Sensorimotor cortical thickness changes following taxane-based chemotherapy: support for a CNS role in CIPN?

Research Objectives: Omran et al (2021) proposed that brain changes may influence the development of chemotherapy-induced neuropathy (CIPN). To begin to evaluate this possibility, we measured the effect of taxane exposure on cortical thickness within sensory-motor regions of the brain.

Design: Prospective, observational

Setting: Outpatient oncology

Participants: Twelve breast cancer (BC) survivors naïve to chemotherapy at commencement of study.

Interventions: One cycle of taxol-based chemotherapy, administered over 2-3 weeks.

Main Outcome Measures: Mean change in sensorimotor region cortical thickness, observed before vs after first chemotherapy cycle.

Results: Structural changes in mean cortical thickness were observed in the sensorimotor region of the brain after only one cycle of taxol-based chemotherapy (Figure 1).

Conclusions: While other studies have shown that BC chemotherapy treatment affects cortical thickness in other central regions (McDonald, 2010; LePage, 2012; Omran, 2021), to our knowledge, this is the first report of such effect in sensorimotor regions. Furthermore, this central effect occurred on the same timeline (i.e., after one chemotherapy cycle) as neurosensorimotor control changes we measured in a different cohort of breast cancer survivors, for whom postural control, gait variability, and patient-reported sensation declined in concert with each chemotherapy cycle (Monfort, 2016, 2017, 2019). It is possible that these reports of central and neurosensorimotor changes after one taxol-based chemotherapy cycle lend support to the hypothesis from Omron (2021): that brain changes influence the pathophysiology of CIPN. These data add support to the proposal that more study is warranted on the neurotraumatic effect of chemotherapy on brain structural integrity as well as on the relationship between central, peripheral, and behavioral effects of chemotherapy exposure.

Author(s) Disclosures: None. Research support was provided by a 2012 Idea Grant from the Pelatonia Foundation at The Ohio State University, NCI (R03-CA182165) and NSF (DGE-1343012). We thank Dr. Michael Knopp and Dr. David Osher for assistance collecting/analyzing neuroimaging data.