Altered structural covariance of the cortex and hippocampal formation in patients with lung cancer after chemotherapy.

OBJECTIVE: In this retrospective study, we aimed to investigate changes in brain morphology and structural topological networks in patients with lung cancer (LC) with or without chemotherapy. METHODS: We retrospectively recruited 191 participants for this cross-sectional study, including 113 patients with LC without chemotherapy (Ch-), 38 patients with LC with chemotherapy (Ch+), and 40 healthy controls (HC) matched for age, sex, and education. The gray matter volume (GMV) and cortical properties were compared among the three groups. We constructed the structural covariant network (SCN) based on cortical thickness, volumes of subcortical structures, and volumes of hippocampal subfields and the amygdala in all participants. The global and nodal topological properties of SCN were compared among groups. In addition, 23 patients with LC (8 Ch+ and 15 Ch-) who received two identical brain magnetic resonance scans were enrolled in the follow-up study. The paired t-test was used to compare group differences in brain morphology and topological properties in the structural network. RESULTS: The GMV of the bilateral caudate and thalamus were smaller in the Ch- and Ch + groups compared to the HC group using threshold-free cluster enhancement and permutation (P < 0.05, 5000 times permutations) for multiple comparison correction. The cortical SCN analysis suggested multiple enhanced nodal properties in several brain areas in Ch+ and Ch-compared to HC, mainly in the temporal gyrus, using permutations test and false discovery rate (FDR) (P < 0.05) corrections. Moreover, an increased sigma was found in the Ch + compared with HC (P = 0.0238). The reduced nodal degree (P = 0.0002) and betweenness (P = 0.0008) in the right amygdala of Ch + compared to HC were detected by subcortical SCN analysis. Furthermore, reduced gamma (P = 0.0342) and sigma (P < 0.0001) were found in Ch-compared with HC in the SCN analysis of subfields of the amygdala-hippocampal complex. In the follow-up study, reduced nodal degree (P < 0.0001) was found in the right anterior amygdala, and reduced clustering coefficient and local efficiency were found in patients with LC after the permutation test. CONCLUSIONS: Our study showed GMV defects and structural topological property abnormalities related to LC and chemotherapy. Such morphological changes associated with LC and chemotherapy could be used as imaging markers for clinical assessments and pathological indicators.