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Nordhjem BJT, Tjørnlund M, Thomsen BL, Hjerming M, Kjær TW, Pappot H, Hjalgrim LL. Protocol for a prospective, longitudinal study of cognitive impairment in young patients with cancer: a multidisciplinary neuroscience approach (MyBrain). BMJ Open 2023; 13:e070534. [PMID: 37202143 DOI: 10.1136/bmjopen-2022-070534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION The aim of this research is to investigate young cancer patients' cognitive functioning and the underlying neurobiological mechanisms when cognitive functions are impaired. The MyBrain protocol is a multidisciplinary study that investigates cancer-related cognitive impairment in children, adolescents and young adults, combining neuropsychology, cognitive neuroscience and cellular neuroscience. The study is exploratory with a wide focus on trajectories of cognitive functions from diagnosis to the end of treatment and into survivorship. METHODS AND ANALYSIS Prospective longitudinal study including patients diagnosed with non-brain cancers at age 7-29 years. Each patient is paired with a control matched on age and social circle. PRIMARY OBJECTIVE Evaluation of neurocognitive function over time. SECONDARY OBJECTIVES Evaluation of self-perceived quality of life and fatigue, P300 in an electroencephalography (EEG) oddball paradigm, power spectrum in resting state EEG, serum and cerebrospinal fluid levels of biomarkers of neuronal damage, neuroplasticity, proinflammatory and anti-inflammatory markers and their association with cognitive function. ETHICS AND DISSEMINATION The study is approved by the Regional Ethics Committee for the Capital Region of Denmark (no. H-21028495), and the Danish Data Protection Agency (no. P-2021-473). Results are expected to guide future interventions to prevent brain damage and support patients with cognitive difficulties. TRIAL REGISTRATION NUMBER The article is registered at clinicaltrials.gov NCT05840575 (https://clinicaltrials.gov/ct2/show/NCT05840575).
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Affiliation(s)
| | - Morten Tjørnlund
- Center for Rehabilitation of Brain Injury, University of Copenhagen, Copenhagen, Denmark
| | - Birthe Lykke Thomsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Haematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Helle Pappot
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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La Carpia D, Liperoti R, Guglielmo M, Di Capua B, Devizzi LF, Matteucci P, Farina L, Fusco D, Colloca G, Di Pede P, Ferrara ML, Hohaus S, Bernabei R, Ripamonti CI. Cognitive decline in older long-term survivors from Non-Hodgkin Lymphoma: a multicenter cross-sectional study. J Geriatr Oncol 2020; 11:790-795. [PMID: 32008957 DOI: 10.1016/j.jgo.2020.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/12/2019] [Accepted: 01/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare cognition in a group of older long-term survivors from Non-Hodgkin Lymphoma (NHL) and in a corresponding group of non-cancer controls of the same age. Functional status, polypharmacy and multimorbidity were also evaluated. METHODS A cross-sectional study was performed in a population of 63 outpatient long-term survivors from NHL, aged 65 or more and 61 non-cancer controls. Socio-demographic, clinical and functional data were collected. Cognitive function was assessed through neuropsychological tests. RESULTS NHL survivors showed a slightly worse functional status than controls, they were affected by more chronic conditions (3.4 vs 2.3; p = .003) and were taking a higher number of medications (3.4 vs 2.3; p = .03). The Mini Mental State Examination (MMSE) was not significantly different between the groups. NHL survivors performed worse than controls in executive functioning (Trail Making Test B-A 47.9 vs 32.1 p = .04, OR for Stroop test time over 75th percentile in survivors: 2.66; CI 95% 1.04-6.61; OR for Multiple Features Target Cancellation time over 75th percentile in survivors: 2.84; CI 95% 1.10-7.31). A small, statistically significant difference was also observed in verbal memory scores between the two groups. . CONCLUSIONS The findings of this study suggest that, compared with non-cancer controls, older survivors from NHL may have a lower cognitive performance, especially in the executive functioning and attention domains, regardless of multimorbidity and polypharmacy. Further evidence from larger samples is needed to confirm such findings and better characterize cognitive decline in NHL survivors.
