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Raafat RS, Habib MZ, AbdElfattah AA, Olama NK, Abdelraouf SM, Hendawy N, Kamal KA, Nawishy SA, Aboul-Fotouh S. Amisulpride attenuates 5-fluorouracil-induced cognitive deficits via modulating hippocampal Wnt/GSK-3β/β-catenin signaling in Wistar rats. Int Immunopharmacol 2023; 124:110945. [PMID: 37716161 DOI: 10.1016/j.intimp.2023.110945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/02/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023]
Abstract
Chemotherapy-induced cognitive impairment (CICI) is a general term describing cognitive dysfunction during/after treatment with chemotherapeutic agents. CICI represents a significant medical problem due to its increasing prevalence with the lack of robust therapeutic approaches. This study aimed at investigating the effects of chronic treatment with amisulpride (5 mg/kg/day) in the management of 5-fluorouracil (5-FU)-induced cognitive deficits in Wistar rats. Rats received 5 intraperitoneal injections of 5-FU (25 mg/kg every 3 days). 5-FU treatment induced impairments in spatial learning (reduction in object location discrimination ratio) and non-spatial learning (reduction in novel object recognition discrimination ratio). Moreover, 5-FU induced a decrease in the activity of the Wnt/GSK-3β/β-catenin pathway with a decrease in brain-derived neurotrophic factor (BDNF) level in the hippocampus. These changes were associated with an increase in the expression of the pro-inflammatory cytokines; tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), in hippocampal tissue sections accompanied by a decrease in the number of Ki-67 positive cells (indicating a decrease in proliferative capacity), a decrease in the Nissl's granules optical density (denoting neurodegeneration), a decrease in the number of viable intact neurons with an increase in the expression of β-amyloid and caspase-3. Amisulpride enhanced Wnt/GSK-3β/β-catenin signaling, increased BDNF levels, and abrogated 5-FU-induced neuroinflammation, apoptosis, β-amyloid accumulation, and neurodegenerative changes with an improvement of cognitive performance. This study draws attention to the pro-cognitive effects of amisulpride in 5-FU-exposed rats that could be attributed to enhancing hippocampal Wnt/GSK-3β/β-catenin signaling pathway, and this could offer a promising therapeutic option for subjects with CICI.
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Affiliation(s)
- Radwa S Raafat
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Z Habib
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Faculty of Medicine, King Salman International University, El-Tor, South Sinai, Egypt.
| | - Amany A AbdElfattah
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, El-Mansoura, Egypt; Faculty of Medicine, King Salman International University, El-Tor, South Sinai, Egypt
| | - Nouran K Olama
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sahar M Abdelraouf
- Department of Biochemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt
| | - Nevien Hendawy
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Faculty of Medicine, Galala University, Suez, Egypt
| | - Khaled A Kamal
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Salwa A Nawishy
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sawsan Aboul-Fotouh
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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The Relationship Between Self-reported Cognitive Abilities and Psychological Symptoms in Breast Cancer Survivors. Cancer Nurs 2023; 46:29-35. [PMID: 35283471 DOI: 10.1097/ncc.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many breast cancer survivors (BCSs) report numerous symptoms following cancer treatment, including cognitive concerns and psychological symptoms (anxiety and depression). However, the association among these symptoms is not well understood. OBJECTIVES The objectives were to, primarily, examine the relationship between self-reported cognitive ability and psychological symptoms (anxiety and depressive symptoms) controlling for potential confounders of age, education, and time posttreatment and, secondarily, examine the relationship between self-reported cognitive domains (attention, language, visuoperception, visual memory, and verbal memory) and psychological symptoms. METHODS This secondary data analysis pooled data from 2 theoretically and conceptually congruent, institutional review board-approved studies of BCSs. Breast cancer survivors completed the Multiple Ability Self-report Questionnaire (cognitive ability), Spielberger State Trait Anxiety Inventory-State (anxiety), and Center for Epidemiological Studies-Depression Scale (depressive symptoms). Data were analyzed using descriptive statistics, Pearson correlations, and separate linear regression. RESULTS One hundred fifty-five BCSs who were on average 54.8 (SD, 8.9) years of age, approximately 5 years (mean, 5.2 [SD, 3.8] years) posttreatment, and well-educated (mean, 15.2 [SD, 2.2] years) completed questionnaires. In bivariate correlations, higher anxiety and depressive symptoms were significantly related to cognitive abilities in all domains ( P = <.01). In the regression model, increased anxiety was associated with poorer cognitive abilities in all domains ( P < .01). CONCLUSIONS Anxiety and depressive symptoms were associated with decrements in self-reported cognitive abilities among BCSs. IMPLICATIONS FOR PRACTICE With increasing numbers of BCSs, more research is needed to address psychological symptoms, which correlate with cognitive function. Findings from this analysis can inform clinical BCS survivorship care planning and future interventional research, focused on comprehensive symptom management.
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Fabbro M, Jacot W, Jarlier M, Guiu S, D'Hondt V, Pouderoux S, Champoiral P, Janiszewski C, Nicklès I. Hypnosis on patients treated with adjuvant chemotherapy for breast cancer: A feasibility study. Cancer Rep (Hoboken) 2022; 6:e1732. [PMID: 36302744 PMCID: PMC9875600 DOI: 10.1002/cnr2.1732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/02/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Acceptability and tolerance of chemotherapy on patients treated for breast cancer remain challenging. Complementary approaches such as hypnosis may have a favorable impact both at the time of announcing and during chemotherapy, due to the notorious anxiety, distress, and self-perceived dysfunction. The objective of the study was that the patients complied with at least four self-hypnosis sessions out of the six cycles of chemotherapy. METHODS This open, prospective longitudinal study assessed feasibility of compliance to self-hypnosis during chemotherapy in an outpatients setting. Training sessions were given by a hypnotherapist. Throughout each cycle of chemotherapy, the patient had to use self-hypnosis to better control her anxiety or any difficulties. Nurses could offer help to the patient. Chemotherapy-associated side effects were evaluated through the NCI-Common Toxicity Criteria for Adverse Events v 4.03; moreover, side effects as pain, nausea, vomiting, fatigue, and anxiety were also evaluated during chemotherapy using a visual analogic scale. Health-related quality of life, emotional distress (anxiety and depression), and cancer-related fatigue were assessed (at inclusion, end of chemotherapy and 3 months later) using the EORTC QLQ-C30 and QLQ-BR23, HADS and MFI-20 questionnaires, respectively. The number of patients screened and actually included in the study was reported, as the reasons for refusal. RESULTS Thirty-five patients were included with a median age of 55 years (35-78). All patients received a hypnosis training session. The overall compliance with self-hypnosis was 68.6% (95% CI: 50.7%-83.2%), meaning that more than two thirds of patients performed at least four sessions of self-hypnosis. According to NCI-CTCAE, Grade 2 nausea and vomiting was observed in 45.7% and 22.9%, respectively, Grade 2 fatigue in 62.9%. Based on the HADS questionnaire, anxiety increased at the end of the chemotherapy and returned to the initial value 3 months later (p = .97) whereas depression significantly decrease 3 months after the end of chemotherapy with respect to the inclusion (p = .003). Role, emotional, and cognitive functioning were slightly affected throughout the treatment, in contrast to dyspnea or physical functioning. CONCLUSION Our study showed that self-hypnosis was feasible on patients newly diagnosed for breast cancer receiving chemotherapy.
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Affiliation(s)
- Michel Fabbro
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance
| | - William Jacot
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance,Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, University of MontpellierMontpellierFrance
| | - Marta Jarlier
- Biometrics UnitMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance
| | - Séverine Guiu
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance,Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, University of MontpellierMontpellierFrance
| | - Véronique D'Hondt
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance,Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, University of MontpellierMontpellierFrance
| | - Stéphane Pouderoux
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance
| | - Patrice Champoiral
- Psycho‐Oncology UnitMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance
| | - Chloé Janiszewski
- Clinical Research CenterMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance
| | - Isabelle Nicklès
- Medical Oncology DepartmentMontpellier Cancer Institute (ICM), University of MontpellierMontpellierFrance,Private officeHypnotherapistMontpellierFrance
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Grégoire C, Marie N, Sombrun C, Faymonville ME, Kotsou I, van Nitsen V, de Ribaucourt S, Jerusalem G, Laureys S, Vanhaudenhuyse A, Gosseries O. Hypnosis, Meditation, and Self-Induced Cognitive Trance to Improve Post-treatment Oncological Patients' Quality of Life: Study Protocol. Front Psychol 2022; 13:807741. [PMID: 35222195 PMCID: PMC8866821 DOI: 10.3389/fpsyg.2022.807741] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction A symptom cluster is very common among oncological patients: cancer-related fatigue (CRF), emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations (e.g., small sample size, no control group, and no follow-up). Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance (SICT). It seems to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions (hypnosis, meditation, and SICT) to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties (primary outcomes). Methods and analysis A power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate (hypnosis, mindful self-compassion meditation, SICT, or no intervention—control group). To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study (baseline); immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured. Discussion In addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers. Clinical Trial Registration ClinicalTrials.gov/ (NCT04873661). Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661
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Affiliation(s)
- Charlotte Grégoire
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Nolwenn Marie
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | | | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Arsène Burny Cancerology Institute, CHU Liège, Liège, Belgium
| | - Ilios Kotsou
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Valérie van Nitsen
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Sybille de Ribaucourt
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, CHU Liège and University of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, CHU Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Algology Interdisciplinary Center, CHU Liège, Liège, Belgium
| | - Olivia Gosseries
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, CHU Liège, Liège, Belgium
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5
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He S, Lim CYS, Dhillon HM, Shaw J. Australian oncology health professionals' knowledge, perceptions, and clinical practice related to cancer-related cognitive impairment and utility of a factsheet. Support Care Cancer 2022; 30:4729-4738. [PMID: 35122530 PMCID: PMC9046357 DOI: 10.1007/s00520-022-06868-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) can have debilitating effects on cancer survivors' quality of life. Despite this, patients often report a lack of information provided by health professionals (HPs) to assist with understanding and managing cognitive changes. This study aimed to explore Australian oncology HPs' understanding of and clinical practice related to CRCI including the use of a Cancer Council Australia CRCI factsheet. METHODS Australian oncology HPs (medical oncologists, cancer nurses, and clinical psychologists) completed a questionnaire that assessed CRCI knowledge, prior to receiving the factsheet. Semi-structured interviews were conducted to explore their perceptions of CRCI and the factsheet. Interviews were recorded, transcribed, and analyzed using framework analysis to identify key themes. RESULTS Questionnaires were completed by twenty-nine HPs. Most HPs had moderate to high knowledge of CRCI, yet low knowledge of the relationship between CRCI and cancer. Twenty-six (response rate 90%) HPs; medical oncologists (n = 7), cancer nurses (n = 12), and clinical psychologists (n = 7), consented to be interviewed. Three main themes were identified: (1) Is CRCI impact real or over-rated?; (2) If it is important, they will tell me: identifying and responding to CRCI in clinical practice; and (3) Using a factsheet in clinical practice. CONCLUSION This study's multi-disciplinary exploration of Australian oncology HPs' perceptions of CRCI highlighted that health professional perceptions drive CRCI discussions with patients. Further education to support clinicians to discuss CRCI is required. Consideration of the barriers and facilitators within healthcare settings is important for successful integration of the factsheet into routine care.
