{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:55:56Z","timestamp":1785862556989,"version":"3.56.0"},"reference-count":57,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer\u2010related fatigue is a prevalent and debilitating symptom in patients with breast cancer (BC) undergoing chemotherapy (CTx), yet its early neural correlates remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal study included 61 female patients with BC and 41 healthy female controls assessed before CTx and after two cycles of CTx, or at matched intervals. Assessments included 3T brain magnetic resonance imaging, patient\u2010reported fatigue and quality\u2010of\u2010life measures, clinician\u2010rated affective symptom scales, and an objective cognitive screening measure. Surface\u2010based analyses were used to extract cortical microstructural measures, including cortical mean diffusivity (cMD), and macrostructural measures. Linear mixed\u2010effects models were used to examine longitudinal changes and group\u2010by\u2010time interaction effects in clinical, patient\u2010reported, cognitive, and cortical structural outcomes, as well as their associations during early CTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During early CTx, patients with BC showed worsening fatigue and worsened emotional well\u2010being, and changes in these outcomes were positively associated. cMD decreased over time in the left isthmus cingulate cortex, and the magnitude of this decrease was associated with worsening fatigue and worsened emotional well\u2010being. Mediation analysis suggested an indirect association between cMD changes in this region and fatigue through worsened emotional well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that early increases in fatigue during CTx are linked to worsening emotional well\u2010being and region\u2010specific cortical microstructural changes. The results highlight a potentially informative neural\u2010affective pathway in the early emergence of fatigue, while requiring replication and further validation before clinical translation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70558","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:39:03Z","timestamp":1785245943000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early neural signatures of cancer\u2010related fatigue: A longitudinal magnetic resonance imaging study of cortical micro\u2010 and macrostructural changes during breast cancer chemotherapy"],"prefix":"10.1002","volume":"132","author":[{"given":"Yanfei","family":"Zhou","sequence":"first","affiliation":[{"name":"University of Science and Technology of China  Hefei China"},{"name":"Hefei Cancer Hospital of CAS Institute of Health and Medical Technology Hefei Institutes of Physical Science 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