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Published in: Breast Cancer Research and Treatment 3/2012

01-10-2012 | Clinical Trial

Advanced cognitive training for breast cancer survivors: a randomized controlled trial

Authors: Diane Von Ah, Janet S. Carpenter, Andrew Saykin, Patrick Monahan, Jingwei Wu, Menggang Yu, George Rebok, Karlene Ball, Bryan Schneider, Michael Weaver, Eileen Tallman, Fred Unverzagt

Published in: Breast Cancer Research and Treatment | Issue 3/2012

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Abstract

The purpose of this study was to evaluate the preliminary efficacy and satisfaction/acceptability of training in memory or speed of processing versus wait-list control for improving cognitive function in breast cancer survivors. 82 breast cancer survivors completed a three-group randomized, controlled trial. Primary outcomes were objective neuropsychological tests of memory and speed of processing. Secondary outcomes were perceived cognitive functioning, symptom distress (mood disturbance, anxiety, and fatigue), quality of life, and intervention satisfaction/acceptability. Data were collected at baseline, post-intervention, and 2-month follow-up. Using repeated-measures mixed-linear ANCOVA models, each intervention was compared to wait-list control while adjusting for age, education, and baseline measures. The effect sizes for differences in means and the reliable improvement percentage were reported. The results show that domain-specific effects were seen for both interventions: memory training improved memory performance at 2-month follow-up (p = 0.036, d = 0.59); speed of processing training improved processing speed post-intervention (p = 0.040, d = 0.55) and 2-month follow-up (p = 0.016; d = 0.67). Transfer effects to non-trained domains were seen for speed of processing training with improved memory post-intervention (p = 0.007, d = 0.75) and 2-month follow-up (p = 0.004, d = 0.82). Both interventions were associated with improvements in perceived cognitive functioning, symptom distress, and quality of life. Ratings of satisfaction/acceptability were high for both interventions. It was concluded that while both interventions appeared promising, speed of processing training resulted in immediate and durable improvements in objective measures of processing speed and verbal memory. Speed of processing training may have broader benefits in this clinical population.
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Literature
1.
go back to reference Hess LM, Insel KC (2007) Chemotherapy-related change in cognitive function: a conceptual model. Oncol Nurs Forum 34(5):981–994PubMedCrossRef Hess LM, Insel KC (2007) Chemotherapy-related change in cognitive function: a conceptual model. Oncol Nurs Forum 34(5):981–994PubMedCrossRef
2.
go back to reference Jansen CE, Miaskowski C, Dodd M, Dowling G, Kramer J (2005) A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function. Cancer 104(10):2222–2233PubMedCrossRef Jansen CE, Miaskowski C, Dodd M, Dowling G, Kramer J (2005) A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function. Cancer 104(10):2222–2233PubMedCrossRef
3.
go back to reference Stewart A, Bielajew C, Collins B, Parkinson M, Tomiak E (2006) A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer. Clin Neuropsychol 20(1):76–89PubMedCrossRef Stewart A, Bielajew C, Collins B, Parkinson M, Tomiak E (2006) A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer. Clin Neuropsychol 20(1):76–89PubMedCrossRef
4.
go back to reference Falleti MG, Sanfilippo A, Maruff P, Weih L, Phillips KA (2005) The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature. Brain Cogn 59(1):60–70PubMedCrossRef Falleti MG, Sanfilippo A, Maruff P, Weih L, Phillips KA (2005) The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature. Brain Cogn 59(1):60–70PubMedCrossRef
5.
go back to reference Anderson-hanley C, Sherman M, Riggs R, Agocha V, Compas B (2003) Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc 9(7):967–982PubMedCrossRef Anderson-hanley C, Sherman M, Riggs R, Agocha V, Compas B (2003) Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc 9(7):967–982PubMedCrossRef
6.