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Affiliation(s)
| | - Rosa Liperoti
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Guglielmo
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Beatrice Di Capua
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Paola Matteucci
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Farina
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Fusco
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Colloca
- Radiation Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Patricia Di Pede
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Stephan Hohaus
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carla Ida Ripamonti
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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Henneghan A, Haley AP, Kesler S. Exploring Relationships Among Peripheral Amyloid Beta, Tau, Cytokines, Cognitive Function, and Psychosomatic Symptoms in Breast Cancer Survivors. Biol Res Nurs 2020; 22:126-138. [PMID: 31707784 PMCID: PMC7068749 DOI: 10.1177/1099800419887230] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Accelerated brain aging has been proposed to explain cancer-related cognitive impairment, but empirical evidence for this relationship is lacking. The purpose of this study was to evaluate amyloid beta (Aβ) and tau, biomarkers of neurodegeneration, in relation to cognition in breast cancer survivors (BCSs). We explored relationships among peripheral concentrations of Aβ42, Aβ-40, tau, and cytokines; cognitive function; and psychosomatic symptoms in a cohort of BCSs post-chemotherapy. METHODS This secondary analysis of a cross-sectional study was conducted with 65 BCSs. Serum total Aβ-42, Aβ-40, and tau levels were measured with single molecule array technology. Cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, granulocyte-macrophage colony-stimulating factor [GM-CSF], interferon [IFN]-g, IL-10, IL-12, IL-13, IL1-b, IL-2, IL-4, IL-5, IL-7, and IL-8) were simultaneously measured in serum using multiplex assays. Cognitive function was measured with five standardized neuropsychological tests and psychosomatic symptoms (stress, loneliness, anxiety, depressive symptoms, fatigue, sleep quality, and daytime sleepiness) with self-report questionnaires. Data analyses included correlations and random forest regression (RFR). RESULTS Significant correlations were identified among hip-to-waste ratio, number of treatment modalities, Aβ-42, Aβ-40, and tau levels (rs = .27-.35, ps < .05). RFR modeling including Aβ-42, Aβ-40, tau, and cytokines as features explained significant variance in cognitive function (R2 = .71, F = 9.01, p < .0001) and psychosomatic symptoms (R2 = .74, F = 10.22, p < .0001). CONCLUSIONS This study suggests that neurodegenerative biomarkers interact with cytokines to influence cognitive functioning and psychosomatic symptoms in BCSs following chemotherapy, but additional research is needed.
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Affiliation(s)
- Ashley Henneghan
- School of Nursing; Department of Oncology, University of Texas at Austin,
Austin, TX, USA
| | - Andreana P. Haley
- Department of Psychology, College of Liberal Arts, University of Texas at
Austin, Austin, TX, USA
| | - Shelli Kesler
- School of Nursing; Department of Oncology, University of Texas at Austin,
Austin, TX, USA
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Van Dyk K, Hunter AM, Ercoli L, Petersen L, Leuchter AF, Ganz PA. Evaluating cognitive complaints in breast cancer survivors with the FACT-Cog and quantitative electroencephalography. Breast Cancer Res Treat 2017; 166:157-166. [PMID: 28707203 DOI: 10.1007/s10549-017-4390-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/07/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Targeted methods for evaluating cognitive dysfunction in breast cancer survivors are needed to effectively address this important survivorship issue. To address this need, we examined the validity of a self-report instrument (The functional assessment of cancer therapy: cognitive function; FACT-Cog) regarding correspondence with neuropsychological performance versus depression and evaluated neurophysiological biomarkers of cognition and depressed mood in a sample of breast cancer survivors several years from diagnosis. METHODS This is a cross-sectional study sample from the prospective observational Mind Body Study. Recruited participants were breast cancer survivors at least 3 years from cancer diagnosis who were part of a longitudinal cohort, and were without current psychiatric disorder or history of a neurological or cognitive disorder at baseline (after completion of primary cancer treatment). Exploratory analysis of the FACT-Cog and quantitative electroencephalography (qEEG) were conducted, with respect to their association with neuropsychological domain scores and depressive symptoms as measured by the Beck Depression Inventory, 2nd edition (BDI-II). RESULTS Self-reported cognitive abilities and the impact of cognitive dysfunction on quality of life were associated with memory function in addition to depressive symptoms in our sample of breast cancer survivors. qEEG measures exhibit differential patterns of association with neuropsychological performance and mood. CONCLUSIONS Our findings indicate that perceived cognitive abilities and the impact of cognitive difficulties on quality of life are valid indicators of objective cognitive function, independent of depressive symptoms. Neurophysiological correlates of cognitive function and depressive symptoms represent promising biomarkers of these behavioral difficulties in survivorship.
