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Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment

Cancer related cognitive impairment (CRCI) is commonly associated with cancer and its treatments, yet the present binary diagnostic approach fails to capture the full spectrum of this syndrome. Cognitive function is highly complex and exists on a continuum that is poorly characterized by dichotomous...

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Autores principales: Kesler, Shelli R., Henneghan, Ashley M., Prinsloo, Sarah, Palesh, Oxana, Wintermark, Max
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499624/
https://www.ncbi.nlm.nih.gov/pubmed/37720513
http://dx.doi.org/10.3389/fmed.2023.1199605
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author Kesler, Shelli R.
Henneghan, Ashley M.
Prinsloo, Sarah
Palesh, Oxana
Wintermark, Max
author_facet Kesler, Shelli R.
Henneghan, Ashley M.
Prinsloo, Sarah
Palesh, Oxana
Wintermark, Max
author_sort Kesler, Shelli R.
collection PubMed
description Cancer related cognitive impairment (CRCI) is commonly associated with cancer and its treatments, yet the present binary diagnostic approach fails to capture the full spectrum of this syndrome. Cognitive function is highly complex and exists on a continuum that is poorly characterized by dichotomous categories. Advanced statistical methodologies applied to symptom assessments have demonstrated that there are multiple subclasses of CRCI. However, studies suggest that relying on symptom assessments alone may fail to account for significant differences in the neural mechanisms that underlie a specific cognitive phenotype. Treatment plans that address the specific physiologic mechanisms involved in an individual patient’s condition is the heart of precision medicine. In this narrative review, we discuss how biotyping, a precision medicine framework being utilized in other mental disorders, could be applied to CRCI. Specifically, we discuss how neuroimaging can be used to determine biotypes of CRCI, which allow for increased precision in prediction and diagnosis of CRCI via biologic mechanistic data. Biotypes may also provide more precise clinical endpoints for intervention trials. Biotyping could be made more feasible with proxy imaging technologies or liquid biomarkers. Large cross-sectional phenotyping studies are needed in addition to evaluation of longitudinal trajectories, and data sharing/pooling is highly feasible with currently available digital infrastructures.
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spelling pubmed-104996242023-09-15 Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment Kesler, Shelli R. Henneghan, Ashley M. Prinsloo, Sarah Palesh, Oxana Wintermark, Max Front Med (Lausanne) Medicine Cancer related cognitive impairment (CRCI) is commonly associated with cancer and its treatments, yet the present binary diagnostic approach fails to capture the full spectrum of this syndrome. Cognitive function is highly complex and exists on a continuum that is poorly characterized by dichotomous categories. Advanced statistical methodologies applied to symptom assessments have demonstrated that there are multiple subclasses of CRCI. However, studies suggest that relying on symptom assessments alone may fail to account for significant differences in the neural mechanisms that underlie a specific cognitive phenotype. Treatment plans that address the specific physiologic mechanisms involved in an individual patient’s condition is the heart of precision medicine. In this narrative review, we discuss how biotyping, a precision medicine framework being utilized in other mental disorders, could be applied to CRCI. Specifically, we discuss how neuroimaging can be used to determine biotypes of CRCI, which allow for increased precision in prediction and diagnosis of CRCI via biologic mechanistic data. Biotypes may also provide more precise clinical endpoints for intervention trials. Biotyping could be made more feasible with proxy imaging technologies or liquid biomarkers. Large cross-sectional phenotyping studies are needed in addition to evaluation of longitudinal trajectories, and data sharing/pooling is highly feasible with currently available digital infrastructures. Frontiers Media S.A. 2023-08-29 /pmc/articles/PMC10499624/ /pubmed/37720513 http://dx.doi.org/10.3389/fmed.2023.1199605 Text en Copyright © 2023 Kesler, Henneghan, Prinsloo, Palesh and Wintermark. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Kesler, Shelli R.
Henneghan, Ashley M.
Prinsloo, Sarah
Palesh, Oxana
Wintermark, Max
Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title_full Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title_fullStr Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title_full_unstemmed Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title_short Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
title_sort neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499624/
https://www.ncbi.nlm.nih.gov/pubmed/37720513
http://dx.doi.org/10.3389/fmed.2023.1199605
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