Objective:

To examine the results of previous functional neuroimaging studies and cognitive rehabilitation interventions explicitly reviewed for subsequent effects of neurocognitive consequences of chemotherapy in breast cancer patients.

Background:

Breast cancer patients who receive adjuvant chemotherapy are given to increase cure rates, with often accompanies cognitive deficits referred to as 'chemobrain'. Patients have noted this, and if neuropsychological assessments are employed even many years after treatment it can be detected.

Design/Methods:

A comprehensive literature search was conducted across Medline, PubMed, Embase, and Cochrane Library for studies published between 2010 and 2024. Descriptive studies in which cognitive changes in breast cancer patients undergoing chemotherapy were examined using functional brain imaging techniques and cognitive rehabilitation strategies were included.

Results:

Forty-two studies ranging from 2010 to 2023 about chemotherapy in breast cancer were included in this systematic review, wherein roughly 35% of thoroughly treated females reported substantial cognitive impairments—more so in executive function (mean difference=[MD]: −3.5 points; [95% confidence interval]=[CI]: −4.7 to −2.3, p<0.001). The imaging studies revealed aberrant functional connectivity of the anterior cingulate cortex (ACC); lower connectivity was negatively correlated with Stroop Interference Test response times (r=0.65, p<0.01). Pre-chemotherapy administered cognition scores showed, in 40% of test patients, evidence of cognitive dysfunction. Thus "Chemobrain" may not be entirely attributable to chemotherapy. In cognitive rehabilitation interventions, the cognitive function potentiated: (MD=+5.2, 95% CI=3.0-7.4 p<0.001) as well as quality of life (MD=+12.4, 95% CI=8.0-16.8, p<0.001).

Conclusions:

These findings hint at the need to consider pre-existing cognitive impairments and aberrations of functional connectivity in planning for treatment. Cognitive rehabilitation interventions show promise as a way to assist patients with chemotherapy-induced cognitive dysfunction; however, studies with bigger sample sizes need to be done to further elucidate these effects and validate intervention.