MRI-Based Brain Signatures of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Systematic Review and Meta-Analysis.

Authors

Ioana Creangă-Murariu, Eliza-Maria Armeanu, Vladimir Poroch, Bogdan-Ionel Tamba, Teodora Alexa-Stratulat, Bogdan Gafton, Mihai-Vasile Marinca, Vlad-Adrian Afrasanie, Diana Maria Puscasu, Matei Ioan Rusu, Iulian Prutianu

Published in

Diagnostics (Basel, Switzerland). Volume 16. Issue 11. May 25, 2026. Epub May 25, 2026.

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, disabling toxicity with no validated biomarkers. MRI-based functional neuroimaging could offer insight into central pain processing and may reveal reproducible brain signatures of CIPN. Methods: Following PRISMA 2020 (PROSPERO: CRD420251132102), we systematically reviewed whole-brain MRI studies in adult cancer patients with CIPN. Eligible MRI techniques included task-based fMRI, resting-state fMRI, perfusion MRI, and structural MRI. Data were synthesized through voxelwise activation likelihood estimation (ALE), systems-level region-of-interest (ROI) mapping, and proportion meta-analysis of regional involvement. Results: Of 2488 screened records, five observational studies were included. The voxelwise ALE analysis did not identify clusters surviving correction, but dispersed foci appeared within the default mode network (DMN), prefrontal executive cortex, and primary sensorimotor regions, suggesting the engagement of these pain-processing networks. ROI synthesis confirmed consistent alterations in the DMN and executive prefrontal and sensorimotor cortices in CIPN patients compared with controls, while the brainstem/periaqueductal gray and cerebellum were rarely implicated. Proportion meta-analysis further quantified these differences: CIPN patients showed altered involvement in 30% (95% CI 0.16-0.48) of contrasts, with the highest frequencies in the DMN (50%), sensorimotor (33%), and executive prefrontal regions (33%). By contrast, control-higher contrasts were less frequent (10%, 95% CI 0.03-0.27), highlighting CIPN-related increases particularly in self-referential and somatosensory networks. Conclusions: Across analytic approaches, CIPN is characterized by reproducible alterations in the DMN and executive prefrontal and sensorimotor networks. These central pain signatures represent promising MRI-based biomarkers for identifying and monitoring CIPN in oncology.

PMID:
42279487
Bibliographic data and abstract were imported from PubMed on 13 Sep 2026.

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