Subjective cancer-related cognitive impairments and salience network connectivity in breast cancer survivors

J Cancer Surviv. 2023 Aug;17(4):967-973. doi: 10.1007/s11764-022-01307-8. Epub 2022 Dec 5.

Abstract

Purpose: Little is known about the neural basis of subjective cancer-related cognitive changes. The purpose of this study was to explore salience network connectivity in relation to subjective executive and memory dysfunction in breast cancer survivors compared to controls.

Methods: A retrospective cross-sectional analysis of neuroimaging, subjective cognitive, clinical, and demographic data in chemotherapy-treated primary breast cancer survivors compared to frequency matched controls was used. Functional connectivity within salience network hubs (anterior cingulate, bilateral insula) was determined using resting state functional MRI. Mann-Whitney U tests were used to evaluate group differences and Spearman's rho correlations were examined among the behavioral measures and salience network connectivity.

Results: We included 65 breast cancer survivors and 71 controls. Survivors demonstrated greater subjective executive dysfunction and memory complaints (p < .001) and lower salience network connectivity (p < .05) than controls. Executive functioning correlated with bilateral insula and left anterior cingulate connectivity (rho > - 0.29, p < .05). Distress did not correlate with salience network connectivity.

Conclusion: These findings suggest that salience network connectivity may represent a biomarker of subjective cancer-related cognitive changes.

Implications for cancer survivors: Subjective cancer-related cognitive changes are common following treatment and associated with objective changes in brain connectivity.

Keywords: Breast cancer survivors; Cancer-related cognitive impairment; Executive function; Functional connectivity; Salience network; Subjective.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Brain
  • Breast Neoplasms* / complications
  • Breast Neoplasms* / drug therapy
  • Cancer Survivors*
  • Cognitive Dysfunction* / etiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Retrospective Studies