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Affiliation(s)
- Sharon He
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
| | - Chloe Yi Shing Lim
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Haryana M. Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
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Groves T, Corley C, Byrum SD, Allen AR. The Effects of 5-Fluorouracil/Leucovorin Chemotherapy on Cognitive Function in Male Mice. Front Mol Biosci 2021; 8:762116. [PMID: 34778377 PMCID: PMC8581634 DOI: 10.3389/fmolb.2021.762116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/04/2021] [Indexed: 12/14/2022] Open
Abstract
5-Fluorouracil (5-Fu) and leucovorin (LV) are often given in combination to treat colorectal cancer. 5-Fu/LV prevents cell proliferation by inhibiting thymidylate synthase, which catalyzes the conversion of deoxyuridine monophosphate to deoxythymidine monophosphate. While 5-Fu has been shown to cause cognitive impairment, the synergistic effect of 5-Fu with LV has not been fully explored. The present investigation was designed to assess how the combination of 5-Fu and LV affect cognition in a murine model. Six-month-old male mice were used in this study; 15 mice received saline injections and 15 mice received 5-Fu/LV injections. One month after treatment, the elevated plus maze, Y-maze, and Morris water maze behavioral tasks were performed. Brains were then extracted, cryosectioned, and stained for CD68 to assay microglial activation and with tomato lectin to assay the vasculature. All animals were able to locate the visible and hidden platform locations in the water maze. However, a significant impairment in spatial memory retention was observed in the probe trial after the first day of hidden-platform training (first probe trial) in animals that received 5-Fu/LV, but these animals showed spatial memory retention by day 5. There were no significant increases in inflammation as measured by CD68, but 5-Fu/LV treatment did modulate blood vessel morphology. Tandem mass tag proteomics analysis identified 6,049 proteins, 7 of which were differentially expressed with a p-value of <0.05 and a fold change of >1.5. The present data demonstrate that 5-Fu/LV increases anxiety and significantly impairs spatial memory retention.
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Affiliation(s)
- Thomas Groves
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Christa Corley
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Stephanie D Byrum
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Antiño R Allen
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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Marton G, Bailo L, Pravettoni G. Exploring the possible application of implementation intention on prospective memory of cancer patients. COGENT PSYCHOLOGY 2021. [DOI: 10.1080/23311908.2021.1880303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Giulia Marton
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Luca Bailo
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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Baumann E, Kuba K, Götze H, Mehnert-Theuerkauf A, Esser P. Initial validation of the German version of the Attentional Function Index in a sample of haematological cancer survivors. Eur J Cancer Care (Engl) 2020; 29:e13226. [PMID: 31958365 DOI: 10.1111/ecc.13226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 12/19/2019] [Accepted: 12/19/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To date, no German instrument exists to assess subjective levels of cancer-related cognitive impairments (CRCI) in cancer survivors. We translated the validated Attentional Function Index (AFI) into German and explored its psychometric properties. METHODS The validation sample consisted of 1,111 haematological cancer survivors mainly recruited from two cancer registries. Factorial structure was explored using principal component analysis, internal consistency via Cronbach's α, construct validity through correlational analyses (Pearson's r) and associations of patient characteristics with the AFI score via regression analyses. RESULTS In line with the original version, we revealed three factors, that is "effective action" (seven items), "attentional lapses" (three items) and "interpersonal effectiveness" (three items). The overall reliability α was .91. Verifying construct validity, the AFI score correlated positively with cognitive functioning (r = .64, p ≤ .01) and global QoL (r = .44, p ≤ .01), but negatively with fatigue (r = -.60, p ≤ .01) and depressive symptomatology (r = -.6, p ≤ .01). Older age (β = .12, p < .001), higher comorbidity (β = -.07, p = .02) and being male patient (β = .07, p = .01) were significantly associated with the AFI scores, but effect sizes were small. CONCLUSION The German translation of the AFI shows good psychometric properties and thus may be reasonably applied to measure the subjective level of CRCI in German-speaking oncological populations.
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Affiliation(s)
- Esther Baumann
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Katharina Kuba
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Heide Götze
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Grégoire C, Faymonville ME, Vanhaudenhuyse A, Charland-Verville V, Jerusalem G, Willems S, Bragard I. Effects of an intervention combining self-care and self-hypnosis on fatigue and associated symptoms in post-treatment cancer patients: A randomized-controlled trial. Psychooncology 2020; 29:1165-1173. [PMID: 32297396 DOI: 10.1002/pon.5395] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Cancer has a lot of consequences such as fatigue, sleep disturbances, emotional distress, cognitive impairment and reduced physical activity. Some hypnosis-based psychological interventions showed positive effects on fatigue, sleep and emotional distress, but generally focused on breast cancer patients. Our study aimed at assessing the effects of a group intervention combining self-care and self-hypnosis on quality of life of cancer patients. METHODS Our longitudinal randomized-controlled trial assessed the benefits of the intervention first on fatigue and secondly on associated symptoms (sleep, emotional distress, cognitive impairment and reduced physical activity) of post-treatment cancer patients, and investigated predictors of the evolution of fatigue. All variables were measured with questionnaires and an actigraph (for sleep and physical activity). RESULTS Ninety five women with different cancers were included in our study. Group-by-time effects were showed for fatigue, sleep, emotional distress and cognitive functioning: symptoms have improved in the intervention group compared to wait-list control group. Three predictors of the evolution of fatigue were revealed: depression, anxiety and worry. CONCLUSIONS Our group intervention had benefits for post-treatment cancer patients' quality of life. Impacting emotional distress could be important in order to decrease fatigue. Further studies are needed to replicate our results. This intervention could be easily implemented to improve quality of life of cancer patients. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.
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Affiliation(s)
- Charlotte Grégoire
- Faculty of Psychology, Speech therapy and Educational Sciences, and Sensation and Perception Research Group, GIGA Research, University of Liège, Liège, Belgium
| | - Marie-Elisabeth Faymonville
- Interdisciplinary Algology Centre, CHU Liège, and Sensation and Perception Research Group, GIGA Research, University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Interdisciplinary Algology Centre, CHU Liège, and Sensation and Perception Research Group, GIGA Research, University of Liège, Liège, Belgium
| | - Vanessa Charland-Verville
- GIGA-Consciousness, Coma Science Group & Neurology Department, University and CHU of Liège, Liège, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, CHU Liège and University of Liège, Liège, Belgium
| | - Sylvie Willems
- Faculty of Psychology, Speech therapy and Educational Sciences, University of Liège, Liège, Belgium
| | - Isabelle Bragard
- Research and Continuing Education Departement, and CRIG Research Center, Haute Ecole Libre Mosane (HELMo), Liège, Belgium
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10
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Allegra A, Innao V, Basile G, Pugliese M, Allegra AG, Pulvirenti N, Musolino C. Post-chemotherapy cognitive impairment in hematological patients: current understanding of chemobrain in hematology. Expert Rev Hematol 2020; 13:393-404. [PMID: 32129131 DOI: 10.1080/17474086.2020.1738213] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Cognitive impairment caused by chemotherapies, a condition known as chemobrain, is a possible side effect that affects alertness, learning, memory, and concentration.Areas covered: Chemobrain has been principally investigated as a possible side-effect among cancer patients. However, numerous drugs used to treat hematological malignancies can determine the appearance of chemobrain. In this review, we have examined some commonly used drugs for the treatment of hematological malignancies which are known to have a deleterious action on cognitive functions.Numerous mechanisms have been suggested, comprising the direct neurotoxicity of chemotherapeutic drugs, oxidative stress, genetic predisposition, cytokine-provoked damage, histone modifications, immune alteration, and the action of chemotherapeutic on trophic factors and structural proteins of brain cells.Expert commentary: Cognitive dysfunction provoked by the treatment of hematological diseases is an actual challenge in clinical practice. Actually, there are no totally efficient and innocuous treatments for this syndrome. It is important that further investigations specify the existence of predictors and gravity factors to pre- and post-therapy cognitive change and identify the influence of tumor treatments on the cognitive alterations in long-term, cancer survivors. Moreover, future studies are needed to analyze the interactions between genetic risk, amyloid accumulation, intrinsic brain networks, and chemotherapy.
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Affiliation(s)
- Alessandro Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
| | - Vanessa Innao
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
| | - Giorgio Basile
- Unit and School of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marta Pugliese
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
| | - Andrea Gaetano Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
| | - Nicolina Pulvirenti
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
| | - Caterina Musolino
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy
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11
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Sousa A, Dinis-Oliveira RJ. Pharmacokinetic and pharmacodynamic of the cognitive enhancer modafinil: Relevant clinical and forensic aspects. Subst Abus 2020; 41:155-173. [PMID: 31951804 DOI: 10.1080/08897077.2019.1700584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Modafinil is a nonamphetamine nootropic drug with an increasingly therapeutic interest due to its different sites of action and behavioral effects in comparison to cocaine or amphetamine. A review of modafinil (and of its prodrug adrafinil and its R-enantiomer armodafinil) chemical, pharmacokinetic, pharmacodynamic, toxicological, clinical and forensic aspects was performed, aiming to better understand possible health problems associated to its unconscious and unruled use. Modafinil is a racemate metabolized mainly in the liver into its inactive acid and sulfone metabolites, which undergo primarily renal excretion. Although not fully clarified, major effects seem to be associated to inhibition of dopamine reuptake and modulation of several other neurochemical pathways, namely noradrenergic, serotoninergic, orexinergic, histaminergic, glutamatergic and GABAergic. Due its wake-promoting effects, modafinil is used for the treatment of daily sleepiness associated to narcolepsy, obstructive sleep apnea and shift work sleep disorder. Its psychotropic and cognitive effects are also attractive in several other pathologies and conditions that affect sleep structure, induce fatigue and lethargy, and impair cognitive abilities. Additionally, in health subjects, including students, modafinil is being used off-label to overcome sleepiness, increase concentration and improve cognitive potential. The most common adverse effects associated to modafinil intake are headache, insomnia, anxiety, diarrhea, dry mouth and raise in blood pressure and heart rate. Infrequently, severe dermatologic effects in children, including maculopapular and morbilliform rash, erythema multiforme and Stevens-Johnson Syndrome have been reported. Intoxication and dependence associated to modafinil are uncommon. Further research on effects and health implications of modafinil and its analogs is steel needed to create evidence-based policies.
