The attention network changes in breast cancer patients receiving neoadjuvant chemotherapy: Evidence from an arterial spin labeling perfusion study

To investigate the neural mechanisms underlying attention deficits that are related to neoadjuvant chemotherapy in combination with cerebral perfusion. Thirty one patients with breast cancer who were scheduled to receive neoadjuvant chemotherapy and 34 healthy control subjects were included. The patients completed two assessments of the attention network tasks (ANT), neuropsychological background tests, and the arterial spin labeling scan, which were performed before neoadjuvant chemotherapy and after completing chemotherapy. After neoadjuvant chemotherapy, the patients exhibited reduced performance in the alerting and executive control attention networks but not the orienting network (p < 0.05) and showed significant increases in cerebral blood flow (CBF) in the left posterior cingulate gyrus, left middle occipital gyrus, bilateral precentral gyrus, inferior parietal gyrus, supramarginal gyrus, angular gyrus, precuneus, cuneus, superior occipital gyrus, calcarine cortex, and temporal gyrus (p < 0.01 corrected) when compared with patients before chemotherapy and healthy controls. A significant correlation was found between the decrease performance of ANT and the increase in CBF changes in some brain regions of the patients with breast cancer. The results demonstrated that neoadjuvant chemotherapy influences hemodynamic activity in different brain areas through increasing cerebral perfusion, which reduces the attention abilities in breast cancer patients.