Cancer-related fatigue is associated with frontoparietal and motor network dysfunction: insights from a functional MRI study of patients with gastrointestinal tumors

Abstract Background and Aim: Although the recovery rate of patients with gastrointestinal tumors has significantly improved after chemotherapy, cancer-related fatigue (CRF) significantly impacts gastrointestinal tumor survivors, leading to fatigue, depression, and cognitive impairment. However, its neural mechanisms remain unclear, limiting the development of effective intervention. Therefore, this study utilizes whole brain functional magnetic resonance imaging (fMRI) analysis to explore CRF-related brain alterations in patients with gastrointestinal tumors. Methods This study included 50 patients with gastrointestinal tumors and 57 healthy controls. Fatigue Severity Scale (FSS), Hamilton Depression Scale, and Montreal Cognitive Assessment were used to assess fatigue, depression, and cognitive impairment, respectively. Brain changes in gastrointestinal cancer patients were investigated using the amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and whole-brain seed-based functional connectivity (FC). Results Compared to control, gastrointestinal cancer patients showed decreased fALFF in the bilateral middle frontal gyrus and reduced ReHo in the bilateral superior frontal gyrus, left precentral gyrus, and right supplementary motor area. Additionally, increased fALFF was observed in the left superior parietal gyrus and right cuneus, whereas FC between the left inferior parietal gyrus and the right supplementary motor area was reduced. Notably, in the patient group, fALFF in the bilateral middle frontal gyrus was significantly negatively correlated with FSS scores. Conclusion Frontoparietal and sensorimotor networks exhibited significantly altered CRF-related functional indicators in gastrointestinal cancer patients, which may aid in developing targeted treatment to alleviate fatigue and improve their quality of life.