The dorsolateral prefrontal cortex is selectively involved in chemotherapy-related cognitive impairment in breast cancer patients with different hormone receptor expression

Abstract

To investigate chemotherapy-related cognitive impairment (CRCI) in breast cancer patients with different hormone receptor (HR) expression and its neural mechanisms, forty BC patient were enrolled in this study and were divided into two groups. HR+ group was composed of twenty-one patients with Estrogen Receptor (ER)+/Progesterone Receptor (PR) +, HR- group included nineteen patients with ER-/PR-. A battery of neuropsychological tests and resting-state functional magnetic resonance imaging (rs-fMRI) examinations were administered to all subjects. The functional connectivity of the dorsolateral prefrontal cortex (DLPFC) of the patients was calculated from the resting-state fMRI data, and the correlation between the DLPFC’s connectivity and the neuropsychological test was analyzed. The functional connectivity (FC) of the left dorsolateral prefrontal cortex (DLPFC) with the left precuneus (PCU), the right DLPFC with the right precuneus and the right superior frontal gyrus (SFG) of the HR- group were significantly increased compared to the HR+ group. Meanwhile, a significant positive correlation was found between the post-chemotherapy prospective memory (PM) score and the functional connectivity of the left DLPFC with the left precuneus in the HR- group. These findings suggest that different hormone receptor expression in patients with breast cancer may be associated with CRCI and provide evidence that the DLPFC functional connectivity (FC) strength may be selectively involved in CRCI in HR- group breast cancer patients, especially in regard to the subjective prospective memory.