Share:
Share this content in WeChat
X
Clinical Article
Study on chemotherapy related cognitive disorders and brain function abnormalities in breast cancer patients based on functional connections of anterior cingulate gyrus
LI Guoqiang  LIU Tonghui  FENG Wei  ZHANG Huawen  LI Peng  ZHANG Ming 

Cite this article as: LI G Q, LIU T H, FENG W, et al. Study on chemotherapy related cognitive disorders and brain function abnormalities in breast cancer patients based on functional connections of anterior cingulate gyrus[J]. Chin J Magn Reson Imaging, 2026, 17(4): 36-40, 55. DOI:10.12015/issn.1674-8034.2026.04.005.


[Abstract] Objective To investigate cognitive impairments and abnormalities in brain function associated with chemotherapy in breast cancer patients based on functional connectivity of the anterior cingulate cortex (ACC).Materials and Methods A patient group consisting of 26 individuals with breast cancer who had undergone surgery, had pathologically confirmed infiltrative ductal carcinoma, and received standard chemotherapy was included. Neuropsychological assessment scales and magnetic resonance imaging of the brain were performed for all patients at the time of surgery, before chemotherapy (T0), and after chemotherapy (T1). 26 patients with breast cancer who were pathologically confirmed as invasive ductal carcinoma and received standardized chemotherapy were included into the patient group. All patients were evaluated with neuropsychological scale and brain MRI after surgery, before chemotherapy (T0 point) and after chemotherapy (T1 point). At T0, 26 healthy volunteers matched in age and education level were included to form a control group. Compare the cognitive function and differences in functional connectivity based on the ACC between the patient group and the control group at T0, as well as the longitudinal changes in cognitive function and functional connectivity based on the ACC between breast cancer patients at T0 and T1, and perform correlation analysis to explore the relationship between abnormal functional connectivity of the ACC and cognitive function. The differences of cognitive function and ACC based functional connectivity between the patient group and the control group at T0 were compared, and the longitudinal changes of cognitive function and ACC based functional connectivity between T0 and T1 in breast cancer patients were compared, and the correlation analysis was conducted to explore the relationship between abnormal ACC functional connectivity and cognitive function.Results At T0, there was no statistically significant difference in neuropsychological scale scores and ACC functional connectivity between the patient group and the control group (P > 0.05); Compared with T0, the scores of short-term delayed recall, long-term delayed recall and word learning of breast cancer patients at T1 decreased (P < 0.05); The results of the functional connectivity analysis based on ACC as a seed point indicate that after chemotherapy, breast cancer patients exhibited reduced functional connectivity between ACC and the left middle cingulate gyrus, the left inferior frontal gyrus, and the left middle frontal gyrus (P < 0.001); Pearson correlation analysis revealed a positive correlation (r = 0.514, P < 0.05; r = 0.441, P < 0.05) between the degree of decline in ACC function connectivity with the left medial dorsal anterior cingulate cortex following chemotherapy and changes in scores for word learning and short-term delayed memory.Conclusions Chemotherapy may have impaired the functional coordination between the ACC and related brain regions in breast cancer patients, manifesting as a general decrease in connectivity strength, and can also lead to cognitive dysfunction in many aspects, such as reduced memory and learning ability. The functional connectivity between ACC and the left middle cingulate gyrus may participate in the regulation of related functions.
[Keywords] breast cance;anterior cingulate cortex;chemotherapy;cognitive impairment;magnetic resonance imaging;functional connection

LI Guoqiang1, 2   LIU Tonghui2   FENG Wei2   ZHANG Huawen2   LI Peng2   ZHANG Ming1*  

1 Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710000, China

2 Department of Imaging, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang 712000, China

Corresponding author: ZHANG M, E-mail: zmmri@163.com

Conflicts of interest   None.

Received  2025-11-24
Accepted  2026-03-24
DOI: 10.12015/issn.1674-8034.2026.04.005
Cite this article as: LI G Q, LIU T H, FENG W, et al. Study on chemotherapy related cognitive disorders and brain function abnormalities in breast cancer patients based on functional connections of anterior cingulate gyrus[J]. Chin J Magn Reson Imaging, 2026, 17(4): 36-40, 55. DOI:10.12015/issn.1674-8034.2026.04.005.

