Pain Empathy Impairment In Breast Cancer Survivors Who Received Chemotherapy

Background: In recent years,chemotherapy-related cognitive impairment(CRCI)among breast cancer patients has become a hotspot in psycho-oncology fields.CRCI is defined that the different degrees of damage in multiple cognitive domains,such as memory,attention,mood,executive function and information processing speed,in breast cancer patients during or after chemotherapy.Previous studies on CRCI have mostly focused on memory,attention and other fields,and there is little research evidence on emotional regulation impairment in breast cancer patients following chemotherapy.Emotional regulation impairment has a negative impact on the quality of life in growing long-term cancer survivors after chemotherapy.Pain empathy is the ability to understand and experience the painful feelings of others and emotional response to others and an essential component of our emotional and social being.Event-related potential(ERP)has been frequently used to detect cognitive neuropsychological with non-invasive,high sensitivity and specificity.It is still unclear that changes and neurological mechanism of pain empathy in breast cancer patients after chemotherapy.Objective: To investigate the potential effects of chemotherapy on pain empathy and its neurological mechanism in breast cancer patients.Methods: Twenty-two patients with breast cancer were recruited from the Department of Oncology in the Second Affiliated Hospital of Anhui Medical University.Breast cancer patients were evaluated with the cognitive neuropsychological background test,the Chinese version of Interpersonal Reactivity Index(IRI-C)and the pain empathy task as well as the event-related potential(ERP)before chemotherapy and after at least six standardized chemotherapy cycles.The accuracy rate and response time and ERP data were recorded.Results: Compared to the baseline(before chemotherapy),patients showed lower scores in Digit Span Backward test(t=2.134,p=0.045)and lower scores in empathic concern(t=3.039,p=0.006)and higher scores(t=-2.324,p=0.030)in personal distress on the IRI-C after chemotherapy.There was a significant main effect of group(after vs.before chemotherapy)on accuracy rate(F=5.099,P=0.035),with patients before chemotherapy showing higher scores than after chemotherapy.For the accuracy rate,both task(F=34.558,P<0.001)and stimuli(F=37.976,P<0.001)main effects were significant,with higher AR in laterality task vs.pain task and lower AR for pain vs.neutral stimuli.There was no significant time × stimulus(neutral vs.pain)× task(pain vs.laterality)interaction for AR(F= 1.379,P=0.253).However,there was no significant difference in the response time in patients before and after chemotherapy.Besides,in the ERP data,the peak value of P2 in patients after chemotherapy was significantly lower(F=15.046,P=0.001)than before chemotherapy,however,the peak value of N1 in patients after chemotherapy was significantly higher(F=38.091,P<0.001).Conclusion: The result suggested pain empathy impairment in breast cancer patients after chemotherapy,which may be related to the changes of N1 and P2 in the ERP data,and added to the literature of chemotherapy-induced cognitive impairment in breast cancer patients.