Complaints of reduced cognitive abilities are frequent following chemotherapy. Research in the breast cancer population has revealed some patients may experience treatment-related decline in cognitive domains such as executive function, information processing speed, memory and learning, attention and concentration, and working memory. The extent and mechanism of action of this phenomenon remain poorly understood. Neuroimaging research can characterize the neural underpinnings of chemotherapy-related cognitive impairment; however, with few longitudinal studies, more prospective studies are needed to elucidate this important topic. The aim of this thesis was to use magnetic resonance imaging and contemporary analysis techniques to better understand the influence chemotherapy exerts on both the brain and cognition. This was achieved in two studies that measured cognitive function and brain structure and function at three time points: pre-treatment, one month post-chemotherapy, and at one-year follow-up. In the first study, the association between regions of brain structural changes and cognitive function was examined. The second study took a narrower approach and investigated the functional profile of brain activity during a working memory task. Patients had more pronounced structural and functional disruptions shortly after treatment, relative to both pre-treatment and one-year post-chemotherapy intervals. Regions of structural compromise were largely associated with information processing speed. Functional disruptions occurred in a frontoparietal network. Overall, this thesis provides more evidence of the injurious role chemotherapy plays on cognition, particularly in the short term. This thesis also provides the first longitudinal neuroimaging study to illustrate a complete resolution of working memory related brain disruption one year post-treatment.

Cognitive impairment, “Chemofog”, has been well established as a negative outcome of otherwise successful medical radiation treatments. Mitigation of this negative feature would dramatically increase quality of life for those recovering from cancer treatment. There is currently no known intervention to protect or restore cognitive function of patients undergoing radiation treatments. Development of a multiple ingredient dietary supplement (MDS) is meant to offer a non-invasive therapy to help mitigate risk and decrease damage to individuals. The MDS was originally designed to off-set 5 key mechanisms associated with aging including oxidative damage, inflammation, impaired glucose metabolism, mitochondrial dysfunction and membrane deterioration. Radiation damage shares many of the same deficiencies that develop with age and supplementation with MDS would impact many of the same pathways. Changes in cytokine profile (inflammation markers), and biomarkers of behavioural functions, sensory functions, and oxidative damage provide preliminary evidence of MDS impacts. / Thesis / Bachelor of Science (BSc) / Cognitive impairment, “Chemofog”, has been well established as a negative outcome of otherwise successful medical radiation treatments. Mitigation of this negative feature would dramatically increase quality of life for those recovering from cancer treatment. There is currently no known intervention to protect or restore cognitive function of patients undergoing radiation treatments. Development of a multiple ingredient dietary supplement (MDS) is meant to offer a non-invasive therapy to help mitigate risk and decrease damage to individuals. The MDS was originally designed to off-set 5 key mechanisms associated with aging including oxidative damage, inflammation, impaired glucose metabolism, mitochondrial dysfunction and membrane deterioration. Radiation damage shares many of the same deficiencies that develop with age and supplementation with MDS would impact many of the same pathways.

The side-effects of chemotherapy treatment are an increasingly important research focus as more cancer patients are reaching survivorship. While treatment allows for survival, it can also lead to problems which can significantly affect quality of life. Cognitive impairments after chemotherapy treatment are one such factor. First presented as anecdotal patient reports, over the last decade empirical evidence for this cognitive concern has been obtained. Much attention has been focused on post-chemotherapy research, yet little attention has been granted to these same patients’ cognition before treatment commences. Breast cancer (BC) patients face many obstacles before chemotherapy treatment such as: surgery and side-effects of anesthesia, increased cytokine activity, stress of a new disease diagnosis and upcoming challenges, and emotional burdens such as depression and anxiety. Many of these factors have independently been shown to affect cognitive abilities in both healthy populations as well as other patient groups. Therefore, the pre-treatment (or baseline) BC patient status warrants systematic study. This would then reduce mistakenly attributing carried-over cognitive deficits to side effects of chemotherapy. As well, it is possible that certain confounding variables may have neural manifestations at baseline that could be exacerbated by chemotherapy agents. The following thesis first presents a review paper which critically describes the current literature examining chemotherapy-related cognitive impairments (CRCIs), as well as possible confound variables affecting this population. Subsequently, three original research papers present pre-chemotherapy data showing significant neuroanatomical and neurofunctional differences in BC patients compared to controls. In particular, these neural differences are present in brain regions that have been reported in post-chemotherapy papers. This, as well as the effects of variables such as the number of days since surgery, depression and anxiety scores and more, support the initiative that research attention should increase focus on these patients at baseline in order to better understand their post-chemotherapy results.