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Affiliation(s)
- Ana Sousa
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal.,UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
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12
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Hormozi M, Hashemi SM, Shahraki S. Investigating Relationship between Pre- and Post- Chemotherapy Cognitive Performance with Levels of Depression and Anxiety in Breast Cancer Patients: A Cross-Sectional Study. Asian Pac J Cancer Prev 2019; 20:3831-3837. [PMID: 31870129 PMCID: PMC7173396 DOI: 10.31557/apjcp.2019.20.12.3831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Evidence suggests that cancer and chemotherapy-related cognitive impairments are an important clinical issue that can have a negative impact on the quality of life (QOL) of many cancer patients during and after treatment. The aim of the current study was to investigate the relationship between cognitive performance before and after chemotherapy with levels of depression and anxiety in patients with breast cancer. MATERIALS AND METHODS This cross-sectional descriptive-analytical study was performed on 100 women with breast cancer in south of Iran. Patients included in the study were evaluated for cognitive performance before chemotherapy and 1, 3, and 6 months after chemotherapy. Patients' cognitive performance was assessed by Mini-Mental State Examination (MMSE). Patients were also assessed for their level of anxiety and depression using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Descriptive tests (percentage, frequency and mean) and ANOVA test used for statistical analysis. RESULTS Results of ANOVA test showed a significant difference between the cognitive performance of patients with breast cancer at 1, 3, and 6 months after chemotherapy compared to pre- chemotherapy phase. The above test also revealed a significant relationship between cognitive performance of patients and anxiety and depression. CONCLUSION The results showed that, due to the decrease in cognitive performance and increased anxiety and depression after initiation of chemotherapy in patients with breast cancer, it is necessary to closely monitor the mental and psychological status of these patients by their family and the treatment staffs so that the patient be able to cope with the disease more optimally and to recover.
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Affiliation(s)
| | - Seyed-Mehdi Hashemi
- Clinical Immunology Research Center, Department of Internal Medicine, Hematology and Medical Oncology Ward, Ali-Ebne-Abitalelb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sara Shahraki
- GP, Zahedan University of Medical Sciences, Zahedan, Iran
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13
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van de Kamp HJ, Molder MT, Schulkes KJG, Stellingwerf M, van Elden LJR, van Lindert ASR, Hamaker ME. Impact of Lung Cancer Treatment on Cognitive Functioning. Clin Lung Cancer 2019; 21:114-126.e3. [PMID: 31839534 DOI: 10.1016/j.cllc.2019.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/18/2019] [Accepted: 06/05/2019] [Indexed: 12/30/2022]
Abstract
The impact of oncologic treatment for (non)-small-cell lung cancer (NSCLC and SCLC, respectively) on cognition is relevant when deciding which treatment is the most preferable option, especially when curation is not possible. A systematic search of Medline and EMBASE for studies on the effect of treatment on cognition in patients with lung cancer was performed. A total of 39 longitudinal articles were included. Study populations were heterogeneous with regards to stage and treatment type. In the 7 studies concerning SCLC, the median age of patients was between 59 and 68 years. Eighty-six percent of these studies had a loss to follow-up > 10%. Six studies used objective tests to assess cognition. Objective measurements showed a negative effect on attention, memory, and fluency after treatment. Thirty-three studies concerning NSCLC were included. The mean age of patients was between 53 and 77 years. Seventy percent of these studies included patients with stage III and IV NSCLC. Over one-half of the studies had a high rate of loss to follow-up. Eighty-eight percent used objective scales to assess cognitive functioning. Subjective decline of cognitive functioning up to 11.1% was experienced, with recovery at 4 to 6 months. Objective measurement of attention showed improvement over the course of chemotherapy. In SCLC, there is a significant negative effect on attention, memory, and fluency. In NSCLC, the longer term impact of treatment on both subjective and objective cognitive functioning appears limited. Thus, there is no evidence directing treatment choice for NSCLC based on longer term cognitive deficits. Further research is needed to precisely assess the impact of lung cancer treatment on cognition.
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Affiliation(s)
| | - Marthe Te Molder
- Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
| | - Karlijn J G Schulkes
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Margriet Stellingwerf
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Anne S R van Lindert
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
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14
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Status and predictors of planning ability in adult long-term survivors of CNS tumors and other types of childhood cancer. Sci Rep 2019; 9:7290. [PMID: 31086281 PMCID: PMC6514211 DOI: 10.1038/s41598-019-43874-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/02/2019] [Indexed: 11/08/2022] Open
Abstract
Long-term childhood cancer survivors' (CCS) quality of life can be impacted by late effects such as cognitive difficulties. Especially survivors of CNS tumors are assumed to be at risk, but reports of cognitive tests in CCS with survival times >25 years are scarce. We assessed planning ability, a capacity closely related to fluid intelligence, using the Tower of London. We compared 122 CNS tumor survivors, 829 survivors of other cancers (drawn from a register-based sample of adult long-term CCS), and 215 healthy controls (using sex-specific one-way ANOVAs and t-tests). Associations of CCS' planning ability with medical and psychosocial factors were investigated with a hierarchical linear regression analysis. Mean planning ability did not differ between CCS and controls. However, female CNS tumor survivors performed worse than female survivors of other cancers and female controls. CNS tumor survivors of both sexes had a lower socioeconomic status, and fewer of them had achieved high education than other survivors. In the regression analysis, lower status and anxiety symptoms were associated with poor planning, suggesting possible mediators of effects of disease and treatment. The results indicate the necessity to contextualize test results, and to include cognitive and psychological assessments into aftercare.
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15
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Clapp JD, Luta G, Small BJ, Ahles TA, Root JC, Graham D, Hurria A, Jacobsen PB, Jim H, McDonald BC, Stern RA, Saykin AJ, Mandelblatt JS. The Impact of Using Different Reference Populations on Measurement of Breast Cancer-Related Cognitive Impairment Rates. Arch Clin Neuropsychol 2018; 33:956-963. [PMID: 29471454 DOI: 10.1093/arclin/acx142] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/07/2018] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate how use of different reference populations affects estimates of breast cancer-related cognitive impairment rates. Methods Patients aged ≥60 years with stage 0-3 breast cancer (n = 371) and matched non-cancer controls (n = 370) completed 13 neuropsychological tests prior to systemic therapy or at enrollment (controls). The tests captured three domains: attention, processing speed and executive function; learning and memory; and visual-spatial function. Domain-specific impairment was defined as having one test score 2 SD below or two or more test scores 1.5 SD below the reference population means. Different reference populations were used to define impairment: published normative data, study-specific controls, age and education-stratified controls, and age and education-adjusted controls. The associations between the resultant impairment rates and breast cancer (vs. control) were evaluated using chi-square tests and logistic regression models. Cohen's kappa coefficients were used to evaluate agreement of impairment rates between study-specific control performance and the other reference population groups. Results The patients and controls were aged 68.0 (SD 6.0) and 67.9 (SD 7.0) years, respectively. The association of breast cancer-control status with impairment did not differ based on reference group. Cognitive impairment based on published normative data yielded less agreement on impairment rates (κ = 0.22-0.89) than study-specific age and education-stratified control performance (κ = 0.62-1.00). Conclusion The choice of reference populations did not affect conclusions about the association of cognition with breast cancer. However, while study-specific reference populations provided greater internal consistency in defining cognitive impairment, benchmarking against published normative data will enhance the ability to compare results across studies.
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Affiliation(s)
- Jonathan D Clapp
- Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.,University of South Florida, Tampa, FL, USA
| | - George Luta
- Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James C Root
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Deena Graham
- Hackensack University Medical Center, Hackensack, NJ, USA
| | | | - Paul B Jacobsen
- National Cancer Institute, Division of Cancer Control & Population Sciences (this work was performed while Dr. Jacobsen was at the Moffitt Cancer Center and does not reflect the views of the National Cancer Institute)
| | | | | | - Robert A Stern
- Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA
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16
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Flanigan TJ, Anderson JE, Elayan I, Allen AR, Ferguson SA. Effects of Cyclophosphamide and/or Doxorubicin in a Murine Model of Postchemotherapy Cognitive Impairment. Toxicol Sci 2018; 162:462-474. [PMID: 29228376 PMCID: PMC6659022 DOI: 10.1093/toxsci/kfx267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Postchemotherapy cognitive impairment, or PCCI, is a common complaint, particularly among breast cancer patients. However, the exact nature of PCCI appears complex. To model the human condition, ovariectomized C57BL/6J mice were treated intravenous weekly for 4 weeks with saline, 2 mg/kg doxorubicin (DOX), 50 mg/kg cyclophosphamide (CYP), or DOX + CYP. For the subsequent 10 weeks, mice were assessed on several behavioral tests, including those measuring spatial learning and memory. After sacrifice, hippocampal spine density and morphology in the dentate gyrus, CA1, and CA3 regions were measured. Additionally, hippocampal levels of total glutathione, glutathione disulfide, MnSOD, CuZnSOD, and cytokines were measured. Body weight decreased in all groups during treatment, but recovered post-treatment. Most behaviors were unaffected by drug treatment: Open field activity, motor coordination, grip strength, water maze and Barnes maze performance, buried food test performance, and novel object and object location recognition tests. There were some significant effects of CYP and DOX + CYP treatment during the initial test of home cage behavior, but these did not persist into the second and third test times. Density of stubby spines, but not mushroom or thin spines, in the dentate gyrus was significantly decreased in the DOX, CYP, and DOX + CYP treatment groups. There were no significant effects in the CA1 or CA3 regions. CuZnSOD levels were significantly increased in DOX + CYP-treated mice; other hippocampal antioxidant levels were unaffected. Most cytokines showed no treatment-related effects, but IL-1β, IL-6, and IL-12 were slightly reduced in mice treated with DOX + CYP. Although the animal model, route of exposure, and DOX and CYP doses used here were reflective of human exposure, there were only sporadic effects due to chemotherapeutic treatment.
