This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Breast cancer survivor (BCS) patients have reported decline of mental performance after chemotherapy (problems in following every-day schedule, fatigue in keeping-up with previous working performance, depression, anxiety, attention and memory decline), a condition called """"""""Chemobrain"""""""". Never the less at routine clinical assessment cognitive compromise is often very subtle. Adjuvant chemotherapy consequences pose a question about subjectively reported and objectively observed symptoms of mental ability decline in BCS. A better understanding of the physiology behind adjuvant chemotherapy in the frontal areas of patients with breast cancer, holds promise to address short and long term effects of circulatory damage in the brain. In this study we will assess the brain hemodynamic behavior of patients with BC. Non-invasive optical techniques offer a tremendous sensitivity to hemoglobin components in breast and brain tissue, and can specifically relate their changes to oxygen transport and exchange impairment: Near infrared spectroscopy (NIRS) and density optical spectroscopy (DOS). The proposed study aims to investigate the neuro-vascular substrate associated with the chemobrain phenomenon in the frontal lobes during rest and during postural tilting in a small sample of BC patients. Subjects will be recruited as a sub-sample of BC patients participating to a larger study on chemotherapy effects on breast tissue, conducted at the UCI-Beckman Laser Institute. A dual optical sensor will be placed on the forehead of each participant and we will measure their neuro-vascular behavior in response to vascular regulation at different medication stages, due to postural tilting. A series of 8 repetitions head-tilt, including recovery time, per subject will require less than an hour acquisition session. Functional magnetic resonance imaging (fMRI) results have supported the hypothesis of lesser brain metabolism at rest in presence of adjuvant chemotherapy, and lesser brain activation in the frontal areas following a memory task. The mechanism behind the abnormal neuro-vascular metabolism in the frontal areas of the brain of BCS patient remains under investigated. Also the memory system is probably not the only one affected by adjuvant chemotherapy;first of all many memory systems exist, secondly strong emotional states interfere with attention. We propose to investigate effects of emotional stress on the attention system using an emotional recognition test (studied words can be nouns with emotional content), with different working memory load level (high vs. low).
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