Chemotherapy-Induced Peripheral Neuropathy May Be Associated With Cerebral Perfusion and Gray Matter Changes


Key Points

  • Chemotherapy-induced peripheral neuropathy symptoms were positively associated with changes in cerebral perfusion and gray matter after treatment for breast cancer.
  • Perfusion was increased in regions associated with pain processing.

In a study reported in the Journal of Clinical Oncology, Nudelman et al found that increased chemotherapy-induced peripheral neuropathy symptoms at 1 month after completing treatment for breast cancer was associated with increased cerebral perfusion and increased gray matter density at 1 month.

Study Details

In the study, patients with breast cancer treated with (n = 24) or without (n = 23) chemotherapy underwent brain magnetic resonance imaging before treatment, 1 month after treatment completion, and 1 year after the 1-month assessment. Perfusion and gray matter density were assessed using voxel-based pulsed arterial spin labeling and morphometric analyses. Chemotherapy-induced peripheral neuropathy symptoms were evaluated with the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity 4-item sensory-specific scale.

Positive Correlations

Patients who received chemotherapy had significantly increased chemotherapy-induced peripheral neuropathy symptoms from baseline to 1 month, with partial recovery by 1 year (P < .001); the increase was significantly greater than that in the no chemotherapy group at 1 month (P = .001). Neuroimaging at 1 month in the chemotherapy group showed that chemotherapy-induced peripheral neuropathy symptoms were positively associated with cerebral perfusion in the right superior frontal gyrus and cingulate gyrus (P < .001), both of which are associated with pain processing.

Chemotherapy-induced peripheral neuropathy symptoms (P < .001) and associated perfusion changes (P = .002) at 1 month were positively correlated with gray matter density change at 1 month, with the finding suggesting that patients with gray matter density decrease may report less severe chemotherapy-induced peripheral neuropathy symptoms while exhibiting less chemotherapy-induced peripheral neuropathy symptom-related perfusion change. Overlap of perfusion and gray matter density changes was observed in the right superior frontal gyrus and left cingulate gyrus. There was no association between chemotherapy-induced peripheral neuropathy symptoms and perfusion at 1 year.

The investigators concluded: “Peripheral neuropathy symptoms after systemic chemotherapy for breast cancer are associated with changes in cerebral perfusion and gray matter. The specific mechanisms warrant further investigation given the potential diagnostic and therapeutic implications.”

The study was supported by the National Cancer Institute, National Institute on Aging, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Indiana Clinical and Translational Sciences Institute, and an Indiana University Melvin and Bren Simon Cancer Center American Cancer Society institutional grant.

Andrew J. Saykin, PsyD, of the Center for Neuroimaging, Indiana University School of Medicine, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.