Graduation Date

Spring 5-5-2018

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Matthew Rizzo, MD

Abstract

Multiple cancer populations frequently report cognitive impairment following treatment with chemotherapy agents (“chemo-brain”). Impaired neuropsychological performance is commonly reported in cognitive domains of attention and executive function. Understanding neural mechanisms underlying cognitive impairments is essential to developing prevention and rehabilitation strategies. Brain imaging studies frequently show chemotherapy-related impairments within the attentional control network, which is comprised of a constellation of cortical regions that govern reportedly impaired cognitive functions. In the current dissertation research, I developed a novel electrophysiology battery aimed at recording near-instantaneous neural activity within the attentional control network during cognitive task performance. Cancer patients diagnosed with hematological malignancy (e.g. lymphoma, myeloma) completed three longitudinal assessments: (1) prior to starting chemotherapy, and following (2) one-month and (3) three-months of chemotherapy. Comparison groups included patients not receiving chemotherapy and demographically-matched healthy controls. Outcome measures provide initial support for contributions from both tumor biology and chemotherapy toxicity to functional changes in attentional control network activity. Furthermore, both cancer groups showed evidence for reduced information processing capacity while completing a simulation of naturalistic driving behavior. These results provide a unique platform for understanding basic neural mechanisms and translational impacts of attentional control impairment in cancer patients. Future large-scale studies must be committed to confirming these results, and further innovative work is necessary to confirm the link between previous brain imaging studies and cognitive electrophysiology measures used here. Innovative chemotherapies are improving survivorship among cancer patients. Thus, ensuring long-term quality of life among our growing cancer survivor population is paramount to achieving the highest level of public health and safety.

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