Comparison of the state of brain metabolism and psycho emotional disorders in patients with postmastectomy syndrome

Abstract

BACKGROUND: The most common consequence of radical treatment of breast cancer is postmastectomy syndrome — a complex of changes in the lymphocirculatory system, central and peripheral nervous system, skeletal and muscular apparatus, that significantly reduce the quality of life and working capacity of women. In recent years, special attention has been paid to the study of psycho emotional disorders in this group of patients. A promising method for preclinical diagnosis of anxiety and depressive disorders in patients with postmastectomy syndrome may be positron emission computed tomography with fluorine-18 labeled glucose — 2(18F)-fluoro-2-deoxy-D-glucose, which makes it possible to deduce typical patterns of changes in glucose metabolism in cerebral structures in various depressive and anxiety states.

AIM: The purpose of this study is to study the relationship between brain metabolism and psycho emotional status in patients with postmastectomy syndrome.

MATERIALS AND METHODS: In our work, the sample consisted of 28 patients who underwent radical treatment for breast cancer, who underwent an assessment of the psycho-emotional state using the State-Trait Anxiety Inventory and Zung scales for self-assessment of depression. Positron emission tomography was also performed with 18-fluorodeoxyglucose.

RESULTS: The study revealed that 71% of patients showed an increased level of anxiety, 64% showed signs of depression. Positron emission tomography data revealed the following areas of hypometabolism in patients with anxiety-depressive disorders: parietal cortex, inferior parietal lobule, precuneus, superior temporal gyrus, prefrontal cortex, posterior cingulate cortex.

CONCLUSION: Thus, typical zones of changes in glucose metabolism in patients with psycho emotional disorders have been identified, which makes it possible to improve the accuracy of diagnosing these conditions, as well as to develop the most effective ways to prevent and treat them.

Keywords

anxiety / brain metabolism / depression / PET / postmastectomy syndrome / prognosis

References

[1] Lovelace DL, McDaniel LR, Golden D. Long-Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care. J Midwifery Womens Health. 2019;64(6):713–724. DOI: 10.1111/jmwh.13012.

[2] Lovelace D.L., McDaniel L.R., Golden D. Long-Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care // J. Midwifery Womens Health. 2019. Vol. 64, No. 6. P. 713–724. DOI: 10.1111/jmwh.13012.

[3] Shah C, Arthur D, Riutta J, et al. Breast-cancer related lymphedema: A review of procedure-specific incidence rates, clinical assessment aids, treatment paradigms, and risk reduction. Breast Journal. 2012;18(4):357–361. DOI: 10.1111/j.1524–4741.2012.01252.x

[4] Shah C., Arthur D., Riutta J., et al. Breast-cancer related lymphedema: A review of procedure-specific incidence rates, clinical assessment aids, treatment paradigms, and risk reduction // Breast Journal. 2012. Vol. 18, No. 4. P. 357–361. DOI: 10.1111/j.1524-4741.2012.01252.x

[5] Tsaras K, Papathanasiou IV, Mitsi D, et al. Assessment of Depression and Anxiety in Breast Cancer Patients: Prevalence and Associated Factors. Asian Pac J Cancer Prev. 2018;19(6):1661–1669. DOI: 10.22034/apjcp.2018.19.6.1661

[6] Tsaras K., Papathanasiou I.V., Mitsi D., et al. Assessment of Depression and Anxiety in Breast Cancer Patients: Prevalence and Associated Factors // Asian Pac. J. Cancer Prev. 2018. Vol. 19, No. 6. P. 1661–1669. DOI: 10.22034/apjcp.2018.19.6.1661

[7] Yi JC, Syrjala KL. Anxiety and Depression in Cancer Survivors. Med Clin North Am. 2017;101(6):1099–1113. DOI: 10.1016/j.mcna.2017.06.005

[8] Yi J.C., Syrjala K.L. Anxiety and Depression in Cancer Survivors // Med. Clin. North Am. 2017. Vol. 101, No. 6. P. 1099–1113. DOI: 10.1016/j.mcna.2017.06.005

[9] Crane TE, Badger TA, Sikorskii A, et al. Trajectories of Depression and Anxiety in Latina Breast Cancer Survivors. Oncol Nurs Forum. 2019;46(2):217–227. DOI: 10.1188/19.ONF.217-227

