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Joly F, Giffard B, Rigal O, De Ruiter MB, Small BJ, Dubois M, LeFel J, Schagen SB, Ahles TA, Wefel JS, Vardy JL, Pancré V, Lange M, Castel H. Impact of Cancer and Its Treatments on Cognitive Function: Advances in Research From the Paris International Cognition and Cancer Task Force Symposium and Update Since 2012. J Pain Symptom Manage 2015; 50:830-41. [PMID: 26344551 DOI: 10.1016/j.jpainsymman.2015.06.019] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/18/2015] [Accepted: 07/06/2015] [Indexed: 12/31/2022]
Abstract
CONTEXT Although cognitive impairments have been identified in patients with non-central nervous system cancer, especially breast cancer, the respective roles of cancer and therapies, and the mechanisms involved in cognitive dysfunction remain unclear. OBJECTIVES To report a state-of-the-art update from the International Cognitive and Cancer Task Force conference held in 2012. METHODS A report of the meeting and recent new perspectives are presented. RESULTS Recent clinical data support that non-central nervous system cancer per se may be involved in cognitive dysfunctions associated with inflammation parameters. The role of chemotherapy on cognitive decline was confirmed in colorectal and testicular cancers. Whereas the impact of hormone therapy remains debatable, some studies support a negative impact of targeted therapies on cognition. Regarding interventions, preliminary results of cognitive rehabilitation showed encouraging results. The methodology of future longitudinal studies has to be optimized by a priori end points, the use of validated test batteries, and the inclusion of control groups. Comorbidities and aging are important factors to be taken into account in future studies. Preclinical studies in animal models highlighted the role of cancer itself on cognition and support the possible benefits of prevention/care during chemotherapy. Progress in neuroimaging will help specify neural processes affected by treatments. CONCLUSION Clinical data and animal models confirmed that chemotherapy induces direct cognitive deficit. The benefits of cognitive rehabilitation are still to be confirmed. Studies evaluating the mechanisms underlying cognitive impairments using advanced neuroimaging techniques integrating the evaluation of genetic factors are ongoing.
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Affiliation(s)
- Florence Joly
- Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France; CHU Côte de Nacre, Caen, France; U1086 INSERM-UCBN Cancers & Préventions, Caen, France.
| | - Bénédicte Giffard
- UMR-S1077, UNICAEN, Normandie Université, Caen, France; U1077 INSERM, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Olivier Rigal
- Service des Soins de Support and Département d'Oncologie Médicale, Centre Henri-Becquerel, Rouen, France
| | - Michiel B De Ruiter
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Martine Dubois
- INSERM U982, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, DC2N, Astrocyte and Vascular Niche, Biomedical Research Institute (IRIB), University of Rouen, Mont-Saint-Aignan, France
| | - Johan LeFel
- Service des Soins de Support and Département d'Oncologie Médicale, Centre Henri-Becquerel, Rouen, France
| | - Sanne B Schagen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Tim A Ahles
- Neurology Service, Memorial Sloan-Kettering Cancer Center, and Weill Medical College of Cornell University, New York, New York, USA
| | - Jeffrey S Wefel
- Section of Neuropsychology, Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Janette L Vardy
- University of Sydney, Sydney, and Concord Cancer Centre, Concord Hospital, Concord, New South Wales, Australia
| | - Véronique Pancré
- NorthWest Canceropole, CNRS-UMR 8161-Institut de Biologie de Lille, Lille, France
| | - Marie Lange
- Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France; U1086 INSERM-UCBN Cancers & Préventions, Caen, France
| | - Hélène Castel
- INSERM U982, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, DC2N, Astrocyte and Vascular Niche, Biomedical Research Institute (IRIB), University of Rouen, Mont-Saint-Aignan, France
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111
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Knight SJ, Conklin HM, Palmer SL, Schreiber JE, Armstrong CL, Wallace D, Bonner M, Swain MA, Evankovich KD, Mabbott DJ, Boyle R, Huang Q, Zhang H, Anderson VA, Gajjar A. Working memory abilities among children treated for medulloblastoma: parent report and child performance. J Pediatr Psychol 2014; 39:501-11. [PMID: 24627465 DOI: 10.1093/jpepsy/jsu009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We investigated the 5-year postsurgical developmental trajectory of working memory (WM) in children with medulloblastoma using parent and performance-based measures. METHOD This study included 167 patients treated for medulloblastoma. Serial assessments of WM occurred at predetermined time points for 5 years. RESULTS There was a subtle, statistically significant increase in parental concern about WM, coupled with a statistically significant decrease in age-standardized scores on performance-based measures. However, whole-group mean scores on both parent and performance-based measures remained in the age-expected range. Posterior fossa syndrome was consistently associated with poorer WM. Younger age at treatment and higher treatment intensity were associated with greater negative change in WM performance only. CONCLUSIONS Most children treated for medulloblastoma display WM within the age-appropriate range according to parent report and performance. However, the subtle negative changes over time and identified subgroups at increased risk highlight the need for ongoing monitoring of this population.
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Affiliation(s)
- Sarah J Knight
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research HospitalClinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research HospitalClinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, D
| | - Heather M Conklin
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Shawna L Palmer
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Jane E Schreiber
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Carol L Armstrong
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Dana Wallace
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Melanie Bonner
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Michelle A Swain
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Karen D Evankovich
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Donald J Mabbott
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Robyn Boyle
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Qinlei Huang
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Hui Zhang
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Vicki A Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research HospitalClinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
| | - Amar Gajjar
- Clinical Sciences, Murdoch Childrens Research Institute, Children's Cancer Centre and Psychology Department, Royal Children's Hospital, Victorian Paediatric Rehabilitation Service, Monash Children's, Department of Paediatrics, The University of Melbourne, Department of Psychology, St. Jude Children's Research Hospital, Neuro-Oncology Program, Children's Hospital of Philadelphia, Department of Psychiatry, Duke University Medical Center, Royal Children's Hospital, Department of Pediatric Medicine, Texas Children's Hospital, Department of Psychology, The Hospital for Sick Children, Psychology Service, Sydney Children's Hospital, Department of Biostatistics St. Jude Children's Research Hospital, and Department of Oncology, St. Jude Children's Research Hospital
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