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Affiliation(s)
- Timothy J Flanigan
- Division of Neurotoxicology, National Center for Toxicological Research/FDA, Jefferson, Arkansas 72079
| | - Julie E Anderson
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Ikram Elayan
- Division of Psychiatry Products, Center for Drug Evaluation and Research/FDA, Silver Spring, Maryland 20993
| | - Antiño R Allen
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Sherry A Ferguson
- Division of Neurotoxicology, National Center for Toxicological Research/FDA, Jefferson, Arkansas 72079
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17
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Kovalchuk A, Rodriguez-Juarez R, Ilnytskyy Y, Byeon B, Shpyleva S, Melnyk S, Pogribny I, Kolb B, Kovalchuk O. Sex-specific effects of cytotoxic chemotherapy agents cyclophosphamide and mitomycin C on gene expression, oxidative DNA damage, and epigenetic alterations in the prefrontal cortex and hippocampus - an aging connection. Aging (Albany NY) 2017; 8:697-711. [PMID: 27032448 PMCID: PMC4925823 DOI: 10.18632/aging.100920] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/30/2016] [Indexed: 01/21/2023]
Abstract
Recent research shows that chemotherapy agents can be more toxic to healthy brain cells than to the target cancer cells. They cause a range of side effects, including memory loss and cognitive dysfunction that can persist long after the completion of treatment. This condition is known as chemo brain. The molecular and cellular mechanisms of chemo brain remain obscure. Here, we analyzed the effects of two cytotoxic chemotherapy drugs—cyclophosphamide (CPP) and mitomycin C (MMC) - on transcriptomic and epigenetic changes in the murine prefrontal cortex (PFC) and hippocampal regions. We for the first time showed that CPP and MMC treatments led to profound sex- and brain region-specific alterations in gene expression profiles. Gene expression changes were most prominent in the PFC tissues of female mice 3 weeks after MMC treatment, and the gene expression response was much greater for MCC than CPP exposure. MMC exposure resulted in oxidative DNA damage, evidenced by accumulation of 8-oxo-2′-deoxyguanosine (8-oxodG) and a decrease in the level of 8-oxodG repair protein OGG1 in the PFC of female animals 3 weeks after treatment. MMC treatment decreased global DNA methylation and increased DNA hydroxymethylation in the PFC tissues of female mice. The majority of the changes induced by chemotherapy in the PFC tissues of female mice resembled those that occur during the brain's aging processes. Therefore, our study suggests a link between chemotherapy-induced chemo brain and brain aging, and provides an important roadmap for future analysis.
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Affiliation(s)
- Anna Kovalchuk
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada
| | - Rocio Rodriguez-Juarez
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada
| | - Yaroslav Ilnytskyy
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada
| | - Boseon Byeon
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada
| | - Svitlana Shpyleva
- Division of Biochemical Toxicology, Food and Drug Administration National Center for Toxicological Research, Jefferson, AR 72079, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA
| | - Stepan Melnyk
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA
| | - Igor Pogribny
- Division of Biochemical Toxicology, Food and Drug Administration National Center for Toxicological Research, Jefferson, AR 72079, USA
| | - Bryan Kolb
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada.,Alberta Epigenetics Network, Calgary, AB, T2L 2A6, Canada.,Canadian Institute for Advanced Research, Toronto, ON, M5G 1Z8, Canada
| | - Olga Kovalchuk
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB, T1K3M4, Canada.,Alberta Epigenetics Network, Calgary, AB, T2L 2A6, Canada
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18
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Prospective Evaluation of the Impact of Antiangiogenic Treatment on Cognitive Functions in Metastatic Renal Cancer. Eur Urol Focus 2016; 2:642-649. [DOI: 10.1016/j.euf.2016.04.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/31/2016] [Accepted: 04/19/2016] [Indexed: 12/21/2022]
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19
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Iarkov A, Appunn D, Echeverria V. Post-treatment with cotinine improved memory and decreased depressive-like behavior after chemotherapy in rats. Cancer Chemother Pharmacol 2016; 78:1033-1039. [PMID: 27709283 DOI: 10.1007/s00280-016-3161-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/27/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Most cancer patients treated with systemic adjuvant chemotherapy endure long-lasting side effects including decrease in concentration, forgetfulness and slower thinking, which are globally termed "chemobrain." Cotinine, the main derivative of nicotine, improved visual and spatial working memory and decreased depressive-like behavior in an animal model of chemotherapy-induced cognitive impairment. METHODS In this study, we investigated the effect of cotinine on weight gain, locomotor activity, cognitive abilities and depressive-like behavior in rats treated with the chemotherapy mix, cyclophosphamide, methotrexate and 5-fluorouracil. Locomotor activity and depressive-like behavior were assessed using the rotarod and Porsolt's tests, respectively. Changes in cognitive abilities were determined using the novel place recognition test. RESULTS Female rats treated with cotinine after chemotherapy, recovered weight faster, showed superior cognitive abilities and lower levels of depressive-like behavior than chemotherapy, vehicle-treated rats. CONCLUSIONS This evidence suggests that treatment with cotinine may facilitate the recovery and diminish the cognitive consequences of chemotherapy.
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Affiliation(s)
- Alexandre Iarkov
- Facultad de ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4080871, Concepción, Chile
| | - Doreen Appunn
- Department of Veterans Affairs, Bay Pines VA Healthcare System, Bay Pines, FL, 33744, USA
| | - Valentina Echeverria
- Facultad de ciencias de la Salud, Universidad San Sebastián, Lientur 1457, 4080871, Concepción, Chile. .,Department of Veterans Affairs, Bay Pines VA Healthcare System, 10,000 Bay Pines Blvd. Bldg. 22, Rm. 123, Bay Pines, FL, 33744, USA.
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20
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Saxena R, Rida PCG, Kucuk O, Aneja R. Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management. Mol Nutr Food Res 2016; 60:1364-73. [PMID: 26842968 DOI: 10.1002/mnfr.201500955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 01/22/2023]
Abstract
Cancer, referred to as the 'disease of civilization', continues to haunt humanity due to its dreadful manifestations and limited success of therapeutic interventions such as chemotherapy in curing the disease. Although effective, chemotherapy has repeatedly demonstrated inadequacy in disease management due to its debilitating side effects arising from its deleterious nonspecific effects on normal healthy cells. In addition, development of chemoresistance due to mono-targeting often results in cessation of chemotherapy. This urgently demands development and implementation of multitargeted alternative therapies with mild or no side effects. One extremely promising strategy that yet remains untapped in the clinic is augmenting chemotherapy with dietary phytochemicals or extracts. Ginger, depository of numerous bioactive molecules, not only targets cancer cells but can also mitigate chemotherapy-associated side effects. Consequently, combination therapy involving ginger extract and chemotherapeutic agents may offer the advantage of being efficacious with reduced toxicity. Here we discuss the remarkable and often overlooked potential of ginger extract to manage cancer, the possibility of developing ginger-based combinational therapies, and the major roadblocks along with strategies to overcome them in clinical translation of such inventions. We are optimistic that clinical implementation of such combination regimens would be a much sought after modality in cancer management.
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Affiliation(s)
- Roopali Saxena
- Department of Biology, Georgia State University, Atlanta, GA, USA
| | | | - Omer Kucuk
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Ritu Aneja
- Department of Biology, Georgia State University, Atlanta, GA, USA
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21
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Van Arsdale A, Rosenbaum D, Kaur G, Pinto P, Kuo DYS, Barrera R, Goldberg GL, Nevadunsky NS. Prevalence and factors associated with cognitive deficit in women with gynecologic malignancies. Gynecol Oncol 2016; 141:323-328. [DOI: 10.1016/j.ygyno.2016.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/01/2016] [Accepted: 03/01/2016] [Indexed: 12/25/2022]
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22
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Taber JM, Klein WMP, Ferrer RA, Kent EE, Harris PR. Optimism and Spontaneous Self-affirmation are Associated with Lower Likelihood of Cognitive Impairment and Greater Positive Affect among Cancer Survivors. Ann Behav Med 2016; 50:198-209. [PMID: 26497697 PMCID: PMC4919121 DOI: 10.1007/s12160-015-9745-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. PURPOSE The aim of this study is to examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. METHODS Cancer survivors (n = 326) completed the Health Information National Trends Survey 2013, a national survey of US adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. RESULTS Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. CONCLUSIONS Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research.
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Affiliation(s)
- Jennifer M Taber
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 3E642, Bethesda, MD, 20892-9761, USA.
| | - William M P Klein
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 3E642, Bethesda, MD, 20892-9761, USA
| | - Rebecca A Ferrer
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 3E642, Bethesda, MD, 20892-9761, USA
| | - Erin E Kent
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 3E642, Bethesda, MD, 20892-9761, USA
| | - Peter R Harris
- School of Psychology, University of Sussex, Brighton BN1 9RH, Falmer, UK
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23
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Magro E, Bergot L, Cuchard S, Lebreton S, Coutte MB, Rolland-Lozachmeur G, Hieu PD, Seizeur R. Diagnosis Disclosure Process in Patients With Malignant Brain Tumors. Clin J Oncol Nurs 2016; 20:E49-54. [PMID: 26991723 DOI: 10.1188/16.cjon.e49-e54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The way to disclose a cancer diagnosis has evolved, and psycho-oncology has developed a more prominent place in cancer care. The diagnosis disclosure process was established to improve the overall quality of patient care and the communication about a cancer diagnosis. OBJECTIVES The aim of this study was to assess the implementation of the disclosure process in a neurosurgical unit. METHODS This study was conducted prospectively during a one-year period. All patients were diagnosed with malignant brain tumors and received their diagnosis using the disclosure process. The communication between the provider and the patient during diagnosis disclosure was recorded for analysis, and patients completed a satisfaction survey. FINDINGS Ninety-one patients with a brain tumor diagnosis participated in the study. Twenty-six were unable to complete the satisfaction survey because they were either deceased or close to the end of their lives. In total, 65 questionnaires were sent to patients and their families, and 43 responded. Patients were satisfied with the quality of the disclosure process regarding information given, psychological support, and communication with all healthcare providers. This assessment allowed the authors to better characterize the impact of the disclosure process on the overall care of patients and to measure the effect of the components of the disclosure process on patient satisfaction.
