Fatigue and resting-state functional brain networks in breast cancer patients treated with chemotherapy

B.M. Bekele, M. Luijendijk, S.B. Schagen, M. de Ruiter, L. Douw

Research output: Contribution to JournalArticleAcademicpeer-review

3 Citations (Scopus)


Purpose: This longitudinal study aimed to disentangle the impact of chemotherapy on fatigue and hypothetically associated functional brain network alterations.

Methods: In total, 34 breast cancer patients treated with chemotherapy (BCC +), 32 patients not treated with chemotherapy (BCC -), and 35 non-cancer controls (NC) were included. Fatigue was assessed using the EORTC QLQ-C30 fatigue subscale at two time points: baseline (T1) and six months after completion of chemotherapy or matched intervals (T2). Participants also underwent resting-state functional magnetic resonance imaging (rsfMRI). An atlas spanning 90 cortical and subcortical brain regions was used to extract time series, after which Pearson correlation coefficients were calculated to construct a brain network per participant per timepoint. Network measures of local segregation and global integration were compared between groups and timepoints and correlated with fatigue.

Results: As expected, fatigue increased over time in the BCC + group (p = 0.025) leading to higher fatigue compared to NC at T2 (p = 0.023). Meanwhile, fatigue decreased from T1 to T2 in the BCC - group (p = 0.013). The BCC + group had significantly lower local efficiency than NC at T2 (p = 0.033), while a negative correlation was seen between fatigue and local efficiency across timepoints and all participants (T1 rho = - 0.274, p = 0.006; T2 rho = - 0.207, p = 0.039).

Conclusion: Although greater fatigue and lower local functional network segregation co-occur in breast cancer patients after chemotherapy, the relationship between the two generalized across participant subgroups, suggesting that local efficiency is a general neural correlate of fatigue.

Original languageEnglish
Pages (from-to)787-796
Number of pages10
JournalBreast Cancer Research and Treatment
Issue number3
Publication statusPublished - 1 Oct 2021


  • Brain/diagnostic imaging
  • Breast Neoplasms/drug therapy
  • Breast cancer
  • Fatigue
  • Fatigue/chemically induced
  • Female
  • Functional connectivity
  • Graph theory
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Network neuroscience

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