Self-judgment on emotional items modulates memory resources in breast cancer patients: a longitudinal MRI study

Abstract Breast-cancer (BC) patients (PT) frequently report memory problems pre-and post-cancer treatments that are not always corroborated by memory tests. We hypothesized that self-reported problems actually coincide with structural brain changes and that the discrepancy partly stems from BC-related distressed self-image and stress that alter arousal at memory encoding. To detect such subtle changes before/after treatments, we leveraged on known memory advantages related to self-image and stress in a longitudinal MRI study: the self-reference effect (SRE; better memory for what concerns oneself) and the negativity effect (NE; better memory for items with emotionally negative associations). We tested women with non-metastatic BC, before and one year after chemotherapy, and age-matched healthy women (HC) at similar time lapses. Neither group had clinical anxiety or depression. At each visit, participants completed an episodic memory fMRI task involving attributing character traits to themselves or someone else. Overall memory accuracy and SRE were similar between groups, but only HC showed NE. PT showed greater activity for self-judged positive traits in brain regions implicated in self-representation and emotional memory regulation. Functional connectivity and structural changes in these regions varied with self-representation and anxiety, but multivariate analyses with unsupervised machine learning suggest differences only partially characterize PT.