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Affiliation(s)
- Kathleen Van Dyk
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
- UCLA Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA
| | - Aimee M Hunter
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Linda Ercoli
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Laura Petersen
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Andrew F Leuchter
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Patricia A Ganz
- UCLA Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA.
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
- UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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Treanor CJ, McMenamin UC, O'Neill RF, Cardwell CR, Clarke MJ, Cantwell M, Donnelly M. Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment. Cochrane Database Syst Rev 2016; 2016:CD011325. [PMID: 27529826 PMCID: PMC8734151 DOI: 10.1002/14651858.cd011325.pub2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND It is estimated that up to 75% of cancer survivors may experience cognitive impairment as a result of cancer treatment and given the increasing size of the cancer survivor population, the number of affected people is set to rise considerably in coming years. There is a need, therefore, to identify effective, non-pharmacological interventions for maintaining cognitive function or ameliorating cognitive impairment among people with a previous cancer diagnosis. OBJECTIVES To evaluate the cognitive effects, non-cognitive effects, duration and safety of non-pharmacological interventions among cancer patients targeted at maintaining cognitive function or ameliorating cognitive impairment as a result of cancer or receipt of systemic cancer treatment (i.e. chemotherapy or hormonal therapies in isolation or combination with other treatments). SEARCH METHODS We searched the Cochrane Centre Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PUBMED, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO databases. We also searched registries of ongoing trials and grey literature including theses, dissertations and conference proceedings. Searches were conducted for articles published from 1980 to 29 September 2015. SELECTION CRITERIA Randomised controlled trials (RCTs) of non-pharmacological interventions to improve cognitive impairment or to maintain cognitive functioning among survivors of adult-onset cancers who have completed systemic cancer therapy (in isolation or combination with other treatments) were eligible. Studies among individuals continuing to receive hormonal therapy were included. We excluded interventions targeted at cancer survivors with central nervous system (CNS) tumours or metastases, non-melanoma skin cancer or those who had received cranial radiation or, were from nursing or care home settings. Language restrictions were not applied. DATA COLLECTION AND ANALYSIS Author pairs independently screened, selected, extracted data and rated the risk of bias of studies. We were unable to conduct planned meta-analyses due to heterogeneity in the type of interventions and outcomes, with the exception of compensatory strategy training interventions for which we pooled data for mental and physical well-being outcomes. We report a narrative synthesis of intervention effectiveness for other outcomes. MAIN RESULTS Five RCTs describing six interventions (comprising a total of 235 participants) met the eligibility criteria for the review. Two trials of computer-assisted cognitive training interventions (n = 100), two of compensatory strategy training interventions (n = 95), one of meditation (n = 47) and one of physical activity intervention (n = 19) were identified. Each study focused on breast cancer survivors. All five studies were rated as having a high risk of bias. Data for our primary outcome of interest, cognitive function were not amenable to being pooled statistically. Cognitive training demonstrated beneficial effects on objectively assessed cognitive function (including processing speed, executive functions, cognitive flexibility, language, delayed- and immediate- memory), subjectively reported cognitive function and mental well-being. Compensatory strategy training demonstrated improvements on objectively assessed delayed-, immediate- and verbal-memory, self-reported cognitive function and spiritual quality of life (QoL). The meta-analyses of two RCTs (95 participants) did not show a beneficial effect from compensatory strategy training on physical well-being immediately (standardised mean difference (SMD) 0.12, 95% confidence interval (CI) -0.59 to 0.83; I(2)= 67%) or two months post-intervention (SMD - 0.21, 95% CI -0.89 to 0.47; I(2) = 63%) or on mental well-being two months post-intervention (SMD -0.38, 95% CI -1.10 to 0.34; I(2) = 67%). Lower mental well-being immediately post-intervention appeared to be observed in patients who received compensatory strategy training compared to wait-list controls (SMD -0.57, 95% CI -0.98 to -0.16; I(2) = 0%). We assessed the assembled studies using GRADE for physical and mental health outcomes and this evidence was rated to be low quality and, therefore findings should be interpreted with caution. Evidence for physical activity and meditation interventions on cognitive outcomes is unclear. AUTHORS' CONCLUSIONS Overall, the, albeit low-quality evidence may be interpreted to suggest that non-pharmacological interventions may have the potential to reduce the risk of, or ameliorate, cognitive impairment following systemic cancer treatment. Larger, multi-site studies including an appropriate, active attentional control group, as well as consideration of functional outcomes (e.g. activities of daily living) are required in order to come to firmer conclusions about the benefits or otherwise of this intervention approach. There is also a need to conduct research into cognitive impairment among cancer patient groups other than women with breast cancer.
