutch language;Experimental group: -newly diagnosed breast cancer patients without distant metastases who will receive anthracycline-based chemotherapy ;Breast cancer control group: -newly diagnosed breast cancer patients without distant metastases who do not require chemotherapy;Healthy control group: -healthy females, matched for age
Exclusion criteria
Exclusion criteria: All groups: -previous malignancies -excessive use of alcohol or drugs -use of psychotropic medication -neurologic or psychiatric disorders that may influence cognitive functioning -conditions that preclude MRI examination.;Experimental group and breast cancer control group: -relapse and/or metastases - treatment with trastuzumab (Herceptin)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| MRI 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-weigthed sequences followed by (automated) volumetric measurement, as a gross measure for tissue loss. 2. FLAIR sequence to determine presence and extent of demyelination. 3. MR spectroscopy allows the safe in vivo measurement of brain neurochemistry. Compounds that can be identified are N-acetylaspartaat (NAA), choline (Cho) en myo-inositol (MI). NAA is contained almost exclusively within neurons and is considered a neuronal marker for neuronal density and viability. Cho indicates integrity of neuronal structure. 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 sequence 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 the dorsolateral prefrontal cortex. Flanker task: previous studies by 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 (a central component of the neural circuit for action monitoring) is reliably observed during this task. Paired associates task: a task concerning implicit memory. The medial temporal lobe (e.g. hippocampus) is reliably activated during encoding as well as retrieval of stimuli. Resting state | — |
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. The neuropsychological tests will take place before the MRI scanning session. The neuropsychological examination will consist of the following classical neuropsychological tests, which were also included in previous neuropsychological examinations conducted at the NKI-AvL: Hopkins Verbal Learning Test, Stroop Color-Word Test, Trail Making Test, Verbal Fluency Test, Digit Symbol Test, Wechsler Memory Scale, PASAT, Fepsy Finger Tapping. 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), previous use of hormone replacement therapy, psychological distress (Hopkins Symptom Checklist), health related quality of life (EORTC QLQ-C30), self-reported cognitive problems (MOS questionnaire), self-reported medical history and medication use. For the women 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. For the breast cancer patients not treated with chemotherapy, the following information will be obtained through the medical records: radiotherapy yes/no, endocrine therapy yes/no. To study possible mediating effects of stress on the relation between chemotherapy and cognition, cortisol levels will be measured in hair samples. Recent studies have indicated a possible mediating role for specific genetic polymorphisms, e.g. APOE, BDNF and COMT, in the development of cognitive dysfunction following chemotherapy. Therefore, saliva samples will be taken to screen for these genetic polymorphisms in relation to cog | — |
Countries
Netherlands
Outcome results
None listed