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Cognitive impairments in breast cancer survivors treated with chemotherapy: a study based on event-related potentials

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Abstract

Purpose

Chemotherapy-related cognitive impairments in breast cancer patients were usually reported through cognitive questionnaires or scales which may be subjective and insensitive. This study is to assess the effect of chemotherapy on cognitive function in breast cancer patients stratified by age using objective electrophysiological measure, the P300 component of event-related potentials (ERPs) with a large sample size.

Methods

Totally, 529 primary breast cancer patients, including 178 cases at initial diagnosis stage and before chemotherapy (Group1), 167 cases during chemotherapy (Group2), and 184 cases post chemotherapy and during follow-up period (Group3), were examined with ERPs (P300 component) to assess the effect of chemotherapy on their cognitive function.

Results

There were significant differences of P300 latency in Group2 (364.74 ± 15.73 ms) and Group3 (364.02 ± 17.12 ms, mean follow-up period of 2.42 years) compared with Group1 (355.13 ± 19.47 ms, P < 0.001), respectively. With further age stratification: in patients of < 50 years, P300 latency was significantly prolonged in Group2 and Group3 compared with Group1 (P < 0.001), respectively; in patients of 50–59 years, P300 latency was significantly prolonged in Group2 compared with Group1 (P < 0.05), but without difference in Group1 and Group3 (P>0.05); In patients of ≥ 60 years, there were no differences of P300 latency among three the groups (P>0.05).

Conclusions

It is first suggested by our objective detection data that the side effect of chemotherapy on cognitive functions in breast cancer patients may decrease with age. Electrophysiological cognitive impairments mainly occur in younger breast cancer patients undergoing chemotherapy and would last for years after chemotherapy, which highlights the importance of early intervention for those patients, especially in younger patients.

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Abbreviations

ERPs:

Event related potentials

fMRI:

Functional magnetic resonance imaging

ms:

Millisecond

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Acknowledgements

This study was performed using data provided by the Breast Cancer Center of Chongqing and the Electromyogram Room of Neurology Department of the First Affiliated Hospital of Chongqing Medical University, China.

Funding

This study was supported by National Natural Science Foundation of China (NSFC) (81372851).

Author information

Author notes

  1. Zhou Xu, Feng Luo, Yu Wang, Bao-shan Zou, and Yuan Man have contributed equally to this work and should be considered as joint first author.

Authors and Affiliations

  1. Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 You Yi Rd., Chongqing, 400016, China

    Zhou Xu, Feng Luo, Bao-shan Zou, Jia-shuo Liu, Hao Li, Bilal Arshad, Hong Li, Shu Li, Yu-xian Wei, Hong-yuan Li, Kai-nan Wu & Ling-quan Kong

  2. Outpatient Department, The First Affiliated Hospital of Chongqing Medical University, No. 1 You Yi Rd., Chongqing, 400016, China

    Yu Wang

  3. Electromyogram Room of Neurology Department of the First Affiliated Hospital of Chongqing Medical University, No. 1 You Yi Rd., Chongqing, 400016, China

    Yuan Man

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  1. Zhou Xu
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Contributions

All authors contributed to the study conception and design. ZX, FL, YW, BSZ, and YM collected data and drafted the manuscript. JSL, HL, BA, HL, SL, and YXW revised the manuscript critically for important intellectual content. HYL and KNW was an auxiliary surgeon and had significant contribution to the conception and design of the manuscript. LQK was responsible for the overall treatment of the patient and revised critically the manuscript and has given the final approval of the version to be published. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ling-quan Kong.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, approval number: 2017-044) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consents were waived on account of the retrospective design of the study.

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Xu, Z., Luo, F., Wang, Y. et al. Cognitive impairments in breast cancer survivors treated with chemotherapy: a study based on event-related potentials. Cancer Chemother Pharmacol 85, 61–67 (2020). https://doi.org/10.1007/s00280-019-03994-0

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