ArticlePloS one2023
Amygdalar activity measured using FDG-PET/CT at head and neck cancer staging independently predicts survival.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 6 citations in OpenAlex.
- Psychological distress as a putative host-state determinant of cancer immunotherapy response.Frontiers in immunology · 2026Review
- Total Body PET.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2026Review
- Association between chronic stress-related amygdala metabolic activity and distant metastasis in colorectal cancer.Frontiers in endocrinology · 2026Article
- Age modulates the link between stress-related neural activity and mortality.Nature communications · 2025Article
- Heart-brain axis: Pushing the boundaries of cardiovascular molecular imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2024Review
- Imaging of the brain-heart axis: prognostic value in a European setting.European heart journal · 2024Article
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Authors and funding
21 authors at 4 institutions in 3 countries.
Funding
Abstract
importanceThe mechanisms underlying the association between chronic stress and higher mortality among individuals with cancer remain incompletely understood.
objectiveTo test the hypotheses that among individuals with active head and neck cancer, that higher stress-associated neural activity (ie. metabolic amygdalar activity [AmygA]) at cancer staging associates with survival.
designRetrospective cohort study.
settingAcademic Medical Center (Massachusetts General Hospital, Boston).
participants240 patients with head and neck cancer (HNCA) who underwent 18F-FDG-PET/CT imaging as part of initial cancer staging. MEASUREMENTS: 18F-FDG uptake in the amygdala was determined by placing circular regions of interest in the right and left amygdalae and measuring the mean tracer accumulation (i.e., standardized uptake value [SUV]) in each region of interest. Amygdalar uptake was corrected for background cerebral activity (mean temporal lobe SUV).
resultsAmong individuals with HNCA (age 59±13 years; 30% female), 67 died over a median follow-up period of 3 years (IQR: 1.7-5.1). AmygA associated with heightened bone marrow activity, leukocytosis, and C-reactive protein (P<0.05 each). In adjusted and unadjusted analyses, AmygA associated with subsequent mortality (HR [95% CI]: 1.35, [1.07-1.70], P = 0.009); the association persisted in stratified subset analyses restricted to patients with advanced cancer stage (P<0.001). Individuals within the highest tertile of AmygA experienced a 2-fold higher mortality rate compared to others (P = 0.01). The median progression-free survival was 25 months in patients with higher AmygA (upper tertile) as compared with 36.5 months in other individuals (HR for progression or death [95%CI], 1.83 [1.24-2.68], P = 0.001). CONCLUSIONS AND RELEVANCE: AmygA, quantified on routine 18F-FDG-PET/CT images obtained at cancer staging, independently and robustly predicts mortality and cancer progression among patients with HNCA. Future studies should test whether strategies that attenuate AmygA (or its downstream biological consequences) may improve cancer survival.
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