The side-effects of chemotherapy treatment are an increasingly important research focus as more cancer patients are reaching survivorship. While treatment allows for survival, it can also lead to problems which can significantly affect quality of life. Cognitive impairments after chemotherapy treatment are one such factor. First presented as anecdotal patient reports, over the last decade empirical evidence for this cognitive concern has been obtained. Much attention has been focused on post-chemotherapy research, yet little attention has been granted to these same patients’ cognition before treatment commences. Breast cancer (BC) patients face many obstacles before chemotherapy treatment such as: surgery and side-effects of anesthesia, increased cytokine activity, stress of a new disease diagnosis and upcoming challenges, and emotional burdens such as depression and anxiety. Many of these factors have independently been shown to affect cognitive abilities in both healthy populations as well as other patient groups. Therefore, the pre-treatment (or baseline) BC patient status warrants systematic study. This would then reduce mistakenly attributing carried-over cognitive deficits to side effects of chemotherapy. As well, it is possible that certain confounding variables may have neural manifestations at baseline that could be exacerbated by chemotherapy agents. The following thesis first presents a review paper which critically describes the current literature examining chemotherapy-related cognitive impairments (CRCIs), as well as possible confound variables affecting this population. Subsequently, three original research papers present pre-chemotherapy data showing significant neuroanatomical and neurofunctional differences in BC patients compared to controls. In particular, these neural differences are present in brain regions that have been reported in post-chemotherapy papers. This, as well as the effects of variables such as the number of days since surgery, depression and anxiety scores and more, support the initiative that research attention should increase focus on these patients at baseline in order to better understand their post-chemotherapy results.

The side-effects of chemotherapy treatment are an increasingly important research focus as more cancer patients are reaching survivorship. While treatment allows for survival, it can also lead to problems which can significantly affect quality of life. Cognitive impairments after chemotherapy treatment are one such factor. First presented as anecdotal patient reports, over the last decade empirical evidence for this cognitive concern has been obtained. Much attention has been focused on post-chemotherapy research, yet little attention has been granted to these same patients’ cognition before treatment commences. Breast cancer (BC) patients face many obstacles before chemotherapy treatment such as: surgery and side-effects of anesthesia, increased cytokine activity, stress of a new disease diagnosis and upcoming challenges, and emotional burdens such as depression and anxiety. Many of these factors have independently been shown to affect cognitive abilities in both healthy populations as well as other patient groups. Therefore, the pre-treatment (or baseline) BC patient status warrants systematic study. This would then reduce mistakenly attributing carried-over cognitive deficits to side effects of chemotherapy. As well, it is possible that certain confounding variables may have neural manifestations at baseline that could be exacerbated by chemotherapy agents. The following thesis first presents a review paper which critically describes the current literature examining chemotherapy-related cognitive impairments (CRCIs), as well as possible confound variables affecting this population. Subsequently, three original research papers present pre-chemotherapy data showing significant neuroanatomical and neurofunctional differences in BC patients compared to controls. In particular, these neural differences are present in brain regions that have been reported in post-chemotherapy papers. This, as well as the effects of variables such as the number of days since surgery, depression and anxiety scores and more, support the initiative that research attention should increase focus on these patients at baseline in order to better understand their post-chemotherapy results.

The side-effects of chemotherapy treatment are an increasingly important research focus as more cancer patients are reaching survivorship. While treatment allows for survival, it can also lead to problems which can significantly affect quality of life. Cognitive impairments after chemotherapy treatment are one such factor. First presented as anecdotal patient reports, over the last decade empirical evidence for this cognitive concern has been obtained. Much attention has been focused on post-chemotherapy research, yet little attention has been granted to these same patients’ cognition before treatment commences. Breast cancer (BC) patients face many obstacles before chemotherapy treatment such as: surgery and side-effects of anesthesia, increased cytokine activity, stress of a new disease diagnosis and upcoming challenges, and emotional burdens such as depression and anxiety. Many of these factors have independently been shown to affect cognitive abilities in both healthy populations as well as other patient groups. Therefore, the pre-treatment (or baseline) BC patient status warrants systematic study. This would then reduce mistakenly attributing carried-over cognitive deficits to side effects of chemotherapy. As well, it is possible that certain confounding variables may have neural manifestations at baseline that could be exacerbated by chemotherapy agents. The following thesis first presents a review paper which critically describes the current literature examining chemotherapy-related cognitive impairments (CRCIs), as well as possible confound variables affecting this population. Subsequently, three original research papers present pre-chemotherapy data showing significant neuroanatomical and neurofunctional differences in BC patients compared to controls. In particular, these neural differences are present in brain regions that have been reported in post-chemotherapy papers. This, as well as the effects of variables such as the number of days since surgery, depression and anxiety scores and more, support the initiative that research attention should increase focus on these patients at baseline in order to better understand their post-chemotherapy results.