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@ARTICLE{Koppelmans:137358,
      author       = {Koppelmans, Vincent and de Groot, Marius and de Ruiter,
                      Michiel B and Boogerd, Willem and Seynaeve, Caroline and
                      Vernooij, Meike W and Niessen, Wiro J and Schagen, Sanne B
                      and Breteler, Monique M B},
      title        = {{G}lobal and focal white matter integrity in breast cancer
                      survivors 20 years after adjuvant chemotherapy.},
      journal      = {Human brain mapping},
      volume       = {35},
      number       = {3},
      issn         = {1065-9471},
      address      = {New York, NY},
      publisher    = {Wiley-Liss},
      reportid     = {DZNE-2020-03680},
      pages        = {889-899},
      year         = {2014},
      abstract     = {To date, only four small studies have investigated the
                      effects of adjuvant chemotherapy for breast cancer on the
                      microstructure of cerebral white matter with magnetic
                      resonance imaging (MRI). These studies, which were conducted
                      shortly up to 10 years post-treatment, showed that
                      chemotherapy is associated with focal loss of
                      microstructural white matter integrity. We investigated the
                      long-term effect of chemotherapy on white matter
                      microstructural integrity by comparing the brains of
                      chemotherapy-exposed breast cancer survivors to those of a
                      population-based sample of women without a history of
                      cancer.Diffusion tensor imaging (DTI) MRI (1.5 T) was
                      performed in 187 CMF (cyclophosphamide, methotrexate, and
                      5-flourouracil) chemotherapy-exposed breast cancer
                      survivors, mean age 64.2 (sd = 6.5) years, who had been
                      diagnosed with cancer on average 21.2 (sd = 4.4) years
                      before, and 374 age-matched cancer-free reference subjects
                      from a population-based cohort study. Outcome measures were
                      whole-brain microstructural integrity as measured by
                      fractional anisotropy and mean/axial/radial diffusivity and
                      focal white matter integrity, which was analyzed with
                      tract-based spatial statistics. All analyses were adjusted
                      for age, cardiovascular risk factors, education, and
                      symptoms of depression.No significant group differences were
                      observed in white matter integrity. However, within the
                      breast cancer survivors, time since treatment was inversely
                      associated with lower global and focal white matter
                      integrity.This cross-sectional study suggests that among
                      chemotherapy-exposed breast cancer survivors white matter
                      microstructural integrity deteriorates with accumulating
                      time since treatment. This warrants further investigation.},
      keywords     = {Aged / Antineoplastic Agents: adverse effects /
                      Antineoplastic Combined Chemotherapy Protocols: adverse
                      effects / Brain: drug effects / Brain: pathology / Breast
                      Neoplasms: drug therapy / Chemotherapy, Adjuvant: adverse
                      effects / Cross-Sectional Studies / Cyclophosphamide:
                      administration $\&$ dosage / Cyclophosphamide: adverse
                      effects / Diffusion Tensor Imaging: instrumentation /
                      Diffusion Tensor Imaging: methods / Female / Fluorouracil:
                      administration $\&$ dosage / Fluorouracil: adverse effects /
                      Humans / Leukoencephalopathies: chemically induced /
                      Leukoencephalopathies: pathology / Methotrexate:
                      administration $\&$ dosage / Methotrexate: adverse effects /
                      Middle Aged / Survivors / Time Factors / Antineoplastic
                      Agents (NLM Chemicals) / Cyclophosphamide (NLM Chemicals) /
                      Fluorouracil (NLM Chemicals) / Methotrexate (NLM Chemicals)},
      cin          = {AG Breteler 1},
      ddc          = {610},
      cid          = {I:(DE-2719)1012001},
      pnm          = {345 - Population Studies and Genetics (POF3-345)},
      pid          = {G:(DE-HGF)POF3-345},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:23281152},
      doi          = {10.1002/hbm.22221},
      url          = {https://pub.dzne.de/record/137358},
}