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Affiliation(s)
- Charlene J Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences Block B, Royal Victoria Hospital Site, Grosvenor Road, Belfast, Northern Ireland, UK, BT12 6BJ
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Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature. PLoS One 2016; 11:e0149085. [PMID: 26914356 PMCID: PMC4767709 DOI: 10.1371/journal.pone.0149085] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 01/27/2016] [Indexed: 01/08/2023] Open
Abstract
The main objective of this study is to review and summarize recent findings on electroencephalographic patterns in individuals with chronic pain. We also discuss recent advances in the use of quantitative Electroencephalography (qEEG) for the assessment of pathophysiology and biopsychosocial factors involved in its maintenance over time. Data collection took place from February 2014 to July 2015 in PubMed, SciELO and PEDro databases. Data from cross-sectional studies and longitudinal studies, as well as clinical trials involving chronic pain participants were incorporated into the final analysis. Our primary findings related to chronic pain were an increase of theta and alpha EEG power at rest, and a decrease in the amplitude of evoked potentials after sensory stimulation and cognitive tasks. This review suggests that qEEG could be considered as a simple and objective tool for the study of brain mechanisms involved in chronic pain, as well as for identifying the specific characteristics of chronic pain condition. In addition, results show that qEEG probably is a relevant outcome measure for assessing changes in therapeutic studies.
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Merriman JD, Sereika SM, Brufsky AM, McAuliffe PF, McGuire KP, Myers JS, Phillips ML, Ryan CM, Gentry AL, Jones LD, Bender CM. Trajectories of self-reported cognitive function in postmenopausal women during adjuvant systemic therapy for breast cancer. Psychooncology 2015; 26:44-52. [PMID: 26486371 DOI: 10.1002/pon.4009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/10/2015] [Accepted: 09/25/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE In a sample of 368 postmenopausal women, we (1) determined within-cohort and between-cohort relationships between adjuvant systemic therapy for breast cancer and self-reported cognitive function during the first 18 months of therapy and (2) evaluated the influence of co-occurring symptoms, neuropsychological function, and other covariates on relationships. METHODS We evaluated self-reported cognitive function, using the Patient Assessment of Own Functioning Inventory (PAOFI), and potential covariates (e.g., co-occurring symptom scores and neuropsychological function z-scores) in 158 women receiving aromatase inhibitor (AI) therapy alone, 104 women receiving chemotherapy followed by AI therapy, and 106 non-cancer controls. Patients were assessed before systemic therapy and then every 6 months, for a total of four assessments over 18 months. Controls were assessed at matched time points. Mixed-effects modeling was used to determine longitudinal relationships. RESULTS Controlling for covariates, patients enrolled before chemotherapy reported poorer global cognitive function (p < 0.001), memory (p < 0.001), language and communication (p < 0.001), and sensorimotor function (p = 0.002) after chemotherapy. These patients reported poorer higher-level cognitive and intellectual functions from before chemotherapy to 12 months after initiation of AI therapy (p < 0.001). Higher levels of depressive symptoms (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.040) at enrollment were predictors of poorer cognitive function over time. PAOFI total score was a predictor of executive function (p = 0.048) and visual working memory (p = 0.005) z-scores, controlling for covariates. CONCLUSIONS Findings provide further evidence of poorer self-reported cognitive function after chemotherapy and of relationships between co-occurring symptoms and cognitive changes. AI therapy alone does not have an impact on self-reported cognitive function. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- John D Merriman
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adam M Brufsky
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Priscilla F McAuliffe
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Kandace P McGuire
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jamie S Myers
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary L Phillips
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Amanda L Gentry
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Jones
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Amidi A, Christensen S, Mehlsen M, Jensen AB, Pedersen AD, Zachariae R. Long-term subjective cognitive functioning following adjuvant systemic treatment: 7-9 years follow-up of a nationwide cohort of women treated for primary breast cancer. Br J Cancer 2015; 113:794-801. [PMID: 26171932 PMCID: PMC4559822 DOI: 10.1038/bjc.2015.243] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/03/2015] [Accepted: 06/10/2015] [Indexed: 11/23/2022] Open
Abstract
Background: There is growing concern among breast cancer (BC) patients and survivors about cognitive impairment following systemic treatments. The aim of the present study was to investigate the long-term effects of standard systemic adjuvant therapies on subjective cognitive impairment (SCI) in a large nationwide cohort of BC survivors 7–9 years after primary surgery. Methods: Participants were recruited from the nationwide Psychosocial Factors and Breast Cancer inception cohort of Danish women treated for primary BC. SCI was assessed with the Cognitive Failures Questionnaire and women allocated to systemic treatment according to nationwide standard protocols were compared with women who had not received any systemic treatments. Results: A total of 1889 recurrence-free survivors were eligible for analysis. No difference in SCI was found between survivors across standardized systemic treatment protocols when analyses were stratified by menopausal status and adjusted for possible sociodemographic and treatment-related confounders. The frequency of significant SCI in a subgroup of survivors in the age range 65–74 years was ∼7%. Conclusions: No differences in long-term SCI at 7–9 years post surgery were found between women who had received systemic therapies and those who had not. Furthermore, the observed proportion of survivors with significant SCI was comparable to normative data. These results are important to communicate to patients, survivors, and clinicians alike, especially in the light of increasing concern about cognitive impairment following systemic therapies.