go back to reference Von Ah D, Russell KM, Storniolo AM, Carpenter JS (2009) Cognitive dysfunction and its relationship to quality of life in breast cancer survivors. Oncol Nurs Forum 36(3):326–336CrossRef Von Ah D, Russell KM, Storniolo AM, Carpenter JS (2009) Cognitive dysfunction and its relationship to quality of life in breast cancer survivors. Oncol Nurs Forum 36(3):326–336CrossRef
7.
go back to reference Mehnert A, Scherwath A, Schirmer L, Schleimer B, Petersen C, Schultz-Kindermann F, Zander AR, Koch U (2007) The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue, and quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy. Patient Educ Couns 66(1):108–118PubMedCrossRef Mehnert A, Scherwath A, Schirmer L, Schleimer B, Petersen C, Schultz-Kindermann F, Zander AR, Koch U (2007) The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue, and quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy. Patient Educ Couns 66(1):108–118PubMedCrossRef
8.
go back to reference Von Ah D, Jansen C, Allen DH, Schiavone RM, Wulff J (2011) Putting evidence into practice: evidence-based interventions for cancer and cancer treatment-related cognitive impairment. Clin J Oncol Nurs 15(6):607–615CrossRef Von Ah D, Jansen C, Allen DH, Schiavone RM, Wulff J (2011) Putting evidence into practice: evidence-based interventions for cancer and cancer treatment-related cognitive impairment. Clin J Oncol Nurs 15(6):607–615CrossRef
9.
go back to reference Fardell JE, Vardy J, Johnston IN, Winocur G (2011) Chemotherapy and cognitive impairment: treatment options. Clin Pharmacol Ther 90(3):366–376PubMedCrossRef Fardell JE, Vardy J, Johnston IN, Winocur G (2011) Chemotherapy and cognitive impairment: treatment options. Clin Pharmacol Ther 90(3):366–376PubMedCrossRef
10.
go back to reference Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M, Morris JN, Rebok GW, Smith DM, Tennstedt SL et al (2002) Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA 288(18):2271–2281PubMedCrossRef Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M, Morris JN, Rebok GW, Smith DM, Tennstedt SL et al (2002) Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA 288(18):2271–2281PubMedCrossRef
11.
go back to reference Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM et al (2006) Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296(23):2805–2814PubMedCrossRef Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM et al (2006) Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296(23):2805–2814PubMedCrossRef
12.
go back to reference Smith GE, Housen P, Yaffe K, Ruff R, Kennison RF, Mahncke HW, Zelinski EM (2009) A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc 57(4):594–603PubMedCrossRef Smith GE, Housen P, Yaffe K, Ruff R, Kennison RF, Mahncke HW, Zelinski EM (2009) A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc 57(4):594–603PubMedCrossRef
13.
go back to reference Zelinski EM, Spina LM, Yaffe K, Ruff R, Kennison RF, Mahncke HW, Smith GE (2011) Improvement in memory with plasticity-based adaptive cognitive training: results of the 3-month follow-up. J Am Geriatr Soc 59(2):258–265PubMedCrossRef Zelinski EM, Spina LM, Yaffe K, Ruff R, Kennison RF, Mahncke HW, Smith GE (2011) Improvement in memory with plasticity-based adaptive cognitive training: results of the 3-month follow-up. J Am Geriatr Soc 59(2):258–265PubMedCrossRef
14.
go back to reference Ferguson RJ, McDonald BC, Rocque MA, Furstenberg CT, Horrigan S, Ahles TA, Saykin AJ (2012) Development of CBT for chemotherapy-related cognitive change: results of a waitlist control trial. Psychooncology 21(2):176–186PubMedCrossRef Ferguson RJ, McDonald BC, Rocque MA, Furstenberg CT, Horrigan S, Ahles TA, Saykin AJ (2012) Development of CBT for chemotherapy-related cognitive change: results of a waitlist control trial. Psychooncology 21(2):176–186PubMedCrossRef
15.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef
16.
go back to reference Jobe JB, Smith DM, Ball K, Tennstedt SL, Marsiske M, Willis SL, Rebok GW, Morris JN, Helmers KF, Leveck MD et al (2001) Active: a cognitive intervention trial to promote independence in older adults. Control Clin Trials 22(4):453–479PubMedCrossRef Jobe JB, Smith DM, Ball K, Tennstedt SL, Marsiske M, Willis SL, Rebok GW, Morris JN, Helmers KF, Leveck MD et al (2001) Active: a cognitive intervention trial to promote independence in older adults. Control Clin Trials 22(4):453–479PubMedCrossRef
