Subjective cancer-related cognitive impairments and salience network connectivity in breast cancer survivors.

PURPOSE
Little is known about the neural basis of subjective cancer-related cognitive changes. The purpose of this study was to explore salience network connectivity in relation to subjective executive and memory dysfunction in breast cancer survivors compared to controls.


METHODS
A retrospective cross-sectional analysis of neuroimaging, subjective cognitive, clinical, and demographic data in chemotherapy-treated primary breast cancer survivors compared to frequency matched controls was used. Functional connectivity within salience network hubs (anterior cingulate, bilateral insula) was determined using resting state functional MRI. Mann-Whitney U tests were used to evaluate group differences and Spearman's rho correlations were examined among the behavioral measures and salience network connectivity.


RESULTS
We included 65 breast cancer survivors and 71 controls. Survivors demonstrated greater subjective executive dysfunction and memory complaints (p < .001) and lower salience network connectivity (p < .05) than controls. Executive functioning correlated with bilateral insula and left anterior cingulate connectivity (rho >  - 0.29, p < .05). Distress did not correlate with salience network connectivity.


CONCLUSION
These findings suggest that salience network connectivity may represent a biomarker of subjective cancer-related cognitive changes.


IMPLICATIONS FOR CANCER SURVIVORS
Subjective cancer-related cognitive changes are common following treatment and associated with objective changes in brain connectivity.