Magnetic resonance spectroscopic imaging and volumetric measurements of the brain in patients with postcancer fatigue: a randomized controlled trial

Hetty Prinsen, Arend Heerschap, Gijs Bleijenberg, Machiel J Zwarts, Jan Willem H Leer, Jack J van Asten, Marinette van der Graaf, Mark Rijpkema, Hanneke W M van Laarhoven, Hetty Prinsen, Arend Heerschap, Gijs Bleijenberg, Machiel J Zwarts, Jan Willem H Leer, Jack J van Asten, Marinette van der Graaf, Mark Rijpkema, Hanneke W M van Laarhoven

Abstract

Background: Postcancer fatigue is a frequently occurring problem, impairing quality of life. Until now, little is known about (neuro) physiological factors determining postcancer fatigue. For non-cancer patients with chronic fatigue syndrome, certain characteristics of brain morphology and metabolism have been identified in previous studies. We investigated whether these volumetric and metabolic traits are a reflection of fatigue in general and thus also of importance for postcancer fatigue.

Methods: Fatigued patients were randomly assigned to either the intervention condition (cognitive behavior therapy) or the waiting list condition. Twenty-five patients in the intervention condition and fourteen patients in the waiting list condition were assessed twice, at baseline and six months later. Baseline measurements of 20 fatigued patients were compared with 20 matched non-fatigued controls. All participants had completed treatment of a malignant, solid tumor minimal one year earlier. Global brain volumes, subcortical brain volumes, metabolite tissue concentrations, and metabolite ratios were primary outcome measures.

Results: Volumetric and metabolic parameters were not significantly different between fatigued and non-fatigued patients. Change scores of volumetric and metabolic parameters from baseline to follow-up were not significantly different between patients in the therapy and the waiting list group. Patients in the therapy group reported a significant larger decrease in fatigue scores than patients in the waiting list group.

Conclusions: No relation was found between postcancer fatigue and the studied volumetric and metabolic markers. This may suggest that, although postcancer fatigue and chronic fatigue syndrome show strong resemblances as a clinical syndrome, the underlying physiology is different.

Trial registration: ClinicalTrials.gov NCT01096641.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow chart of the study.
Figure 1. Flow chart of the study.
Figure 2. Examples of subcortical and global…
Figure 2. Examples of subcortical and global brain segmentation.
An example of subcortical brain segmentation of the thalamus in red in coronal (A), sagittal (B), and transversal plane (C), and an example of voxel-based segmentation of an anatomical image (D) in a gray matter image (E) and a white matter image (F).
Figure 3. Examples of spectra, background images,…
Figure 3. Examples of spectra, background images, and 1H Magnetic Resonance Spectroscopic Imaging grid.
An example of a Hanning filtered spectrum in the occipital cortex (A) and in the hippocampus (B) and the accompanying background image plus 1H Magnetic Resonance Spectroscopic Imaging grid (respectively C and D).

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Source: PubMed

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