Structural and functional brain alterations associated with cancer-associated cognitive decline in gastric cancer patients: A preliminary longitudinal neuroimaging study

Abstract

Objective: Despite the clinical significance of cancer-associated cognitive decline (CACD), no longitudinal study has evaluated CACD in gastric cancer patients. This preliminary study explored structural and functional neural changes of CACD in gastric cancer patients focusing on the effects of chemotherapy.

Methods: 13 gastric cancer patients who received adjuvant chemotherapy (CTx+ group), 9 gastric cancer patients who did not receive adjuvant chemotherapy (CTx- group), and 10 healthy controls (HCs) were enrolled in this study. We performed self-report questionnaires, neurocognitive tests, voxel-based morphometry (VBM), and resting-state functional magnetic resonance imaging (rsfMRI) analyses before and 3 months after chemotherapy.

Results: Compared to the CTx- group, the CTx+ group exhibited statistically significant decrease in attention and executive function over time and dysfunction in delayed recognition performance. The results of the rsfMRI analysis showed a significant group-by-time interaction in the left hippocampus-anterior thalamus. However, no significant structural change was observed in the VBM analysis.

Conclusion: To the best of our knowledge, this is the first longitudinal neuroimaging study on CACD in gastric cancer patients. Based on the results of our preliminary study, we suggest that the neuropathological processes and clinical presentation of CACD in gastric cancer patients is similar to those of patients associated with age-related neurodegenerative disorders.