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Affiliation(s)
- Elsa Magro
- Centre Hospitalier Regional Universitare
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24
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PAN-811 Blocks Chemotherapy Drug-Induced In Vitro Neurotoxicity, While Not Affecting Suppression of Cancer Cell Growth. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2016:9392404. [PMID: 26640619 PMCID: PMC4657105 DOI: 10.1155/2016/9392404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 12/11/2022]
Abstract
Chemotherapy often results in cognitive impairment, and no neuroprotective drug is now available. This study aimed to understand underlying neurotoxicological mechanisms of anticancer drugs and to evaluate neuroprotective effects of PAN-811. Primary neurons in different concentrations of antioxidants (AOs) were insulted for 3 days with methotrexate (MTX), 5-fluorouracil (5-FU), or cisplatin (CDDP) in the absence or presence of PAN-811·Cl·H2O. The effect of PAN-811 on the anticancer activity of tested drugs was also examined using mouse and human cancer cells (BNLT3 and H460) to assess any negative interference. Cell membrane integrity, survival, and death and intramitochondrial reactive oxygen species (ROS) were measured. All tested anticancer drugs elicited neurotoxicity only under low levels of AO and elicited a ROS increase. These results suggested that ROS mediates neurotoxicity of tested anticancer drugs. PAN-811 dose-dependently suppressed increased ROS and blocked the neurotoxicity when neurons were insulted with a tested anticancer drug. PAN-811 did not interfere with anticancer activity of anticancer drugs against BNLT3 cells. PAN-811 did not inhibit MTX-induced death of H460 cells but, interestingly, demonstrated a synergistic effect with 5-FU or CDDP in reducing cancer cell viability. Thus, PAN-811 can be a potent drug candidate for chemotherapy-induced cognitive impairment.
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Tanimukai H, Kudo T. Fluvoxamine alleviates paclitaxel-induced neurotoxicity. Biochem Biophys Rep 2015; 4:202-206. [PMID: 29124205 PMCID: PMC5668922 DOI: 10.1016/j.bbrep.2015.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 01/07/2023] Open
Abstract
Paclitaxel (Px) is an effective chemotherapeutic agent for the treatment of various cancers. However, it is often associated with neurological side effects, including chemotherapy-associated cognitive impairment (CACI), such as "chemobrain". Previously, we reported that endoplasmic reticulum (ER) stress is involved in Px-induced neurotoxicity, and immunoglobulin heavy chain binding protein (BiP) inducer X (BIX) alleviates Px-induced neurotoxicity. However, BIX has not been used in clinical practice yet. We recently reported that fluvoxamine (Flv) alleviates ER stress via induction of sigma-1 receptor (Sig-1R). The purpose of this study was to investigate whether Flv could alleviate Px-induced neurotoxicity in vitro. SK-N-SH cells were pre-treated for 12 h with or without 10 μg/ml Flv followed by treatment with 1 μM Px with or without co-existence of 10 μg/ml Flv for 24 h. To investigate the involvement of Sig-1R in alleviation effect on Px-induced neurotoxicity,1 μM NE100, an antagonist of Sig-1R, was added for 24 h. Neurotoxicity was assessed using the MTS viability assay and ER stress-mediated neurotoxicity was assessed by evaluating the expression of C/EBP homologous protein (CHOP), cleaved caspase 4, and cleaved caspase 3. Pre-treatment with Flv significantly alleviated the induction of CHOP, cleaved caspase 4, and cleaved caspase 3 in SK-N-SH cells. At the same time, pre-treatment with Flv significantly induced Sig-1R in SK-N-SH cells. In addition, viability was significantly higher in Flv-treated cells than in untreated cells, which was reversed by treatment with NE100. Our results suggest that Flv alleviates Px-induced neurotoxicity in part through the induction of Sig-1R. Our findings should contribute to one of the novel approaches for the alleviation of Px-induced neurotoxicity, including chemobrain.
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Key Words
- BIX, BiP inducer X
- BiP, immunoglobulin heavy-chain binding protein
- CACI, chemotherapy-associated cognitive impairments
- CHOP, C/EBP homologous protein
- CYP, cytochrome P450
- Chemobrain
- ER, endoplasmic reticulum
- Endoplasmic reticulum stress
- Fluvoxamine
- Flv, fluvoxamine
- JNK, c-Jun NH2-terminal kinase
- Paclitaxel
- Px, paclitaxel
- QOL, quality of life
- SSRI, selective serotonin reuptake inhibitor
- Selective serotonin reuptake inhibitor
- Sig-1R, sigma 1 receptor
- Sigma 1 receptor
- UPR, unfolded protein response
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Affiliation(s)
- Hitoshi Tanimukai
- Department of Clinical Oncology, Pharmacogenomics, and Palliative Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Japan.,Palliative Care Center, Department of Palliative Medicine, Kyoto University Hospital, 54 Kawaharacho, Syogoin, Sakyou-ku, Kyoto City, Kyoto 606-8507, Japan
| | - Takashi Kudo
- Department of Psychiatry, Osaka University Health Care Center, 1-17, Machikaneyama-cho, Toyonaka, Osaka 560-0043, Japan
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Emotional specificities of autobiographical memory after breast cancer diagnosis. Conscious Cogn 2015; 35:42-52. [DOI: 10.1016/j.concog.2015.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 04/03/2015] [Accepted: 04/26/2015] [Indexed: 01/10/2023]
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Liet C, Amenouche F, Freret T, Boulouard M, Mauvieux B, Lelong-Boulouard V, Bocca ML. Effects of acute administration of melatonin on attentional, executive, and working memory processes in rats. Fundam Clin Pharmacol 2015; 29:472-7. [DOI: 10.1111/fcp.12134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/15/2015] [Accepted: 07/10/2015] [Indexed: 01/29/2023]
Affiliation(s)
- Christophe Liet
- Normandy University; 14032 France
- COMETE; UNICAEN; 14032 Caen France
- U1075 COMETE; INSERM; 14032 Caen France
| | - Fella Amenouche
- Normandy University; 14032 France
- COMETE; UNICAEN; 14032 Caen France
- U1075 COMETE; INSERM; 14032 Caen France
| | - Thomas Freret
- Normandy University; 14032 France
- EA 4259 GMPc; UCBN; 14032 Caen France
| | - Michel Boulouard
- Normandy University; 14032 France
- EA 4259 GMPc; UCBN; 14032 Caen France
| | - Benoit Mauvieux
- Normandy University; 14032 France
- COMETE; UNICAEN; 14032 Caen France
- U1075 COMETE; INSERM; 14032 Caen France
| | - Véronique Lelong-Boulouard
- Normandy University; 14032 France
- COMETE; UNICAEN; 14032 Caen France
- U1075 COMETE; INSERM; 14032 Caen France
- Department of Pharmacology; CHU of Caen; 14033 Caen France
| | - Marie-Laure Bocca
- Normandy University; 14032 France
- COMETE; UNICAEN; 14032 Caen France
- U1075 COMETE; INSERM; 14032 Caen France
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Prevalence of perceived cognitive dysfunction in survivors of a wide range of cancers: results from the 2010 LIVESTRONG survey. J Cancer Surviv 2015; 10:302-11. [PMID: 26238504 DOI: 10.1007/s11764-015-0476-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/15/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE With cancer survivors now numbering over 13 million in the United States, and expected to continue to increase, it is important to consider the needs of this growing population. In the literature, one of the most common complaints by cancer survivors is perceived cognitive dysfunction. Since the preponderance of the research has focused on breast cancer survivors, the purpose of the present study was to explore the prevalence and correlates of perceived cognitive dysfunction in a large sample of cancer survivors with representation across a wide range of different types of cancer. METHODS A sample of 3108 post-treatment cancer survivors completed the 2010 LIVESTRONG survey as part of a larger study of cancer survivorship. Respondents completed standardized questions regarding current and past perceived cognitive dysfunction, as well as depressive symptoms, and demographic and medical variables. RESULTS Current perceived cognitive dysfunction was reported by nearly half of respondents (45.7%), across a wide range of cancer types, with the highest prevalence among survivors of central nervous system cancers. Receiving chemotherapy and current report of depressive symptoms were both strongly associated with current perceived cognitive dysfunction. CONCLUSION These findings contribute to a growing appreciation of the high prevalence of perceived cognitive dysfunction in survivors of a wide range of cancer types and the potential interactive effect of concurrent symptoms of depression. These findings highlight a need to develop more effective means of preventing or reducing cognitive dysfunction in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Perceived cognitive dysfunction was reported in a wide range of cancer survivors. The potential interactive effect of symptoms of depression suggests the need to develop interventions targeting both cognitive dysfunction and depression to achieve improvements in cognitive functioning.
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Lengacher CA, Reich RR, Kip KE, Paterson CL, Park HY, Ramesar S, Jim HSL, Alinat CB, Park JY. Moderating Effects of Genetic Polymorphisms on Improvements in Cognitive Impairment in Breast Cancer Survivors Participating in a 6-Week Mindfulness-Based Stress Reduction Program. Biol Res Nurs 2015; 17:393-404. [PMID: 25882604 PMCID: PMC10131135 DOI: 10.1177/1099800415577633] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single-nucleotide polymorphisms (SNPs). The purpose of this study was to test whether particular SNPs were associated with changes in cognitive function in BC survivors and whether these polymorphisms moderated cognitive improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. BC survivors recruited from Moffitt Cancer Center and the University of South Florida's Breast Health Program, who had completed adjuvant radiation and/or chemotherapy treatment, were randomized to either the 6-week MBSR(BC) program (n = 37) or usual care (UC; n = 35) group. Measures of cognitive function and demographic and clinical history data were attained at baseline and at 6 and 12 weeks. A total of 10 SNPs from eight genes known to be related to cognitive function were analyzed using blood samples. Results showed that SNPs in four genes (ankyrin repeat and kinase domain containing 1 [ANKK1], apolipoprotein E [APOE], methylenetetrahydrofolate reductase [MTHFR], and solute carrier family 6 member 4 [SLC6A4]) were associated with cognitive impairment. Further, rs1800497 in ANKK1 was significantly associated with improvements in cognitive impairment in response to MBSR(BC). These results may help to identify individuals who would be better served by MBSR(BC) or other interventions.
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Affiliation(s)
- Cecile A Lengacher
- College of Nursing, University of South Florida, Tampa, FL, USA Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Richard R Reich
- College of Arts and Sciences, University of South Florida Sarasota-Manatee, Sarasota, FL, USA Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Kevin E Kip
- College of Nursing, University of South Florida, Tampa, FL, USA
| | | | - Hyun Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Sophia Ramesar
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
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Acharya MM, Martirosian V, Chmielewski NN, Hanna N, Tran KK, Liao AC, Christie LA, Parihar VK, Limoli CL. Stem cell transplantation reverses chemotherapy-induced cognitive dysfunction. Cancer Res 2015; 75:676-86. [PMID: 25687405 DOI: 10.1158/0008-5472.can-14-2237] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The frequent use of chemotherapy to combat a range of malignancies can elicit severe cognitive dysfunction often referred to as "chemobrain," a condition that can persist long after the cessation of treatment in as many as 75% of survivors. Although cognitive health is a critical determinant of therapeutic outcome, chemobrain remains an unmet medical need that adversely affects quality of life in pediatric and adult cancer survivors. Using a rodent model of chemobrain, we showed that chronic cyclophosphamide treatment induced significant performance-based decrements on behavioral tasks designed to interrogate hippocampal and cortical function. Intrahippocampal transplantation of human neural stem cells resolved all cognitive impairments when animals were tested 1 month after the cessation of chemotherapy. In transplanted animals, grafted cells survived (8%) and differentiated along neuronal and astroglial lineages, where improved cognition was associated with reduced neuroinflammation and enhanced host dendritic arborization. Stem cell transplantation significantly reduced the number of activated microglia after cyclophosphamide treatment in the brain. Granule and pyramidal cell neurons within the dentate gyrus and CA1 subfields of the hippocampus exhibited significant reductions in dendritic complexity, spine density, and immature and mature spine types following chemotherapy, adverse effects that were eradicated by stem cell transplantation. Our findings provide the first evidence that cranial transplantation of stem cells can reverse the deleterious effects of chemobrain, through a trophic support mechanism involving the attenuation of neuroinflammation and the preservation host neuronal architecture.