17.
go back to reference Mahncke HW, Conner BB, Appelman J, Ahsanuddin ON, Hardy JL, Wood RA, Joyce NM, Boniske T, Atkins SM, Merzenich MM (2006) Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. Proc Natl Acad Sci USA 103(33):12523–12538PubMedCrossRef Mahncke HW, Conner BB, Appelman J, Ahsanuddin ON, Hardy JL, Wood RA, Joyce NM, Boniske T, Atkins SM, Merzenich MM (2006) Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. Proc Natl Acad Sci USA 103(33):12523–12538PubMedCrossRef
18.
go back to reference Rey A (1941) L’examen psychologique dans les cas d’encephalopathie traumatique. Archives de Psychologie 28:286–340 Rey A (1941) L’examen psychologique dans les cas d’encephalopathie traumatique. Archives de Psychologie 28:286–340
19.
go back to reference Wilson B, Cockburn J, Baddeley A (1985) The rivermead behavioral memory test. Thames Valley Test Co., Reading and National Rehabilitation Services, Gaylord Wilson B, Cockburn J, Baddeley A (1985) The rivermead behavioral memory test. Thames Valley Test Co., Reading and National Rehabilitation Services, Gaylord
20.
go back to reference Owsley C, Ball K, McGwin G Jr, Sloane ME, Roenker DE, White MF, Overley ET (1998) Visual processing impairment and risk of motor vehicle crash among older adults. JAMA 279(14):1083–1088PubMedCrossRef Owsley C, Ball K, McGwin G Jr, Sloane ME, Roenker DE, White MF, Overley ET (1998) Visual processing impairment and risk of motor vehicle crash among older adults. JAMA 279(14):1083–1088PubMedCrossRef
21.
go back to reference Ball K, Owsley C (1993) The useful field of view test: a new technique for evaluating age-related declines in visual function. J Am Optom Assoc 64:71–79PubMed Ball K, Owsley C (1993) The useful field of view test: a new technique for evaluating age-related declines in visual function. J Am Optom Assoc 64:71–79PubMed
22.
go back to reference Edwards JD, Ross LA, Wadley VG, Clay OJ, Crowe M, Roenker DL, Ball KK (2006) The useful field of view test: normative data for older adults. Arch Clin Neuropsychol 21(4):275–286PubMedCrossRef Edwards JD, Ross LA, Wadley VG, Clay OJ, Crowe M, Roenker DL, Ball KK (2006) The useful field of view test: normative data for older adults. Arch Clin Neuropsychol 21(4):275–286PubMedCrossRef
23.
go back to reference Jacobs SR, Jacobsen PB, Booth-Jones M, Wagner LI, Anasetti C (2007) Evaluation of the functional assessment of cancer therapy cognitive scale with hematopoietic stem cell transplant patients. J Pain Symptom Manage 33(1):13–23PubMedCrossRef Jacobs SR, Jacobsen PB, Booth-Jones M, Wagner LI, Anasetti C (2007) Evaluation of the functional assessment of cancer therapy cognitive scale with hematopoietic stem cell transplant patients. J Pain Symptom Manage 33(1):13–23PubMedCrossRef
24.
go back to reference Squire LR, Wetzel CD, Slater PC (1979) Memory complaint after electroconvulsive therapy: assessment with a new self-rating instrument. Biol Psychiatry 14:791–801PubMed Squire LR, Wetzel CD, Slater PC (1979) Memory complaint after electroconvulsive therapy: assessment with a new self-rating instrument. Biol Psychiatry 14:791–801PubMed
25.
go back to reference Spielberger CD, Gorsuch RI, Lushene RG (1971) Manual for the state-trait anxiety inventory. Consulting Press, Palo Alto Spielberger CD, Gorsuch RI, Lushene RG (1971) Manual for the state-trait anxiety inventory. Consulting Press, Palo Alto
26.
go back to reference Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 13(2):63–74PubMedCrossRef Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 13(2):63–74PubMedCrossRef
27.
go back to reference Ferrell BR, Dow KH, Leigh S, Ly J, Gulasekaram P (1995) Quality of life in long-term cancer survivors. Oncol Nurs Forum 22(6):915–922PubMed Ferrell BR, Dow KH, Leigh S, Ly J, Gulasekaram P (1995) Quality of life in long-term cancer survivors. Oncol Nurs Forum 22(6):915–922PubMed
28.
go back to reference Ferrans CE, Powers MJ (1985) Quality of life index: development and psychometric properties. ANS Adv Nurs Sci 8(1):15–24PubMed Ferrans CE, Powers MJ (1985) Quality of life index: development and psychometric properties. ANS Adv Nurs Sci 8(1):15–24PubMed
29.
