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Aspelund SG, Halldorsdottir T, Agustsson G, Sigurdardottir Tobin HR, Wu LM, Amidi A, Johannsdottir KR, Lutgendorf SK, Telles R, Daly HF, Sigurdardottir K, Valdimarsdottir HB, Baldursdottir B. Biological and psychological predictors of cognitive function in breast cancer patients before surgery. Support Care Cancer 2024; 32:88. [PMID: 38185720 DOI: 10.1007/s00520-023-08282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE Research suggests that cancer-related cognitive impairment (CRCI) can occur before breast cancer (BC) treatment. The limited extant evidence suggests the underlying mechanisms could be stress-related. Potential psychological and biological predictors of CRCI prior to any BC treatment were examined. METHODS 112 treatment-naïve women with BC and 67 healthy controls (HC) completed a neuropsychological test battery to assess cognitive impairment and a self-report battery to assess cognitive complaints, cancer-related stress, depressive and anxiety symptoms. Morning and evening cortisol and α-amylase were collected from saliva. Multilinear regressions were conducted. RESULTS Treatment-naïve BC patients were more frequently impaired in verbal memory and processing speed and reported more cognitive complaints (all p < .001) than HC. BC patients and HC did not differ in overall cognitive impairment (p = .21). Steeper α-amylase, lower cancer-related stress and younger age was associated with better overall cognitive function in treatment-naïve BC patients. Higher depressive symptoms predicted higher levels of cognitive complaints in BC patients. CONCLUSION Overall, these findings suggest that stress plays a role in CRCI. This study is the first to associate α-amylase with cognitive function in cancer patients, informing future research. The findings on impairment in processing speed and verbal memory among treatment-naïve BC highlight the need to screen for such impairments among BC patients and indicate that future studies on CRCI should include baseline assessments prior to BC treatment. If replicated, these findings could inform the development and testing of appropriate interventions to decrease CRCI among cancer patients. CLINICAL TRIALS REGISTRATION NUMBER NCT04418856, date of registration: 06.05.2020.
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Affiliation(s)
| | | | - Gudjon Agustsson
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | | | - Lisa M Wu
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Kamilla R Johannsdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Rachel Telles
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | | | | | - Heiddis B Valdimarsdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
- Department of Population Health Science and Policy, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Birna Baldursdottir
- Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland.
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Molina-Hidalgo C, Stillman CM, Collins AM, Velazquez-Diaz D, Ripperger HS, Drake JA, Gianaros PJ, Marsland AL, Erickson KI. Changes in stress pathways as a possible mechanism of aerobic exercise training on brain health: a scoping review of existing studies. Front Physiol 2023; 14:1273981. [PMID: 37885801 PMCID: PMC10598664 DOI: 10.3389/fphys.2023.1273981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Physical activity (PA) in the form of aerobic exercise (AE) preserves and improves neurocognitive function across the lifespan. However, a mechanistic understanding of the pathways by which aerobic exercise impacts brain health is still lacking, particularly with respect to stress-related pathways. One mechanistic hypothesis is that AE improves neurocognitive health in part by modifying circulating levels of stress-related hormones and signaling factors associated with the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS), as commonly measured by the biomarkers cortisol (CORT) and salivary α-amylase (sAA). Thus, this hypothesis predicts that changes in stress biomarkers, such as CORT and sAA, are possible explanatory pathways mediating the positive effects of AE on neurocognitive health. In the present review article, we provide a summary of available studies examining the possibility that exercise-induced changes to stress biomarkers could partly account for exercise-related improvements in neurocognitive health. Our review indicates that despite the intuitive appeal of this hypothesis, there is insufficient evidence available to conclude that chronic and habitual AE affects neurocognitive health by altering stress biomarker pathways. The cross-sectional nature of the majority of reviewed studies highlights the need for well-controlled studies to adequately test this hypothesis.
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Affiliation(s)
| | - Chelsea M. Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Audrey M. Collins
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Daniel Velazquez-Diaz
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Cadiz, Spain
| | - Hayley S. Ripperger
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jermon A. Drake
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I. Erickson
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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