Inflammation, Attention, and Processing Speed in Patients with Breast Cancer before and after Chemotherapy
Menée à partir de données portant sur 519 patientes atteintes d'un cancer du sein et sur 338 témoins, cette étude analyse l'association entre la présence d'une inflammation et des difficultés dans l'attention et la rapidité de traitement des informations, avant et après la chimiothérapie
Background : Inflammation may contribute to cognitive difficulties in patients with breast cancer. We tested two hypotheses: inflammation is elevated in patients versus control subjects, and inflammation is associated with worse attention and processing speed over the course of chemotherapy. Methods : Serum cytokines (IL-4, 6, 8, 10; TNF-
α) and soluble receptors (sTNFRI, II) were measured in 519 females with breast cancer before and after chemotherapy and 338 females without cancer serving as controls. Attention/processing speed were measured by Rapid Visual Processing (RVP), Backward Counting (BCT), and Trail Making-A (TMT-A) tests. Linear regression models examined patient versus control cytokines/receptor levels, adjusting for covariates. Linear regression models also examined relationships between patient cytokines/receptor levels and test performance, adjusting for age, BMI, anxiety, depression, cognitive reserve, and chemotherapy duration. Statistical tests were two-sided (α
= 0.05). Results : sTNFRI and sTNFRII increased over time in patients relative to controls, while IL-4, IL-6 and IL-10 decreased. Pre-chemotherapy, higher IL-8 associated with worse BCT (
β
= 0.610, SE = 0.241, p = .01); higher IL-4 (
β=-1.098, SE
= 0.516, p = .03) and IL-10 (
β=-0.835, SE
= 0.414, p = .04) associated with better TMT-A. Post-chemotherapy, higher IL-8 (
β
= 0.841, SE = 0.260, p=.001), sTNFRI (
β
= 6.638, SE = 2.208, p = .003), sTNFRII (
β
= 0.913, SE = 0.455, p = .045) associated with worse BCT; higher sTNFRII also associated with worse RVP (
β=-1.316, SE
= 0.587, p = .03). Longitudinally, higher pre-chemotherapy IL-4 predicted RVP improvement over time (
β
= 0.820, SE = 0.336, p = .02); sTNFRI predicted worse BCT over time (
β
= 5.566, SE = 2.367, p = .02). Increases in IL-4 associated with BCT improvement over time (
β=-0.564, SE
= 0.253, p = .03). Conclusions : Generally, worse attention and processing speed were associated with higher inflammatory cytokines/receptors and lower anti-inflammatory cytokines in patients; future confirmatory studies are needed.