Abstract
OBJECTIVE: This study employed the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index to investigate the glymphatic system's involvement in Managing Cancer and Living Meaningfully (CALM) intervention to improve chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCs). METHODS: 68 BCs were randomly assigned to the CALM (34 patients) or care-as-usual (CAU) (34 patients) groups. The Mini-Mental State Examination (MMSE) and Prospective and Retrospective Memory Questionnaire (PRMQ) were calculated for all patients before and after the intervention. Imaging data were collected from the CALM group to analyze the DTI-ALPS index before and after the intervention. RESULTS: The CALM group showed significant improvements than the CAU group in MMSE (F = 6.612; P = 0.012), retrospective memory (RM) (F = 5.154; P = 0.027), and prospective memory (PM) (F = 8.731; P = 0.004) scores after the intervention. A significantly increased in the DTI-ALPS index was observed following CALM intervention compared to baseline (t = -2.111; P = 0.042). The ∆DTI-ALPS index was correlated with both ΔMMSE (P = 0.027, r = 0.378) and ∆RM (P = 0.026, r = -0.381) scores. CONCLUSION: CALM intervention improved CRCI and glymphatic function in BCs,with observed correlations between these enhancements.