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Background <p>Breast cancer (BC) survivors frequently endure psychological distress following chemotherapy, with subjective memory decline being a prevalent aspect of chemotherapy-related cognitive impairment (CRCI). This study aimed to assess the influence of psychological distress on subjective memory decline in BC survivors with CRCI and investigate potential underlying mechanisms.</p> Methods <p>A total of 104 BC survivors who had completed chemotherapy were categorized based on the distress thermometer (DT) score into a no-psychological distress group (NPD group, <i>n</i> = 51) and a psychological distress group (PD group, <i>n</i> = 53). The groups were compared using the Mini-Mental State Examination (MMSE), the Prospective and Retrospective Memory (PM and RM) Questionnaire (PRMQ), cytokine levels (of interleukin-1β [IL-1β], tumor necrosis factor-alpha [TNF-α], and IL-4), and inflammatory markers (neutrophil-to- lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte count-to-lymphocyte ratio [MLR], granulocyte-to-lymphocyte ratio [GLR], and systemic immune-inflammation index [SII]). Mediation analysis was performed to explore whether cytokine and inflammatory marker levels mediate the effect of psychological distress on subjective memory function complaints.</p> Results <p>The NPD group performed significantly better in the PD group both RM (<i>z</i> = -3.370, <i>p</i> = 0.001) and PM (<i>z</i> = -1.967, <i>p</i> = 0.049). The IL-1β levels were substantially higher in the PD group than in the NPD group (<i>z</i> = -2.920, <i>p</i> = 0.004). Similarly, NLR (<i>z</i> = -2.585, <i>p</i> = 0.010), GLR (<i>z</i> = -2.858, <i>p</i> = 0.004), and SII (<i>z</i> = -2.747, <i>p</i> = 0.006) were higher in the PD group. Mediation analysis revealed that IL-1β partially mediated the relationship between DT and RM (<i>β</i> = 0.019, <i>p</i> = 0.007), while SII fully mediated the relationship between DT and PM (<i>β</i> = 0.003, <i>p</i> = 0.017).</p> Conclusion <p>BC survivors experiencing psychological distress exhibited worse subjective memory and elevated levels of IL-1β, NLR, GLR, and SII. These findings suggest that inflammation may be a cause of subjective memory function complaints in BC survivors with psychological distress.</p>

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Expression of inflammatory states in response to psychological distress in breast cancer survivors and its relationship to subjective memory function complaints

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月25日

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  • Chen Gan,
  • Senbang Yao,
  • Jingjing Zhao,
  • Huangyuxin Shi,
  • Jian Xu,
  • Mingjun Zhang,
  • Huaidong Cheng

摘要

Background

Breast cancer (BC) survivors frequently endure psychological distress following chemotherapy, with subjective memory decline being a prevalent aspect of chemotherapy-related cognitive impairment (CRCI). This study aimed to assess the influence of psychological distress on subjective memory decline in BC survivors with CRCI and investigate potential underlying mechanisms.

Methods

A total of 104 BC survivors who had completed chemotherapy were categorized based on the distress thermometer (DT) score into a no-psychological distress group (NPD group, n = 51) and a psychological distress group (PD group, n = 53). The groups were compared using the Mini-Mental State Examination (MMSE), the Prospective and Retrospective Memory (PM and RM) Questionnaire (PRMQ), cytokine levels (of interleukin-1β [IL-1β], tumor necrosis factor-alpha [TNF-α], and IL-4), and inflammatory markers (neutrophil-to- lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte count-to-lymphocyte ratio [MLR], granulocyte-to-lymphocyte ratio [GLR], and systemic immune-inflammation index [SII]). Mediation analysis was performed to explore whether cytokine and inflammatory marker levels mediate the effect of psychological distress on subjective memory function complaints.

Results

The NPD group performed significantly better in the PD group both RM (z = -3.370, p = 0.001) and PM (z = -1.967, p = 0.049). The IL-1β levels were substantially higher in the PD group than in the NPD group (z = -2.920, p = 0.004). Similarly, NLR (z = -2.585, p = 0.010), GLR (z = -2.858, p = 0.004), and SII (z = -2.747, p = 0.006) were higher in the PD group. Mediation analysis revealed that IL-1β partially mediated the relationship between DT and RM (β = 0.019, p = 0.007), while SII fully mediated the relationship between DT and PM (β = 0.003, p = 0.017).

Conclusion

BC survivors experiencing psychological distress exhibited worse subjective memory and elevated levels of IL-1β, NLR, GLR, and SII. These findings suggest that inflammation may be a cause of subjective memory function complaints in BC survivors with psychological distress.