go back to reference Ware JE Jr, Snow KK, Kosinski M, Gandek B (1993) SF-36 health survey manual and interpretation guide. The Health Institute, The New England Medical Center, Boston Ware JE Jr, Snow KK, Kosinski M, Gandek B (1993) SF-36 health survey manual and interpretation guide. The Health Institute, The New England Medical Center, Boston
30.
go back to reference Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD (1979) Assessment of client/patient satisfaction: development of a general scale. Eval Program Plan 2(3):197–207CrossRef Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD (1979) Assessment of client/patient satisfaction: development of a general scale. Eval Program Plan 2(3):197–207CrossRef
31.
go back to reference Carpenter JS, Neal JG, Payne J, Kimmick G, Storniolo AM (2007) Cognitive-behavioral intervention for hot flashes. Oncol Nurs Forum 34(1):E1–E8CrossRef Carpenter JS, Neal JG, Payne J, Kimmick G, Storniolo AM (2007) Cognitive-behavioral intervention for hot flashes. Oncol Nurs Forum 34(1):E1–E8CrossRef
32.
go back to reference Blom G (1958) Statistical estimates and transformed beta variables. Wiley, New York Blom G (1958) Statistical estimates and transformed beta variables. Wiley, New York
33.
go back to reference Dudek FJ (1979) The continuing misinterpretation of the standard error of measurement. Psychol Bull 86(2):335–337CrossRef Dudek FJ (1979) The continuing misinterpretation of the standard error of measurement. Psychol Bull 86(2):335–337CrossRef
34.
go back to reference Uchiyama CL, D’Elia LF, Dellinger AM, Becker JT, Seines DA, Wescln JE, Chen BB, Satz P, van Gorp WG, Miller EN (1995) Alternate forms of the auditory-verbal learning test: issues of test comparability, longitudinal reliability and moderating demographic variables. Arch Clin Neuropsychol 10(2):133–145PubMed Uchiyama CL, D’Elia LF, Dellinger AM, Becker JT, Seines DA, Wescln JE, Chen BB, Satz P, van Gorp WG, Miller EN (1995) Alternate forms of the auditory-verbal learning test: issues of test comparability, longitudinal reliability and moderating demographic variables. Arch Clin Neuropsychol 10(2):133–145PubMed
35.
go back to reference Von Ah D, Harvison K, Monahan P, Moser L, Zhao Q, Carpenter J, Sledge G Jr, Champion V, Unverzagt F (2009) Cognitive function in breast cancer survivors compared to healthy age- and education-matched women. Clin Neuropsychol 23(4):661–674CrossRef Von Ah D, Harvison K, Monahan P, Moser L, Zhao Q, Carpenter J, Sledge G Jr, Champion V, Unverzagt F (2009) Cognitive function in breast cancer survivors compared to healthy age- and education-matched women. Clin Neuropsychol 23(4):661–674CrossRef
36.
go back to reference Valenzuela M, Sachdev P (2009) Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 17(3):179–187PubMedCrossRef Valenzuela M, Sachdev P (2009) Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 17(3):179–187PubMedCrossRef
37.
go back to reference Boykoff N, Moieni M, Subramanian SK (2009) Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232PubMedCrossRef Boykoff N, Moieni M, Subramanian SK (2009) Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232PubMedCrossRef
38.
go back to reference Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M (2010) Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med 52(2):219–227PubMedCrossRef Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M (2010) Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med 52(2):219–227PubMedCrossRef
39.
go back to reference Munir F, Burrows J, Yarker J, Kalawsky K, Bains M (2010) Women’s perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group. J Clin Nurs 19(9–10):1362–1370PubMedCrossRef Munir F, Burrows J, Yarker J, Kalawsky K, Bains M (2010) Women’s perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group. J Clin Nurs 19(9–10):1362–1370PubMedCrossRef
Metadata
Title
Advanced cognitive training for breast cancer survivors: a randomized controlled trial
Authors
Diane Von Ah
Janet S. Carpenter
Andrew Saykin
Patrick Monahan
Jingwei Wu
Menggang Yu
George Rebok
Karlene Ball
Bryan Schneider
Michael Weaver
Eileen Tallman
Fred Unverzagt
Publication date
01-10-2012
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2012
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-012-2210-6

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