Chemotherapy-induced Peripheral Neuropathy Linked To Cognitive Dysfunction In Breast Cancer Patients

MedicalResearch.com Interview with:
Kelly N. H. Nudelman, Ph.D.
Department of Radiology and Imaging Sciences
Indiana University-Purdue University Indianapolis (IUPUI)
Indianapolis, IN 46202

Medical Research: What is the background for this study?

Dr. Nudelman: Varying levels of cognitive problems and related changes in brain structure and function have been reported in breast cancer patients treated with chemotherapy. Pain has also been associated with altered brain structure and function. However, the association of chemotherapy-induced peripheral neuropathy (CIPN), a side-effect of chemotherapy treatment characterized by nerve damage primarily in the extremities, has not been specifically investigated for association with cognitive symptoms in breast cancer. We used data from a prospective, longitudinal breast cancer cohort to investigate the relationship of CIPN and neuroimaging measures of cognitive dysfunction. 

Medical Research: What are the main findings?

Dr. Nudelman: We found that increased chemotherapy-induced peripheral neuropathy symptoms were associated with resting brain blood flow increase in regions known to be involved in pain processing. We also found that decreased frontal lobe gray matter density was correlated with these changes, suggesting a link between chemotherapy-induced peripheral neuropathy and cognitive dysfunction.

Medical Research: What should clinicians and patients take away from your report?

Dr. Nudelman: This is the first study to demonstrate significant associations between CIPN and brain structure and function in breast cancer. The relationship we found between brain blood flow, CIPN symptoms, and gray matter change raises the possibility that chemotherapy treatment-related gray matter change may interfere with pain processing, and therefore with patient perception of CIPN symptoms.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Nudelman: More research is needed to replicate these results and further identify the underlying brain mechanisms, which may have an important impact on diagnostic and biomarker research, as well as the development of treatment and preventative interventions.

Citation:

Cerebral Perfusion and Gray Matter Changes Associated With Chemotherapy-Induced Peripheral Neuropathy

Kelly N.H. Nudelman, Brenna C. McDonald, Yang Wang, Dori J. Smith, John D. West,Darren P. O’Neill, Noah R. Zanville, Victoria L. Champion, Bryan P. Schneider,and Andrew J. Saykin

JCO JCO.2015.62.1276; published online on November 2, 2015;

 

Kelly N. H. Nudelman, Ph.D. (2015). Chemotherapy-induced Peripheral Neuropathy Linked To Cognitive Dysfunction In Breast Cancer Patients