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Affiliation(s)
- Munjal M Acharya
- Department of Radiation Oncology, University of California, Irvine, California
| | - Vahan Martirosian
- Department of Radiation Oncology, University of California, Irvine, California
| | | | - Nevine Hanna
- Department of Radiation Oncology, University of California, Irvine, California
| | - Katherine K Tran
- Department of Radiation Oncology, University of California, Irvine, California
| | - Alicia C Liao
- Department of Radiation Oncology, University of California, Irvine, California
| | - Lori-Ann Christie
- Department of Radiation Oncology, University of California, Irvine, California
| | - Vipan K Parihar
- Department of Radiation Oncology, University of California, Irvine, California
| | - Charles L Limoli
- Department of Radiation Oncology, University of California, Irvine, California.
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Jean-Pierre P, Grandner MA, Garland SN, Henry E, Jean-Louis G, Burish TG. Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia. Sleep Med 2015; 16:845-9. [PMID: 26026625 DOI: 10.1016/j.sleep.2015.02.531] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 02/06/2015] [Accepted: 02/17/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems. OBJECTIVE To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors. METHODS We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health. RESULTS The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p < 0.01) significantly predicted SRMP, uniquely explaining 12% of the variance. Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p < 0.05). The large CI is a consequence of analyzing a sub-group of a subpopulation. Among participants without a cancer history, cardiovascular disease and insomnia were not associated with SRMP (p > 0.05). LIMITATIONS We could not determine severity and time-related changes in SRMP. CONCLUSION Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA.
| | - Michael A Grandner
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA
| | - Sheila N Garland
- Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA; Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Henry
- Department of Hematology/Oncology, Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, IL, USA
| | - Girardin Jean-Louis
- Department of Population Health, Center for Healthful Behavior Change, New York University, New York, NY, USA
| | - Thomas G Burish
- Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA
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Defrancesco M, Sperner-Unterweger B. [Diagnosis and therapy of cognitive deficits in oncology patients]. DER NERVENARZT 2015; 86:282-290. [PMID: 25676924 DOI: 10.1007/s00115-014-4155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Improvements in the diagnostics and therapy of almost all types of cancer have extended the survival rates and average life expectancies of oncology patients. As a result the assessment of cognitive deficits is becoming much more important not only in cancer diagnostics but also in the disease-free period following treatment. Various cognitive deficits can occur in patients with intracranial as well as extracranial malignancies. These deficits can be caused by tumor or treatment-related factors. Previous studies have shown that cognitive deficits may negatively influence the quality of life, therapy adherence, prognosis and mortality of patients. Currently, standardized specially designed cognitive tests for oncology patients are lacking; nevertheless, neurocognitive assessment should become an integral element in the diagnostic procedure as well as in the therapeutic process of these patients. An increasing number of studies are currently evaluating pharmacological and non-pharmacological strategies to treat or prevent cognitive deficits; however, recommendations for daily clinical use are still lacking.
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Affiliation(s)
- M Defrancesco
- Universitätsklinik für Allgemeine und Sozialpsychiatrie, Department für Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich,
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Evaluation of the impact of the cancer therapy everolimus on the central nervous system in mice. PLoS One 2014; 9:e113533. [PMID: 25436776 PMCID: PMC4250083 DOI: 10.1371/journal.pone.0113533] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 10/24/2014] [Indexed: 01/13/2023] Open
Abstract
Cancer and treatments may induce cognitive impairments in cancer patients, and the causal link between chemotherapy and cognitive dysfunctions was recently validated in animal models. New cancer targeted therapies have become widely used, and their impact on brain functions and quality of life needs to be explored. We evaluated the impact of everolimus, an anticancer agent targeting the mTOR pathway, on cognitive functions, cerebral metabolism, and hippocampal cell proliferation/vascular density in mice. Adult mice received everolimus daily for 2 weeks, and behavioral tests were performed from 1 week after the last treatment. Everolimus-treated mice displayed a marked reduction in weight gain from the last day of the treatment period. Ex vivo analysis showed altered cytochrome oxidase activity in selective cerebral regions involved in energy balance, food intake, reward, learning and memory modulation, sleep/wake cycle regulation, and arousal. Like chemotherapy, everolimus did not alter emotional reactivity, learning and memory performances, but in contrast to chemotherapy, did not affect behavioral flexibility or reactivity to novelty. In vivo hippocampal neural cell proliferation and vascular density were also unchanged after everolimus treatments. In conclusion, two weeks daily everolimus treatment at the clinical dose did not evoke alteration of cognitive performances evaluated in hippocampal- and prefrontal cortex-dependent tasks that would persist at one to four weeks after the end of the treatment completion. However, acute everolimus treatment caused selective CO modifications without altering the mTOR effector P70S6 kinase in cerebral regions involved in feeding behavior and/or the sleep/wake cycle, at least in part under control of the solitary nucleus and the parasubthalamic region of the hypothalamus. Thus, this area may represent a key target for everolimus-mediating peripheral modifications, which has been previously associated with symptoms such as weight loss and fatigue.
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Li J, Yu L, Long Z, Li Y, Cao F. Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue. Psychooncology 2014; 24:676-82. [PMID: 25345397 DOI: 10.1002/pon.3710] [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] [Received: 02/16/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Clinical reports have shown that adjuvant chemotherapy has a negative impact on perceived cognitive impairment (PCI) of patients with breast cancer; however, evidence concerning the effects of psychological factors such as post-traumatic stress disorder (PTSD) symptoms on PCI is limited, especially in relation to Chinese patients with breast cancer. This research investigated the associations between psychological factors and PCI in Chinese women with breast cancer. METHODS In total, 204 women with breast cancer were assessed for PCI, PTSD symptoms, fatigue, anxiety, and depression using self-report measures. Hierarchical linear regression was conducted to investigate the associations between the variables of interest and PCI. RESULTS Two hundred and two women were included in the final analysis; two of those originally tested were excluded because of missing data. A univariate analysis showed that PCI was significantly related to education, PTSD symptoms (re-experience, avoidance, and hyperarousal), fatigue, depression, anxiety, and undergoing chemotherapy or radiotherapy. Hierarchical linear regression revealed that PTSD symptoms and fatigue (ΔR(2) = 0.26, P < 0.001) independently accounted for PCI in Chinese women with breast cancer regardless of age, education level, chemotherapy and radiotherapy. Hyperarousal was the only contributing PTSD symptom to PCI (B = -1.24, SE = 0.33, β = -0.39, P < 0.001). CONCLUSIONS Besides chemotherapy, PTSD symptoms, especially hyperarousal, and fatigue are important risk factors for significant PCI and are therefore worthy of further investigation.
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Affiliation(s)
- Jie Li
- Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China
| | - Lixiang Yu
- The Second Hospital of Shandong University, Shandong University, 247 Beiyuan Road, Jinan, Shandong Province, 250033, China
| | - Zhouting Long
- Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China
| | - Yang Li
- Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China
| | - Fenglin Cao
- Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China
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Lange M, Giffard B, Noal S, Rigal O, Kurtz JE, Heutte N, Lévy C, Allouache D, Rieux C, Fel JL, Daireaux A, Clarisse B, Veyret C, Barthélémy P, Longato N, Eustache F, Joly F. Baseline cognitive functions among elderly patients with localised breast cancer. Eur J Cancer 2014; 50:2181-9. [DOI: 10.1016/j.ejca.2014.05.026] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/22/2014] [Accepted: 05/29/2014] [Indexed: 01/16/2023]
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Jean-Pierre P, Johnson-Greene D, Burish TG. Neuropsychological care and rehabilitation of cancer patients with chemobrain: strategies for evaluation and intervention development. Support Care Cancer 2014; 22:2251-60. [PMID: 24671433 PMCID: PMC4256074 DOI: 10.1007/s00520-014-2162-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 02/05/2014] [Indexed: 12/20/2022]
Abstract
Malignant tumors and their various treatments such as chemotherapy, radiotherapy and hormonal therapy can deleteriously affect a large number of cancer patients and survivors on multiple dimensions of psychosocial and neurocognitive functioning. Oncology researchers and clinicians are increasingly cognizant of the negative effects of cancer and its treatments on the brain and its mental processes and cognitive outcomes. Nevertheless, effective interventions to treat cancer and treatment-related neurocognitive dysfunction (CRND), also known as chemobrain, are still lacking. The paucity of data on effective treatments for CRND is due, at least partly, to difficulties understanding its etiology, and a lack of reliable methods for assessing its presence and severity. This paper provides an overview of the incidence, etiology, and magnitude of CRND, and discusses the plausible contributions of psychological, motor function, and linguistic and behavioral complications to CRND. Strategies for reliable neuropsychological screening and assessment, and development and testing of effective ways to mitigate CRND are also discussed.