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Affiliation(s)
- A Amidi
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital & Aarhus University, Bartholins Allé 9, bygn. 1340, DK-8000 Aarhus C, Denmark
| | - S Christensen
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital & Aarhus University, Bartholins Allé 9, bygn. 1340, DK-8000 Aarhus C, Denmark
| | - M Mehlsen
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital & Aarhus University, Bartholins Allé 9, bygn. 1340, DK-8000 Aarhus C, Denmark
| | - A B Jensen
- Department of Oncology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark
| | - A D Pedersen
- Vejlefjord Rehabilitation, Sanatorievej 27b, DK-7140 Stouby, Denmark
| | - R Zachariae
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital & Aarhus University, Bartholins Allé 9, bygn. 1340, DK-8000 Aarhus C, Denmark
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Ercoli LM, Petersen L, Hunter AM, Castellon SA, Kwan L, Kahn-Mills BA, Embree LM, Cernin PA, Leuchter AF, Ganz PA. Cognitive rehabilitation group intervention for breast cancer survivors: results of a randomized clinical trial. Psychooncology 2015; 24:1360-7. [DOI: 10.1002/pon.3769] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/27/2014] [Accepted: 01/15/2015] [Indexed: 01/13/2023]
Affiliation(s)
- L. M. Ercoli
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
- UCLA David Geffen School of Medicine; Los Angeles CA USA
| | - L. Petersen
- Jonsson Comprehensive Cancer Center; Los Angeles CA USA
| | - A. M. Hunter
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
- UCLA David Geffen School of Medicine; Los Angeles CA USA
| | - S. A. Castellon
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
- UCLA David Geffen School of Medicine; Los Angeles CA USA
- Veteran's Administration Greater Los Angeles Healthcare System; Los Angeles CA USA
| | - L. Kwan
- UCLA David Geffen School of Medicine; Los Angeles CA USA
| | | | - L. M. Embree
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
- Veteran's Administration Greater Los Angeles Healthcare System; Los Angeles CA USA
| | - P. A. Cernin
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
| | - A. F. Leuchter
- UCLA Semel Institute for Neuroscience and Human Behavior; Los Angeles CA USA
- UCLA David Geffen School of Medicine; Los Angeles CA USA
| | - P. A. Ganz
- UCLA David Geffen School of Medicine; Los Angeles CA USA
- Jonsson Comprehensive Cancer Center; Los Angeles CA USA
- UCLA Fielding School of Public Health; Los Angeles CA USA
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Wefel JS, Kesler SR, Noll KR, Schagen SB. Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. CA Cancer J Clin 2015; 65:123-38. [PMID: 25483452 PMCID: PMC4355212 DOI: 10.3322/caac.21258] [Citation(s) in RCA: 320] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Answer questions and earn CME/CNE Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported-that cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed.
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Affiliation(s)
- Jeffrey S. Wefel
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Corresponding author: Jeffrey S. Wefel, PhD, Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 431, Houston, TX 77030;
| | - Shelli R. Kesler
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kyle R. Noll
- Associate Professor, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sanne B. Schagen
- Associate Professor, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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