ABSTRACT
Chemotherapy is one of the most widely used treatments for breast cancer (BC). However, there is evidence of side effects like cognitive changes related to the chemotherapy treatment. The aim of the study was not only to summarize the existing evidence on the relationship between chemotherapy and cognitive performance in women with BC but also to identify additional consequences and aspects associated with these impairments. We conducted a systematic review with meta-analysis and meta-regression to present updated information on the matter. We retrieved data from the databases PubMed, Web of Science, PsycINFO, CINAHL, and Scopus. Twenty studies comprising over 2,500 women were examined and the results indicated that chemotherapy can compromise cognition in women with BC (-1.10 OR [95%CI: -1.81 to -0.74], P<0.01), with working memory (-0.49 OR [95%CI: -0.85 to -0.13], P=0.03) being the most affected among the domains. Furthermore, additional data indicated that cognitive impairment is most likely amid women with BC having a lower education level (Q=4.85, P=0.02). Our results suggested that chemotherapy affects cognitive functions in women with BC, and certain characteristics can worsen the deterioration. A comprehensive study of women with breast cancer and existing predictors contributes to optimized personal journeys, elevated life prospects, and advanced care that can also aid prognosis and therapeutic approaches.
ABSTRACT
Purpose: To evaluate and compare choroidal thickness in patients with fibromyalgia (FM) and healthy controls. Methods: In this prospective, cross-sectional study, forty eyes of 40 patients with FM and 40 eyes of 40 age- and sex-matched healthy subjects were enrolled. FM was diagnosed according to the American College of Rheumatology criteria. The choroidal thickness measurements of the subjects were obtained using spectral-domain optical coherence tomography (RTVue-100, Optovue). Widespread pain index (WPI), symptom severity scale (SSS), and fibromyalgia impact questionnaire (FIQ) scores were recorded. The choroidal thickness measurements of the groups were compared, and correlations among the WPI, SSS, and FIQ scores and these measurements were calculated. Results: Choroidal thicknesses at 1500 ?m nasally were 198.5 ± 46.7 ?m and 306.3 ± 85.4 ?m; at 1000 ?m nasally were 211.7 ± 50.2 ?m and 310.05 ± 87.26 ?m; at 500 ?m nasally were 216 ± 55.05 ?m and 311.5 ± 83.4 ?m; at subfoveal region were 230.9 ± 58.4 ?m and 332.4 ± 91.3 ?m; at 500 ?m temporally 227.5 ± 58.1 ?m and 318.15 ± 92.3 ?m; at 1000 ?m temporally 224.5 ± 57.07 ?m and 315.1 ± 84.2 ?m; at 1500 ?m temporally 212.5 ± 56.08 ?m and 312.9 ± 87.8 ?m in the FM and control groups, respectively (P < 0.001). Choroidal thicknesses were thinner at all measurement location, except temporal 1000 and 1500 in patients with FIQ score ?50 than in FIQ score <50. Conclusion: The results of this study demonstrated that choroidal thickness decreases in patients with FM and correlated with disease activity. This choroidal changes might be related with the alterations in autonomic nervous system functioning. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and FM.