Negative affect and stress-related brain metabolism in patients with metastatic breast cancer

Joaquim C. Reis, Luzia Travado, Michael H. Antoni, Francisco P.M. Oliveira, Silvia D. Almeida, Pedro Almeida, Aaron S. Heller, Berta Sousa, Durval C. Costa

Research output: Contribution to journalArticlepeer-review


Background: Cancer and its treatment represent major stressors requiring that patients make multiple adaptations. Despite evidence that poor adaptation to stressors is associated with more distress and negative affect (NA), neuroimmune dysregulation and poorer health outcomes, current understanding is very limited of how NA covaries with central nervous system changes to account for these associations. Methods: NA was correlated with brain metabolic activity using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in several regions of interest in 61 women with metastatic breast cancer. Patients underwent 18F-FDG PET/CT and completed an assessment of NA using the Brief Symptom Inventory. Results: Regression analyses revealed that NA was significantly negatively correlated with the standardized uptake value ratio of the insula, thalamus, hypothalamus, ventromedial prefrontal cortex, and lateral prefrontal cortex. Voxel-wise correlation analyses within these 5 regions of interest demonstrated high left-right symmetry and the highest NA correlations with the anterior insula, thalamus (medial and ventral portion), lateral prefrontal cortex (right Brodmann area 9 [BA9], left BA45, and right and left BA10 and BA8), and ventromedial prefrontal cortex (bilateral BA11). Conclusions: The regions of interest most strongly negatively associated with NA represent key areas for successful adaptation to stressors and may be particularly relevant in patients with metastatic breast cancer who are dealing with multiple challenges of cancer and its treatment.

Original languageEnglish (US)
Pages (from-to)3122-3131
Number of pages10
Issue number13
StatePublished - Jul 1 2020


  • distress
  • metastatic breast cancer; negative affect
  • stress-related brain metabolism

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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