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Affiliation(s)
- Pascal Jean-Pierre
- Department of Psychology, Neurocognitive Translational Research Laboratory, Cancer Control and Survivorship Program, University of Notre Dame, 109 Haggar Hall, Notre Dame, IN, 46566, USA,
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Benderitter M, Caviggioli F, Chapel A, Coppes RP, Guha C, Klinger M, Malard O, Stewart F, Tamarat R, van Luijk P, Limoli CL. Stem cell therapies for the treatment of radiation-induced normal tissue side effects. Antioxid Redox Signal 2014; 21:338-55. [PMID: 24147585 PMCID: PMC4060814 DOI: 10.1089/ars.2013.5652] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
SIGNIFICANCE Targeted irradiation is an effective cancer therapy but damage inflicted to normal tissues surrounding the tumor may cause severe complications. While certain pharmacologic strategies can temper the adverse effects of irradiation, stem cell therapies provide unique opportunities for restoring functionality to the irradiated tissue bed. RECENT ADVANCES Preclinical studies presented in this review provide encouraging proof of concept regarding the therapeutic potential of stem cells for treating the adverse side effects associated with radiotherapy in different organs. Early-stage clinical data for radiation-induced lung, bone, and skin complications are promising and highlight the importance of selecting the appropriate stem cell type to stimulate tissue regeneration. CRITICAL ISSUES While therapeutic efficacy has been demonstrated in a variety of animal models and human trials, a range of additional concerns regarding stem cell transplantation for ameliorating radiation-induced normal tissue sequelae remain. Safety issues regarding teratoma formation, disease progression, and genomic stability along with technical issues impacting disease targeting, immunorejection, and clinical scale-up are factors bearing on the eventual translation of stem cell therapies into routine clinical practice. FUTURE DIRECTIONS Follow-up studies will need to identify the best possible stem cell types for the treatment of early and late radiation-induced normal tissue injury. Additional work should seek to optimize cellular dosing regimes, identify the best routes of administration, elucidate optimal transplantation windows for introducing cells into more receptive host tissues, and improve immune tolerance for longer-term engrafted cell survival into the irradiated microenvironment.
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Affiliation(s)
- Marc Benderitter
- 1 Laboratory of Radiopathology and Experimental Therapies, IRSN , PRP-HOM, SRBE, Fontenay-aux-Roses, France
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Cognitive dysfunctions in elderly cancer patients: A new challenge for oncologists. Cancer Treat Rev 2014; 40:810-7. [DOI: 10.1016/j.ctrv.2014.03.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/07/2014] [Accepted: 03/11/2014] [Indexed: 01/31/2023]
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McDougall GJ, Oliver JS, Scogin F. Memory and cancer: a review of the literature. Arch Psychiatr Nurs 2014; 28:180-6. [PMID: 24856270 PMCID: PMC4033831 DOI: 10.1016/j.apnu.2013.12.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/30/2013] [Indexed: 12/31/2022]
Abstract
The mental health of cancer survivors has not always been the primary emphasis of treatment protocols since physical health outcomes have taken precedence. Older cancer survivors experience a double jeopardy since they are at risk for memory impairments and mild cognitive impairment and because they are greater than 55 years of age. Of the 9.6 million cancer survivors in the US who have completed active treatment, many report cognitive difficulties, with labels such as "chemo brain," "not as sharp," "woolly-headedness," or the "mind does not work as quickly". To date, most of our knowledge of cognitive impairment in cancer survivors comes from female breast cancer survivors. Studies indicate that these survivors have diminished executive function, verbal memory, and motor function. Cancer survivors want to live independently in the community for as long as possible however, these cognitive deficits may prevent this desired lifestyle. To broaden our understanding this paper reviews the literature on the cognitive impairment and memory deficits experienced by three groups of cancer survivors breast, colorectal, and prostate cancer, that make up 60% of all survivors nationally. Even though mental health declined after a cancer diagnosis, the long-term outcomes of cancer survivors did not differ from persons without cancer in depression or cognitive function.
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Affiliation(s)
| | - JoAnn S Oliver
- The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL
| | - Forrest Scogin
- The University of Alabama, Department of Psychology, Tuscaloosa, AL
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Lai JS, Wagner LI, Jacobsen PB, Cella D. Self-reported cognitive concerns and abilities: two sides of one coin? Psychooncology 2014; 23:1133-41. [PMID: 24700645 DOI: 10.1002/pon.3522] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 02/04/2014] [Accepted: 02/24/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patient-reported cognitive function can be measured using negatively worded items (concerns) and positively worded (abilities) items. It is possible that reporting abilities is less subject to the influence of emotional states. This study evaluated the relationship between cognitive concerns and cognitive abilities. METHODS Cancer patients (N = 509; mean age = 61 years; 50% men; 86% White) completed concerns and abilities items developed by the National Institutes of Health Patient-Reported Outcomes Information System (PROMIS). Confirmatory factor analysis was used to evaluate the extent to which items were loaded on one single factor (unidimensionality). Multidimensionality was evaluated using bi-factor analysis (local factors: concerns and abilities). Slope parameters from multidimensional item response theory (IRT) and unidimensional IRT were compared to evaluate which factor solution fits best. RESULTS Acceptable fit indices were found in both one-factor confirmatory factor analysis (comparative fit index (CFI) = 0.96; root mean squared error of approximation (RMSEA) = 0.062) and bi-factor analysis (CFI = 0.98; RMSEA = 0.043). Thus, abilities and concerns could be considered as a single dimension. Yet, high loadings on the local factor in bi-factor analysis and slope discrepancies between unidimensional IRT and multidimensional IRT indicate that abilities should be considered as a separate factor from concerns. CONCLUSIONS Concerns and abilities could be measured using one-unidimensional item bank. Results also support measuring each construct separately. We recommend a conservative approach by measuring and reporting concerns and abilities separately. We therefore recommend two separate but co-calibrated item banks in the PROMIS network: cognitive function item bank-concerns and cognitive function item bank-abilities. Both item banks showed good psychometric properties and are available for research and clinical purposes.
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Dubois M, Lapinte N, Villier V, Lecointre C, Roy V, Tonon MC, Gandolfo P, Joly F, Hilber P, Castel H. Chemotherapy-induced long-term alteration of executive functions and hippocampal cell proliferation: Role of glucose as adjuvant. Neuropharmacology 2014; 79:234-48. [DOI: 10.1016/j.neuropharm.2013.11.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 11/18/2013] [Accepted: 11/19/2013] [Indexed: 11/28/2022]
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Miki E, Kataoka T, Okamura H. Feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients in Japan. Psychooncology 2014; 23:906-13. [PMID: 24532471 DOI: 10.1002/pon.3501] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 12/17/2013] [Accepted: 01/17/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We conducted this study with the aim of demonstrating the feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients. METHODS The subjects were patients with breast or prostate cancer who were 65 years of age or over. Among 146 patients, 78 were randomly assigned to the intervention group (n = 38) or the control group (n = 40). The intervention group received speed-feedback therapy with a bicycle ergometer once a week for four successive weeks. The control group was advised to spend the 4-week period engaged in their routine activities. Evaluations were carried out at the baseline and 4 weeks after the baseline (week 4) using the Frontal Assessment Battery, the Barthel Index, the Lawton and Brody Instrumental Activities of Daily Living, and the Functional Assessment of Cancer Therapy-General ver.4. Data were analyzed by a two-way repeated-measures analysis of variance. RESULTS The mean score of Frontal Assessment Battery for the intervention group was higher than that for the control group at week 4. In addition to significant main effects of time and group, we also found a significant interaction between the two groups (p = 0.006). Moreover, all of the subjects in the intervention group could complete all the four sessions of therapy without any pain or distress. CONCLUSION These results suggest that speed-feedback therapy with a bicycle ergometer may be feasible as well as effective for improving the cognitive function in elderly cancer patients.
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Affiliation(s)
- Emi Miki
- Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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43
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Pyter LM, El Mouatassim Bih S, Sattar H, Prendergast BJ. Peripheral tumors alter neuroinflammatory responses to lipopolysaccharide in female rats. Brain Res 2014; 1552:55-63. [PMID: 24457042 DOI: 10.1016/j.brainres.2014.01.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/05/2014] [Accepted: 01/14/2014] [Indexed: 01/07/2023]
Abstract
Cancer is associated with an increased prevalence of depression. Peripheral tumors induce inflammatory cytokine production in the brain and depressive-like behaviors. Mounting evidence indicates that cytokines are part of a pathway by which peripheral inflammation causes depression. Neuroinflammatory responses to immune challenges can be exacerbated (primed) by prior immunological activation associated with aging, early-life infection, and drug exposure. This experiment tested the hypothesis that peripheral tumors likewise induce neuroinflammatory sensitization or priming. Female rats with chemically-induced mammary carcinomas were injected with either saline or lipopolysaccharide (LPS, 250μg/kg; i.p.), and expression of mRNAs involved in the pathway linking inflammation and depression (interleukin-1beta [Il-1β], CD11b, IκBα, indolamine 2,3-deoxygenase [Ido]) was quantified by qPCR in the hippocampus, hypothalamus, and frontal cortex, 4 or 24h post-treatment. In the absence of LPS, hippocampal Il-1β and CD11b mRNA expression were elevated in tumor-bearing rats, whereas Ido expression was reduced. Moreover, in saline-treated rats basal hypothalamic Il-1β and CD11b expression were positively correlated with tumor weight; heavier tumors, in turn, were characterized by more inflammatory, necrotic, and granulation tissue. Tumors exacerbated CNS proinflammatory gene expression in response to LPS: CD11b was greater in hippocampus and frontal cortex of tumor-bearing relative to tumor-free rats, IκBα was greater in hippocampus, and Ido was greater in hypothalamus. Greater neuroinflammatory responses in tumor-bearing rats were accompanied by attenuated body weight gain post-LPS. The data indicate that neuroinflammatory pathways are potentiated, or primed, in tumor-bearing rats, which may exacerbate future negative behavioral consequences.
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MESH Headings
- Animals
- CD11b Antigen/biosynthesis
- CD11b Antigen/genetics
- Depression/etiology
- Depression/genetics
- Depression/immunology
- Down-Regulation/drug effects
- Endotoxemia/genetics
- Endotoxemia/immunology
- Endotoxemia/psychology
- Endotoxins/toxicity
- Enzyme Induction/drug effects
- Female
- Frontal Lobe/drug effects
- Frontal Lobe/metabolism
- Gene Expression Regulation, Neoplastic/drug effects
- Hippocampus/drug effects
- Hippocampus/metabolism
- Hypothalamus/drug effects
- Hypothalamus/metabolism
- Indoleamine-Pyrrole 2,3,-Dioxygenase/biosynthesis
- Indoleamine-Pyrrole 2,3,-Dioxygenase/genetics
- Inflammation/chemically induced
- Inflammation/genetics
- Inflammation/immunology
- Inflammation/psychology
- Interleukin-1beta/biosynthesis
- Interleukin-1beta/genetics
- Mammary Neoplasms, Experimental/chemically induced
- Mammary Neoplasms, Experimental/immunology
- Mammary Neoplasms, Experimental/psychology
- RNA, Messenger/biosynthesis
- RNA, Neoplasm
- Rats
- Rats, Wistar
- Tumor Burden/drug effects
- Weight Gain
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Affiliation(s)
- Leah M Pyter
- Department of Psychology, Institute for Mind and Biology, University of Chicago, Chicago, IL 60637, USA.