[10] Crane T.E., Badger T.A., Sikorskii A., et al. Trajectories of Depression and Anxiety in Latina Breast Cancer Survivors // Oncol. Nurs. Forum. 2019. Vol. 46, No. 2. P. 217–227. DOI: 10.1188/19.ONF.217-227

[11] Gong Y, Tan Q, Qin Q, et al. Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study. Medicine (Baltimore). 2020;99(20): e19834. DOI: 10.1097/MD.0000000000019834

[12] Gong Y., Tan Q., Qin Q., et al. Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study // Medicine (Baltimore). 2020. Vol. 99, No. 20. Art. e19834. DOI: 10.1097/MD.0000000000019834

[13] Jensen MP, Chang HY, Lai YH, et al. Pain in long-term breast cancer survivors: frequency, severity, and impact. Pain Med. 2010;11(7):1099–1106. DOI: 10.1111/j.1526-4637.2010.00880.x

[14] Jensen M.P., Chang H.Y., Lai Y.H., et al. Pain in long-term breast cancer survivors: frequency, severity, and impact // Pain Med. 2010. Vol. 11, No. 7. P. 1099–1106. DOI: 10.1111/j.1526–4637.2010.00880.x

[15] Liu Z, Xu C, Xu Y, et al. Decreased regional homogeneity in insula and cerebellum: A resting-state fMRI study in patients with major depression and subjects at high risk for major depression. Psychiatry Res. 2010;182(3):211–215. DOI: 10.1016/j.pscychresns.2010.03.004

[16] Liu Z., Xu C., Xu Y., et al. Decreased regional homogeneity in insula and cerebellum: A resting-state fMRI study in patients with major depression and subjects at high risk for major depression // Psychiatry Res. 2010. Vol. 182, No. 3. P. 211–215. DOI: 10.1016/j.pscychresns.2010.03.004

[17] Fitzgerald PB, Laird AR, Maller J, Daskalakis ZJ. A meta-analytic study of changes in brain activation in depression. Hum Brain Mapp. 2008;29:683–695. DOI: 10.1002/hbm.20426

[18] Fitzgerald P.B., Laird A.R., Maller J., Daskalakis Z.J. A meta-analytic study of changes in brain activation in depression // Hum. Brain Mapp. 2008. Vol. 29. P. 683–695. DOI: 10.1002/hbm.20426

[19] Guo WB, Sun XL, Liu L, et al.. Disrupted regional homogeneity in treatment-resistant depression: A resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35:1297–1302.

[20] Guo W.B., Sun X.L., Liu L., et al.. Disrupted regional homogeneity in treatment-resistant depression: A resting-state fMRI study // Prog. Neuropsychopharmacol. Biol. Psychiatry. 2011. Vol. 35. P. 1297–1302.

[21] Kennedy SH, Evans KR, Krüger S, et al. Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. Am J Psychiatry. 2001;158:899–905. DOI: 10.1176/appi.ajp.158.6.899

[22] Kennedy S.H., Evans K.R., Krüger S., et al. Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression // Am. J. Psychiatry. 2001. Vol. 158. P. 899–905. DOI: 10.1176/appi.ajp.158.6.899

[23] Mayberg HS, Brannan SK, Tekell JL, et al. Regional metabolic effects of fluoxetine in major depression: Serial changes and relationship to clinical response. Biol Psychiatry. 2000;48:830–843. DOI: 10.1016/s0006-3223(00)01036-2

[24] Mayberg H.S., Brannan S.K., Tekell J.L., et al. Regional metabolic effects of fluoxetine in major depression: Serial changes and relationship to clinical response // Biol. Psychiatry. 2000. Vol. 48. P. 830–843. DOI: 10.1016/s0006-3223(00)01036-2

[25] 13.De Asis JM, Silbersweig DA, Pan H, et al. Neuroimaging studies of fronto-limbic dysfunction in geriatric depression. Clin Neurosci Res. 2003;2:324–330. DOI: 10.1016/s1566-2772(03)00009-4

[26] De Asis J.M., Silbersweig D.A., Pan H., et al. Neuroimaging studies of fronto-limbic dysfunction in geriatric depression // Clin. Neurosci. Res. 2003. Vol. 2. P. 324–330. DOI: 10.1016/s1566-2772(03)00009-4