[1]
INTERNATIONAL B R. RETRACTED: Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures[J/OL]. Biomed Res Int, 2023, 2023: 9872034 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/10769770/. DOI: 10.1155/2022/9605439.
[2]
MONTAZERI ALIABADI H. Molecular Targets for Breast Cancer Therapy[J/OL]. Biomolecules, 2024, 14(10): 1219 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/11506731/. DOI: 10.3390/biom14101219.
[3]
LLOYD M R, JHAVERI K, KALINSKY K, et al. Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer[J]. Nat Rev Clin Oncol, 2024, 21(10): 743-761. DOI: 10.1038/s41571-024-00935-6.
[4]
DINAPOLI L, COLLOCA G, DI CAPUA B, et al. Psychological Aspects to Consider in Breast Cancer Diagnosis and Treatment[J/OL]. Curr Oncol Rep, 2021, 23(3): 38 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/7952347/. DOI: 10.1007/s11912-021-01049-3.
[5]
OLIVA G, GIUSTINIANI A, DANESIN L, et al. Cognitive impairment following breast cancer treatments:an umbrella review[J/OL]. Oncologist, 2024, 29(7): e848-e863 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/11224991/. DOI: 10.1093/oncolo/oyae090.
[6]
CONTI L, PIZZOLI S F M, MARZORATI C, et al. Cognitive alterations and brain functional changes following chemotherapy treatment in breast cancer patients: A systematic review on resting-state fMRI studies[J]. Appl Neuropsychol Adult, 2025, 32(6): 1803-1818.· DOI: 10.1080/23279095.2024.2303362.
[7]
LESKINEN S, ALSALEK S, GALVEZ R, et al. Chemotherapy-Related Cognitive Impairment and Changes in Neural Network Dynamics: A Systematic Review[J/OL]. Neurology, 2025, 104(2): e210130 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/39804577/. DOI: 10.1212/WNL.0000000000210130.
[8]
ROLLS E T. Emotion, motivation, decision-making, the orbitofrontal cortex, anterior cingulate cortex, and the amygdala[J]. Brain Struct Funct, 2023, 228(5): 1201-1257. DOI: 10.1007/s00429-023-02644-9.
[9]
MOON H C, PARK Y S. Optogenetic Stimulation of the Anterior Cingulate Cortex Modulates the Pain Processing in Neuropathic Pain: A Review[J]. J Mol Neurosci, 2022, 72(1): 1-8. DOI: 10.1007/s12031-021-01898-4.
[10]
IMI G, TKAL I M, VUKI V, et al. Understanding Emotions: Origins and Roles of the Amygdala[J/OL]. Biomolecules, 2021, 11(6): 823 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/8228195/. DOI: 10.3390/biom11060823.
[11]
KUANG Q, ZHONG N, YE C, et al. Propofol Versus Remimazolam on Cognitive Function, Hemodynamics, and Oxygenation During One-Lung Ventilation in Older Patients Undergoing Pulmonary Lobectomy: A Randomized Controlled Trial[J]. J Cardiothorac Vasc Anesth, 2023, 37(10): 1996-2005. DOI: 10.1053/j.jvca.2023.06.027.
[12]
WANG L, ZHANG J, GUO C, et al. The efficacy and safety of transcutaneous auricular vagus nerve stimulation in patients with mild cognitive impairment: A double blinded randomized clinical trial[J]. Brain Stimul, 2022, 15(6): 1405-1414. DOI: 10.1016/j.brs.2022.09.003.
[13]
JIA X, WANG Z, HUANG F, et al. A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study[J/OL]. BMC Psychiatry, 2021, 21(1): 485 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/8489046/. DOI: 10.1186/s12888-021-03495-6.
[14]
DANQUAH M O, YAN E, LEE J W, et al. The utility of the Montreal cognitive assessment (MoCA) in detecting cognitive impairment in surgical populations - A systematic review and meta-analysis[J/OL]. J Clin Anesth, 2024, 97: 111551 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/39033616/. DOI: 10.1016/j.jclinane.2024.111551.
[15]
INDOREWALLA K K, OSHER J, LANCA M, et al. A normative study of the Color Trails Test in the adult Indian population[J]. Appl Neuropsychol Adult, 2022, 29(5): 899-906. DOI: 10.1080/23279095.2020.1819279.
[16]
GALOR N, WILF M, PLOTNIK M. Developing multiple shortened forms of virtual reality-based color trails test[J]. Appl Neuropsychol Adult, 2024, 31(6): 1383-1390. DOI: 10.1080/23279095.2022.2130067.
[17]
I ESTA C, OLTRA-CUCARELLA J, BONETE-LÓPEZ B, et al. Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Digit Span, Letters and Numbers, Trail Making Test and Symbol Digit Modalities Test[J/OL]. Int J Environ Res Public Health, 2021, 18(19): 9958 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/8507906/. DOI: 10.3390/ijerph18199958.
[18]
SHA P, DONG X. Research on Adolescents Regarding the Indirect Effect of Depression, Anxiety, and Stress between TikTok Use Disorder and Memory Loss[J/OL]. Int J Environ Res Public Health, 2021, 18(16): 8820 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/8393543/. DOI: 10.3390/ijerph18168820.
[19]
