乳腺癌术前化疗过程中脑静息态功能活动与类淋巴功能改变及相关性分析  

Resting-state Brain Functional Activity and Glymphatic Function Changes during Neoadjuvant Chemotherapy for Breast Cancer and Correlation Analysis

作　　者：何旋 李翠荣 王艾博 王伟 HE Xuan;LI CUI-rong;WANG Ai-bo;WANG Wei(Department of Rehabilitation Radiology,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China;Department of Radiology,Tianjin Medical University Cancer Hospital,Tianjin 300060,China)

机构地区：[1]首都医科大学附属北京康复医院康复放射科,北京100144 [2]天津医科大学肿瘤医院放射科,天津300060

出　　处：《中国CT和MRI杂志》2024年第5期14-17,共4页Chinese Journal of CT and MRI

基　　金：首都医科大学附属北京康复医院引进人才科研启动基金项目(2022R-01)。

摘　　要：目的探究女性乳腺癌患者术前新辅助化疗后脑静息态功能和类淋巴功能变化及其之间的相关性。方法40名健康女性被试及80名女性乳腺癌患者被纳入本次研究,乳腺癌患者均进行术前新辅助化疗。应用MMSE、DSST和FACT-CogPCI评分评估被试认知功能。应用rsfMRI获取反映大脑功能活动的ALFF指标。应用DTI-ALPS技术获取反映脑类淋巴功能的ALPS指数。分析乳腺癌患者化疗前后ALFF及ALPS变化,分析各指标与认知评分之间的相关性,并分析ALFF与ALPS之间的相关性情况。结果乳腺癌患者化疗后MMSE、DSST及FACT-CogPCI评分均减低(P<0.05)。化疗后,左侧颞极中部、左侧丘脑腹外侧核及右侧顶后中回团块ALFF值减低,双侧颞叶、枕叶及顶叶多个脑区的ALFF值与FACTCogPCI评分呈正相关(pFDR-C<0.001)。化疗后ALPS指数相比正常被试增高(1.42±0.29 vs 1.56±0.24,P=0.011),同时ALPS指数与FACT-CogPCI评分呈正相关(r=0.241,P=0.04)。与此同时化疗后左侧舌状回ALFF值与ALPS指数呈正相关(r=0.69,P<0.001)。结论研究结果提示,大脑功能活动和类淋巴引流均参与化疗后认知功能改变的过程,同时两者存在相关性。Objective This study aimed to investigate the changes in cognitive function,brain resting state function,and glymphatic function in female breast cancer patients before and after neoadjuvant chemotherapy,as well as explore the correlations between these variables.Methods A total of 40 healthy female subjects and 80 female breast cancer patients undergoing neoadjuvant chemotherapy were included in the study.Cognitive function was assessed using MMSE,DSST,and FACT-CogPCI scores.rsfMRI was employed to measure the ALFF,reflecting brain function.The Diffusion Tensor Imaging ALPS technique was used to assess the ALPS index,reflecting brain glymphatic function.Changes in ALFF and ALPS before and after chemotherapy in breast cancer patients were analyzed.The correlation between each indicator and cognitive scores was examined,as well as the correlation between ALFF and ALPS.Results After chemotherapy,breast cancer patients showed a decrease in MMSE,DSST,and FACT-CogPCI scores(P<0.05).ALFF values decreased in the left middle temporal pole,left thalamus,and right posterior cingulate gyrus cluster.ALFF values in several brain regions,including bilateral temporal lobes,occipital lobes,and parietal lobes,were positively correlated with FACT-CogPCI scores(pFDR-C<0.001).After chemotherapy,the ALPS index increased compared to normal subjects(1.42±0.29 vs.1.56±0.24,P=0.011),and the ALPS index was positively correlated with FACT-CogPCI scores(r=0.241,P=0.04).Additionally,post-chemotherapy ALFF values in the left lingual gyrus were positively correlated with the ALPS index(r=0.69,P<0.001).Conclusion The study results suggest that changes in both brain function and lymphatic drainage are involved in the cognitive function alterations after chemotherapy in breast cancer patients,and there exists a correlation between the two processes.

关 键 词：化疗相关认知损伤 静息态脑功能磁共振 弥散张量成像 低频振幅 脑类淋巴功能 

分 类 号：R445.2[医药卫生—影像医学与核医学]