[27] Fu C, Zhang H, Xuan A, et al. A combined study of 18F-FDG PET-CT and fMRI for assessing resting cerebral function in patients with major depressive disorder. Exp Ther Med. 2018;16(3):1873–1881. DOI: 10.3892/etm.2018.6434

[28] Fu C, Zhang H, Xuan A, et al. A combined study of 18F-FDG PET-CT and fMRI for assessing resting cerebral function in patients with major depressive disorder // Exp. Ther. Med. 2018. Vol. 16, No. 3. P. 1873–1881. DOI: 10.3892/etm.2018.6434

[29] Horti AG, Naik R, Foss CA, et al. PET imaging of microglia by targeting macrophage colony-stimulating factor 1 receptor (CSF1R). Proc Natl Acad Sci USA. 2019;116(5):1686–1691. DOI: 10.1073/pnas.1812155116

[30] Horti A.G., Naik R., Foss C.A., et al. PET imaging of microglia by targeting macrophage colony-stimulating factor 1 receptor (CSF1R) \\ Proc. Natl. Acad. Sci. U S A. 2019. Vol. 116, No. 5. P. 1686–1691. DOI: 10.1073/pnas.1812155116

[31] Li J, Ouyang W. Application of PET Imaging in the Brain Regions of the Emotional Control Loop in Patients with Generalized Anxiety Disorder. J Healthc Eng. 2021;2021:4505227. DOI: 10.1155/2021/4505227

[32] Li J., Ouyang W. Application of PET Imaging in the Brain Regions of the Emotional Control Loop in Patients with Generalized Anxiety Disorder // J Healthc Eng. 2021. Vol. 2021. Art. 4505227. DOI: 10.1155/2021/4505227

[33] Wu JC, Buchsbaum MS, Hershey TG, et al. PET in generalized anxiety disorder. Biol Psychiatry. 1991;29(12):1181–1199. DOI: 10.1016/0006-3223(91)90326-h

[34] Wu J.C., Buchsbaum M.S., Hershey T.G., et al. PET in generalized anxiety disorder // Biol. Psychiatry. 1991. Vol. 29, No. 12. P. 1181–1199. DOI: 10.1016/0006-3223(91)90326-h

[35] Shah NN, Schwandt ML, Hobden B, et al. The validity of the state-trait anxiety inventory and the brief scale for anxiety in an inpatient sample with alcohol use disorder. Addiction. 2021;116(11): 3055–3068. DOI: 10.1111/add.15516

[36] Shah N.N., Schwandt M.L., Hobden B., et al. The validity of the state-trait anxiety inventory and the brief scale for anxiety in an inpatient sample with alcohol use disorder // Addiction. 2021. Vol. 116, No. 11. P. 3055–3068. DOI: 10.1111/add.15516

[37] Passik SD, Kirsh KL, Donaghy KB, et al.An attempt to employ the Zung Self-Rating Depression Scale as a “lab test” to trigger follow-up in ambulatory oncology clinics: criterion validity and detection. J Pain Symptom Manage. 2001;21(4):273–281. DOI: 10.1016/s0885-3924(00)00264-5

[38] Passik S.D., Kirsh K.L., Donaghy K.B., et al. An attempt to employ the Zung Self-Rating Depression Scale as a “lab test” to trigger follow-up in ambulatory oncology clinics: criterion validity and detection // J. Pain Symptom Manage. 2001. Vol. 21, No. 4. P. 273–281. DOI: 10.1016/s0885-3924(00)00264-5

[39] Northoff G, Zilio F. Temporo-spatial Theory of Consciousness (TTC) — Bridging the gap of neuronal activity and phenomenal states. Behavioural Brain Research. 2022;424:113788. DOI: 10.1016/j.bbr.2022.113788

[40] Northoff G., Zilio F. Temporo-spatial Theory of Consciousness (TTC) — Bridging the gap of neuronal activity and phenomenal states // Behav. Brain Res. 2022. Vol. 424. Art. 113788. DOI: 10.1016/j.bbr.2022.113788

Funding

Грант Минобрнауки РФGrant of the Ministry of Education and Science of the Russian Federation(075-15-2020-901)

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