Vincent Chin-Hung Chen1,2, Chin-Kuo Lin3,4, Han-Pin Hsiao1, Bor-Show Tzang5,6, Yen-Hsuan Hsu7,8, Shu-I Wu9,10, Robert Stewart11,12. 1. Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi 613016, Taiwan. 2. School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. 3. Division of Pulmonary Infection and Critical Care, Department of Pulmonary and Critical Care Medicine Chang Gung Memorial Hospital, Chiayi 61306, Taiwan. 4. Graduate Institute of Clinical Medicine Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. 5. Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan. 6. Clinical Laboratory, Chung Shan Medical University Hospital, Taichung 40201, Taiwan. 7. Department of Psychology, National Chung Cheng University, Chiayi County 62102, Taiwan. 8. Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi County 62102, Taiwan. 9. Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan. 10. Department of Psychiatry, Mackay Memorial Hospital, New Taipei City 251020, Taiwan. 11. Department of Psychological Medicine, King's College London, London SE5 8AF, UK. 12. South London and Maudsley NHS Foundation Trust, London SE5 8AF, UK.
Abstract
BACKGROUND: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. METHODS: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. RESULTS: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. CONCLUSIONS: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.
BACKGROUND: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. METHODS: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. RESULTS: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. CONCLUSIONS: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.
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