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Dear Students, choose one article found for your proposal, and make a critique of it as an essay.Brain Imaging and Behavior (2022) 16:43–53
Effect of chemotherapy on default mode network connectivity
in older women with breast cancer
Bihong T. Chen 1,2 & Zikuan Chen 1 & Sunita K. Patel 3 & Russell C. Rockne 4 & Chi Wah Wong 5 & James C. Root 6 &
Andrew J. Saykin 7 & Tim A. Ahles 6 & Andrei I. Holodny 8 & Can-Lan Sun 2 & Mina S. Sedrak 9 & Heeyoung Kim 2 &
Ashley Celis 2 & Vani Katheria 2 & William Dale 2,10
Received: 21 October 2020 / Accepted: 25 April 2021 / Published online: 21 May 2021
# The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
Chemotherapy may impair cognition and contribute to accelerated aging. The purpose of this study was to assess the effects of
chemotherapy on the connectivity of the default mode network (DMN) in older women with breast cancer. This prospective longitudinal study enrolled women aged ≥ 60 years with stage I–III breast cancer (CTx group) and matched healthy controls (HC group).
Study assessments, consisting of resting-state functional MRI (rs-fMRI) and the Picture Sequence Memory (psm) test for episodic
memory from the NIH Toolbox for Cognition, were obtained at baseline and within one month after the completion of chemotherapy
for the CTx group and at matched intervals for the HC group. Two-sample t-test and FDR multiple comparison were used for statistical
inference. Our analysis of the CTx group (N = 19; 60–82 years of age, mean = 66.6, SD = 5.24) compared to the HC group (N = 14;
60–78 years of age, mean = 68.1, SD = 5.69) revealed weaker DMN subnetwork connectivity in the anterior brain but stronger
connectivity in the posterior brain at baseline. After chemotherapy, this pattern was reversed, with stronger anterior connectivity and
weaker posterior connectivity. In addition, the meta-level functional network connectivity (FNC) among the DMN subnetworks after
chemotherapy was consistently weaker than the baseline FNC as seen in the couplings between anterior cingulate cortex (ACC) and
retrosplenial (rSplenia) region, with ΔFNC(‘ACC’,’rSplenia’)=-0.14, t value=-2.44, 95 %CI=[-0.27,-0.10], pFDR 0.15). This effect was most predominant in subnetworks of ‘ACC’, ‘L Parietal’, and ‘rSplenia’.
Meta‐level FNC matrices
Not Applicable
TC: docetaxel (Taxotere) and cyclophosphamide; b Non-TC, including
TCPH: docetaxel (Taxotere), carboplatin, and trastuzumab (Herceptin),
ddAC-T: dose dense doxorubicin (Adriamycin) and cyclophosphamide,
followed by paclitaxel (Taxol); TAC: docetaxel (Taxotere), doxorubicin
(Adriamycin), and cyclophosphamide; Paclitaxel/trastuzumab;
TP: time point. psm: Picture Sequence Memory
DMN subnetwork was comprised of a single blob such as the
medial prefrontal cortex (‘mPFC’) subnetwork, indicating no
remote (or far) connectivity with other brain regions.
We detected baseline differences in DMN subnetworks
between the CTx group and the HC group, using
|Δcorr|>0.15 (Fig. 2b and 2c). The threshold of 0.15 was
empirically specified to display the large baseline differences
while suppressing the small differences. The CTx group
showed weaker connectivity initiated from ‘mPFC’, ‘R
Front: right frontal lobe’, ‘R Temp: right temporal lobe’, ‘L
Hippo: left hippocampus’ and ‘R Hippo: right hippocampus’,
and stronger connectivity initiated from ‘L Pariet: left parietal
lobe’ and ‘R Pariet: right parietal lobe’. Notably, in the ‘ACC:
anterior cingulate cortex’ subnetwork, the CTx group showed
stronger connectivity to the posterior region than the HC
group but weaker connectivity to the anterior region at baseline (in Fig. 2c).
Longitudinal changes of DMN subnetwork
We estimated longitudinal changes of DMN FC subnetworks
from TP1 to TP2 (ΔDMN) for the CTx group, which was
Using the subject-specific DMN subnetworks as presented in
the FC maps, we rendered a meta-level analysis in a FNC
matrix in the size of 12 × 12 for the 12 DMN subnetworks.
When comparing baseline FNC couplings in the CTx and HC
groups, we observed four statistically significant FNC couplings with pFDR 0.15. Void: indicating no group-by-time interaction
in the DMN subnetwork initiated at the right temporal cortex.
Abbreviations: mPFC: medial prefrontal cortex, ACC: anterior cingulate
cortex, PCC: posterior cingulate cortex, L Pariet: left parietal cortex, R
Pariet: right parietal cortex, L Front: left superior frontal cortex, R Front:
right superior frontal cortex, L Temp: left inferior temporal cortex, R
Temp: right inferior temporal cortex, L Hippo: left hippocampal gyrus,
R Hippo: right hippocampus gyrus, rSplenia: retrosplenial
posterior brain (parietal lobe) (Chen et al., 2019b), as well as
altered intrinsic brain activity in right anterior cingulate gyrus
and left precuneus (Chen et al., 2019a). Thus, converging
evidence indicates a brain structural basis for functional alterations underlying CRCI in older patients with cancer receiving
chemotherapy. We speculate that brain structure and DMN
connectivity are closely related to maintain cognitive function
for older adults undergoing cancer treatment.
Our study also indicated that pre-treatment DMN connectivity was different in the CTx group compared to the HC
Brain Imaging and Behavior (2022) 16:43–53
Table 2 Significant couplings from the meta-level functional connectivity network (FNC) analysis for the chemotherapy (CTx) group and the
healthy control (HC) group (pFDR
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