Structural and functional MRI of the brain as biomarker for postcancer fatigue.

J Clin Oncol. 2011 May 20;29(15_suppl):9050

Authors: Prinsen H, Heerschap A, Bleijenberg G, Zwarts M, van der Graaf M, Rijpkema M, Van Laarhoven H

Abstract
9050 Background: Fatigue after curative cancer treatment is a frequently occurring problem, impairing quality of life. Little is known about physiological factors determining postcancer fatigue. We aim to assess if structural and/or functional magnetic resonance imaging (MRI) of the brain can be used as a biomarker for postcancer fatigue.
METHODS: Severely fatigued (n=25) and matched non-fatigued (n=16) disease-free cancer survivors, who completed treatment of a malignant tumor ≥1 year earlier, participated in this case-control study. Patients with a brain tumor were excluded. Structural MRI was performed on a 3T MR system and segmentation of the brain into gray matter (GM) and white matter (WM) was carried out using a voxel-based morphometry method. Volumes of hippocampus and thalamus were obtained using FMRIB Software Library (FSL FIRST). Functional MRI by magnetic resonance spectroscopic imaging (MRSI) at 3T was used to measure N-acetylaspartate (NAA) levels in the hippocampus and the ratio of choline to creatine (Cho:Cr) in the occipital cortex. LCModel was used to analyze the (1)H-spectra. One-way ANOVA was performed and differences were considered statistically significant at p<0.05.
RESULTS: Volumetry results (Table) showed a significantly smaller volume of the thalamus (p=0.015) in fatigued compared to non-fatigued cancer-survivors. Other MR(S)I parameters were not significantly different between severely fatigued and non-fatigued participants (Table).
CONCLUSIONS: Thalamus volume was significantly smaller in fatigued compared to non-fatigued cancer-survivors. As non-motor functions of the basal ganglia play a key role in central fatigue, the thalamus, which interacts with the basal ganglia, may also contribute to fatigue. Thus, thalamus volume may serve as a possible biological marker for postcancer fatigue. [Table: see text].

PMID: 28021598 [PubMed - in process]