| | - Sarah El Mouatassim Bih
- Department of Psychology, Institute for Mind and Biology, University of Chicago, Chicago, IL 60637, USA
| | - Husain Sattar
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA
| | - Brian J Prendergast
- Department of Psychology, Institute for Mind and Biology, University of Chicago, Chicago, IL 60637, USA
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Integrating functional near-infrared spectroscopy in the characterization, assessment, and monitoring of cancer and treatment-related neurocognitive dysfunction. Neuroimage 2014; 85 Pt 1:408-14. [DOI: 10.1016/j.neuroimage.2013.06.075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 06/22/2013] [Accepted: 06/24/2013] [Indexed: 01/26/2023] Open
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Li J, O W, Li W, Jiang ZG, Ghanbari HA. Oxidative stress and neurodegenerative disorders. Int J Mol Sci 2013; 14:24438-75. [PMID: 24351827 PMCID: PMC3876121 DOI: 10.3390/ijms141224438] [Citation(s) in RCA: 281] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 11/27/2013] [Accepted: 12/06/2013] [Indexed: 12/14/2022] Open
Abstract
Living cells continually generate reactive oxygen species (ROS) through the respiratory chain during energetic metabolism. ROS at low or moderate concentration can play important physiological roles. However, an excessive amount of ROS under oxidative stress would be extremely deleterious. The central nervous system (CNS) is particularly vulnerable to oxidative stress due to its high oxygen consumption, weakly antioxidative systems and the terminal-differentiation characteristic of neurons. Thus, oxidative stress elicits various neurodegenerative diseases. In addition, chemotherapy could result in severe side effects on the CNS and peripheral nervous system (PNS) of cancer patients, and a growing body of evidence demonstrates the involvement of ROS in drug-induced neurotoxicities as well. Therefore, development of antioxidants as neuroprotective drugs is a potentially beneficial strategy for clinical therapy. In this review, we summarize the source, balance maintenance and physiologic functions of ROS, oxidative stress and its toxic mechanisms underlying a number of neurodegenerative diseases, and the possible involvement of ROS in chemotherapy-induced toxicity to the CNS and PNS. We ultimately assess the value for antioxidants as neuroprotective drugs and provide our comments on the unmet needs.
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Affiliation(s)
- Jie Li
- Department of Geratology, First Hospital of Jilin University, Changchun, Jilin 130021, China; E-Mail:
| | - Wuliji O
- College of Pharmacology, Inner Mongolia University for the Nationalities, Tongliao, Inner Mongolia 028000, China; E-Mail:
| | - Wei Li
- Cancer Center, First Hospital of Jilin University, Changchun, Jilin 130021, China; E-Mail:
| | - Zhi-Gang Jiang
- Panacea Pharmaceuticals, Inc., Gaithersburg, MD 20877, USA; E-Mail:
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Cognitive impairment in gynecologic cancers: a systematic review of current approaches to diagnosis and treatment. Support Care Cancer 2013; 22:279-87. [PMID: 24212261 DOI: 10.1007/s00520-013-2029-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 10/18/2013] [Indexed: 12/30/2022]
Abstract
PURPOSE To review the etiology and assessment of chemotherapy-related cognitive impairment (CRCI). To explore current treatment and prevention strategies for CRCI and propose future research goals in the field of gynecologic oncology. METHODS Computerized searches in PubMed of cognitive impairment in cancer between 2000 and 2012 were conducted. The inclusion criteria were randomized control trials evaluating treatment of CRCI and search terms 'cognitive function, cognitive impairment, cognitive decline, chemobrain, chemofog, and cancer'. RESULTS To date, numerous modalities have been utilized for assessing CRCI in patients undergoing therapy. It has been proposed to move towards web-based assessment modalities as a possible standard. Few studies have aimed to elucidate possible treatment and prevention options for CRCI; even less in the field of gynecologic oncology. Only seven of these studies were subjected to randomized control trials. Only one of these studies looked at treatment in patients with gynecologic cancers. CONCLUSIONS The etiology of CRCI is multi-factorial. Following from this, there is no consensus on the best way to assess CRCI although objective measures are more reliable. One must extrapolate data from the non-gynecologic cancer literature, even venturing to non-cancer literature, to explore the treatment and prevention of CRCI. The methods found in these areas of research have not yet been applied to CRCI in gynecologic oncology.
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Davis J, Ahlberg FM, Berk M, Ashley DM, Khasraw M. Emerging pharmacotherapy for cancer patients with cognitive dysfunction. BMC Neurol 2013; 13:153. [PMID: 24156319 PMCID: PMC4015674 DOI: 10.1186/1471-2377-13-153] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 01/04/2023] Open
Abstract
Advances in the diagnosis and multi-modality treatment of cancer have increased survival rates for many cancer types leading to an increasing load of long-term sequelae of therapy, including that of cognitive dysfunction. The cytotoxic nature of chemotherapeutic agents may also reduce neurogenesis, a key component of the physiology of memory and cognition, with ramifications for the patient's mood and other cognition disorders. Similarly radiotherapy employed as a therapeutic or prophylactic tool in the treatment of primary or metastatic disease may significantly affect cognition. A number of emerging pharmacotherapies are under investigation for the treatment of cognitive dysfunction experienced by cancer patients. Recent data from clinical trials is reviewed involving the stimulants modafinil and methylphenidate, mood stabiliser lithium, anti-Alzheimer's drugs memantine and donepezil, as well as other agents which are currently being explored within dementia, animal, and cell culture models to evaluate their use in treating cognitive dysfunction.
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Affiliation(s)
| | | | | | | | - Mustafa Khasraw
- School of Medicine of Deakin University, Geelong, VIC, Australia.
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Arndt J, Das E, Schagen SB, Reid-Arndt SA, Cameron LD, Ahles TA. Broadening the cancer and cognition landscape: the role of self-regulatory challenges. Psychooncology 2013; 23:1-8. [PMID: 23839818 DOI: 10.1002/pon.3351] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 06/05/2013] [Accepted: 06/17/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND The potentially detrimental effects of cancer and related treatments on cognitive functioning have emerged as one of the key foci of cancer survivorship research, but little is known about how psychological variables other than depression influence these relationships. To illustrate the potential of social psychological perspectives, we examine how a self-regulatory analysis and specific self-regulatory challenges of contending with cancer-related expectancies and stereotypes provide conceptual frameworks for understanding some of the potential causes and consequences of cancer-related cognitive deficits. METHODS Literatures on cancer-related cognitive deficits, self-regulatory ego depletion, expectancy stereotypes, and their points of convergence are briefly reviewed. RESULTS A review and conceptual integration of relevant literatures suggest that coping with cancer can impair self-regulatory capacity. There is an overlap between cognitive deficits associated with self-regulatory challenge and with cancer and its treatment, and restoring self-regulatory resources can attenuate cancer-related cognitive deficits. Examination of specific regulatory challenges of contending with expectancies and stereotypes related to treatment suggests insights that can inform when and among whom cognitive deficits may most likely emerge. CONCLUSIONS Integrating social psychological ideas with a substantial knowledge base can illustrate novel research trajectories that can deepen our understanding of cancer-related cognitive deficits and their impact on psychosocial well-being.
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Affiliation(s)
- Jamie Arndt
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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Tanimukai H, Kanayama D, Omi T, Takeda M, Kudo T. Paclitaxel induces neurotoxicity through endoplasmic reticulum stress. Biochem Biophys Res Commun 2013; 437:151-5. [PMID: 23806691 DOI: 10.1016/j.bbrc.2013.06.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 06/14/2013] [Indexed: 11/28/2022]
Abstract
Due to chemotherapy, the majority of breast cancer patients survive, but frequently complain of chemotherapy-associated cognitive impairment. This phenomenon is termed "chemobrain" or "chemofog" in the literature. However, its mechanisms are unclear. The objective of this study was to investigate the mechanisms of paclitaxel (Px)-induced neurotoxicity, with a focus on endoplasmic reticulum (ER) stress. To investigate Px-induced neurotoxicity and ER stress induction, SK-N-SH cells were treated with 1, 10, 50, and 100 μM Px for 24 h. Neurotoxicity was assessed using MTS viability assays, and ER stress was assessed by evaluating the expression of phosphorylated elF2α (phospho-eIF2α), C/EBP homologous protein (CHOP), and cleaved caspase 4 and caspase 3 (the active form of each caspase). Furthermore, to investigate whether immunoglobulin heavy-chain binding protein (BiP) inducer X (BIX), which induces the molecular chaperone BiP, could attenuate Px-induced neurotoxicity, SK-N-SH cells were pre-treated for 12 h with 3.5 μM BIX before Px treatment. Neurotoxicity was observed in SK-N-SH cells treated with Px in a dose-dependent manner compared with vehicle control. Furthermore, phospho-eIF2α, CHOP, and activated caspase 4 and caspase 3 were significantly induced in Px-treated cells. In addition, pre-treatment with BIX significantly attenuated the induction of CHOP and activated caspase 4 and caspase 3. The viability of BIX pre-treated cells prior to Px treatment was significantly increased compared with cells that were not treated with BIX. Our results suggest that Px induces neurotoxicity in part through activating the ER stress response. Our findings should contribute to novel approaches regarding the mechanism of Px-induced neurotoxicity, including chemobrain.
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Affiliation(s)
- Hitoshi Tanimukai
- Osaka University Hospital, Oncology Center, 2-15 Yamadaoka, Suita City, Osaka 565-0871, Japan.
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Paquet L, Collins B, Song X, Chinneck A, Bedard M, Verma S. A pilot study of prospective memory functioning in early breast cancer survivors. Breast 2013; 22:455-61. [PMID: 23648279 DOI: 10.1016/j.breast.2013.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/17/2013] [Accepted: 04/03/2013] [Indexed: 01/06/2023] Open
Abstract
AIMS To evaluate prospective memory (PM) functioning in early breast cancer (BC) survivors and its association with fatigue and depression. METHODS The Memory for Intention Screening Test, the Center for Epidemiologic Studies Depression Scale and the Functional Assessment of Cancer Therapy-Fatigue subscale were administered to 80 patients and 80 aged-matched healthy controls. RESULTS Patients performed more poorly than controls on the memory test (p < 0.001) and had a higher rate of impairment (odds ratio = 5.5, p < 0.01). Fatigue mediated the relationship between Group membership and PM performance. CONCLUSIONS BC survivors exhibited a clear pattern of PM deficit and fatigue was a major contributor to this deficit. This suggests that a common mechanism may be involved in fatigue symptoms and memory disturbances experienced by patients. Further research is needed to evaluate the role of adjuvant therapy in PM deficits and to explore whether interventions targeted at improving fatigue may also improve memory functioning in BC survivors.
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Affiliation(s)
- Lise Paquet
- Carleton University, Ottawa, Ontario, Canada
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