MASON S R, WILLSON M L, EGGER S J, et al. Platinum-based chemotherapy for early triple-negative breast cancer[J/OL]. Cochrane Database Syst Rev, 2023, 9(9): CD14805 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/10486188/. DOI: 10.1002/14651858.
[20]
FLEMING B, EDISON P, KENNY L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management[J/OL]. BMJ, 2023, 380: e71726 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/36921926/. DOI: 10.1136/bmj-2022-071726.
[21]
KERKMANN A, SCHINKE C, Dordevic A, et al. Chemotherapy-induced cognitive impairment and its long-term development in patients with breast cancer: results from the observational CICARO study[J/OL]. Oncologist, 2025, 30(2): oyae268 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/11881063/. DOI: 10.1136/bmj-2022-071726.
[22]
ONZI G R, D'AGUSTINI N, GARCIA S C, et al. Chemobrain in Breast Cancer: Mechanisms, Clinical Manifestations, and Potential Interventions[J]. Drug Saf, 2022, 45(6): 601-621. DOI: 10.1007/s40264-022-01182-3.
[23]
KHAN M A, BHURANI D, HODA U, et al. Cognitive impairment and elevated peripheral cytokines in breast cancer patients receiving chemotherapy[J]. Arq Neuropsiquiatr, 2022, 80(8): 786-793. DOI: 10.1055/s-0042-1755234.
[24]
LI Y, LUO Y, SU W, et al. Anterior cingulate cortex projections to the dorsal medial striatum underlie insomnia associated with chronic pain[J]. Neuron, 2024, 112(8): 1328-1341. DOI: 10.1016/j.neuron.2024.01.014.
[25]
SASAOKA T, HIROSE K, MAEKAWA T, et al. The anterior cingulate cortex is involved in intero-exteroceptive integration for spatial image transformation of the self-body[J/OL]. NeuroImage, 2024, 293: 120634 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/38705431/. DOI: 10.1016/j.neuroimage.2024.120634.
[26]
TANG F, ZHU D, MA W, et al. Differences Changes in Cerebellar Functional Connectivity Between Mild Cognitive Impairment and Alzheimer's Disease: A Seed-Based Approach[J/OL]. Front Neurol, 2021, 12: 645171 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/8248670/. DOI: 10.3389/fneur.2021.645171.
[27]
BOREN S B, SAVITZ S I, ELLMORE T M, et al. Longitudinal Resting-State Functional Magnetic Resonance Imaging Study: A Seed-Based Connectivity Biomarker in Patients with Ischemic and Intracerebral Hemorrhage Stroke[J]. Brain Connect, 2023, 13(8): 498-507. DOI: 10.1089/brain.2022.0017.
[28]
GUAN L, LIU R, WANG C, et al. Abnormal resting-state functional connectivity in subregions of amygdala in adults and adolescents with major depressive disorder[J/OL]. BMC Psychiatry, 2024, 24(1): 54 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/11293025/. DOI: 10.1186/s12888-024-05977-9.
[29]
LUIJENDIJK M J, BEKELE B M, SCHAGEN S B, et al. Temporal Dynamics of Resting-state Functional Networks and Cognitive Functioning following Systemic Treatment for Breast Cancer[J]. Brain Imaging Behav, 2022, 16(5): 1927-1937. DOI: 10.1007/s11682-022-00651-8.
[30]
ROSEMANN S, RAUSCHECKER J P. Neuroanatomical alterations in middle frontal gyrus and the precuneus related to tinnitus and tinnitus distress[J/OL]. Hear Res, 2022, 424: 108595 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/35963187/. DOI: 10.1016/j.heares.2022.108595.
[31]
ZHANG H, LI P, LIU T, et al. Focal white matter microstructural alteration after anthracycline-based systemic treatment in long-term breast cancer survivors: a structural magnetic resonance imaging study[J]. Brain Imaging Behav, 2022, 16(2): 843-854.· DOI: 10.1007/s11682-021-00551-3.
[32]
JONES D T, GRAFF-RADFORD J. Executive Dysfunction and the Prefrontal Cortex[J]. Continuum (Minneapolis, Minn), 2021, 27(6): 1586-1601. DOI: 10.1212/CON.0000000000001009.
[33]
DENG Y, LI W, ZHANG B. Functional Activity in the Effect of Transcranial Magnetic Stimulation Therapy for Patients with Depression: A Meta-Analysis[J/OL]. J Pers Med, 2023, 13(3): 405 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/10051603/. DOI: 10.3390/jpm13030405.
[34]
GAN C, XU J, YAO S, et al. Neural mechanisms of CALM intervention to improve CRCI in breast cancer survivors: an fMRI-based study[J]. Am J Cancer Res, 2025, 15(4): 1733-1746. DOI: 10.62347/OOVH5568.
[35]
Beyer J, Couch R, Ruddy K J, et al. Longitudinal cognitive function and brain metabolites in women receiving chemotherapy for stage 1 to 3 breast cancer: Observational study[J/OL]. Medicine, 2023, 102(42): e35524 [2025-11-24]. https://pubmed.ncbi.nlm.nih.gov/10589550/. DOI: 10.1097/MD.0000000000035524.

PREV Effects of sham acupuncture on brain activity in migraine patients: A Meta-analysis of neuroimaging-based activation likelihood estimation
NEXT Independent component-based dynamic functional connectivity network analysis in manganese-exposed welders
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn