Top

Published in:

01-06-2018 | Original Article

Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study

Authors: Lisa M. Wu, Ali Amidi, Molly L. Tanenbaum, Gary Winkel, Wayne A. Gordon, Simon J. Hall, Katrin Bovbjerg, Michael A. Diefenbach

Published in: Supportive Care in Cancer | Issue 6/2018

Abstract

Purpose

Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment.

Methods

Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent (T2) and 8 weeks later (T3). The acceptability of CCT was also assessed.

Results

Feasibility:A priori feasibility thresholds were partially met (i.e., randomization rate > 50%, retention rate > 70% excluding CCT drop-outs, but < 70% for intent-to-treat). Acceptability: Participants were mostly satisfied with CCT and found it somewhat enjoyable, though barriers to uptake existed. Preliminary efficacy: Linear mixed models indicated significant time by group effects favorable to CCT in reaction time (p = .01), but unfavorable to CCT in verbal and visual memory (ps < .05). Memory was temporarily suppressed in the CCT group at T2, but normalized by T3. There was no effect of CCT on self-reported cognitive functioning, neurobehavioral functioning, nor quality of life.

Conclusions

This study provides tentative support for the feasibility and acceptability of CCT to treat mild cognitive impairment in ADT patients. CCT had a beneficial effect on reaction time, but temporarily suppressed memory. CCT’s benefits may be limited to a narrow area of functioning. Larger-scale studies are needed.

Han M, Partin AW, Pound CR, Epstein JI, Walsh PC (2001) Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 28(3):555–565. https://doi.org/10.1016/S0094-0143(05)70163-4 CrossRefPubMed

Singh J, Trabulsi EJ, Gomella LG (2010) Is there an optimal management for localized prostate cancer? Clin Interv Aging 5:187–197. https://doi.org/10.2147/CIA.56555

Gonzalez BD, Jim HS, Booth-Jones M, Small BJ, Sutton SK, Lin HY, Park JY, Spiess PE, Fishman MN, Jacobsen PB (2015) Course and predictors of cognitive function in patients with prostate cancer receiving androgen-deprivation therapy: a controlled comparison. J Clin Oncol 33(18):2021–2027. https://doi.org/10.1200/JCO.2014.60.1963 CrossRefPubMedPubMedCentral

McGinty HL, Phillips KM, Jim HS, Cessna JM, Asvat Y, Cases MG, Small BJ, Jacobsen PB (2014) Cognitive functioning in men receiving androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis. Support Care Cancer 22(8):2271–2280. https://doi.org/10.1007/s00520-014-2285-1 CrossRefPubMedPubMedCentral

Alibhai SMH, Timilshina N, Duff-Canning S, et al (2017) Effects of long-term androgen deprivation therapy on cognitive function over 36 months in men with prostate cancer. Cancer 123(2):237-244. https://doi.org/10.1002/cncr.30320 CrossRef

Wu LM, Tanenbaum ML, Dijkers MPJM, Amidi A, Hall SJ, Penedo FJ, Diefenbach MA (2016) Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: a mixed methods study. Soc Sci Med 156:80–89. https://doi.org/10.1016/j.socscimed.2016.03.016 CrossRef

Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU (2010) Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 28(2):340–347. https://doi.org/10.1200/JCO.2009.23.2488 CrossRefPubMed

Treanor CJ, McMenamin UC, O’Neill RF, Cardwell CR, Clarke MJ, Cantwell M, Donnelly M (2016) Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment. Cochrane Database Syst Rev 2016:CD011325. https://doi.org/10.1002/14651858.CD011325.pub2

Bray VJ, Dhillon HM, Bell ML, Kabourakis M, Fiero MH, Yip D, Boyle F, Price MA, Vardy JL (2017) Evaluation of a web-based cognitive rehabilitation program in cancer survivors reporting cognitive symptoms after chemotherapy. J Clin Oncol 35(2):217–225. https://doi.org/10.1200/JCO.2016.67.8201 CrossRefPubMed

10.

Mahncke HW, Bronstone A, Merzenich MM (2006) Brain plasticity and functional losses in the aged: scientific bases for a novel intervention. Prog Brain Res 157:81–109. https://doi.org/10.1016/S0079-6123(06)57006-2 CrossRefPubMed

11.

Salthouse TA (1996) The processing-speed theory of adult age differences in cognition. Psychol Rev 103(3):403–428. https://doi.org/10.1037/0033-295X.103.3.403 CrossRefPubMed

12.

Von Ah D, Carpenter JS, Saykin A et al (2012) Advanced cognitive training for breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 135(3):799–809. https://doi.org/10.1007/s10549-012-2210-6 CrossRef

13.

Kesler S, Hadi Hosseini SM, Heckler C, Janelsins M, Palesh O, Mustian K, Morrow G (2013) Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors. Clin Breast Cancer 13(4):299–306. https://doi.org/10.1016/j.clbc.2013.02.004 CrossRefPubMedPubMedCentral

14.

Lebowitz MS, Dams-O’Connor K, Cantor JB (2012) Feasibility of computerized brain plasticity-based cognitive training after traumatic brain injury. J Rehabil Res Dev 49(10):1547–1556. https://doi.org/10.1682/JRRD.2011.07.0133 CrossRefPubMed

15.

Boivin MJ, Busman RA, Parikh SM, Bangirana P, Page CF, Opoka RO, Giordani B (2010) A pilot study of the neuropsychological benefits of computerized cognitive rehabilitation in Ugandan children with HIV. Neuropsychology 24(5):667–673. https://doi.org/10.1037/a0019312 CrossRefPubMed

16.

Morgan NP, Graves KD, Poggi EA, Cheson BD (2008) Implementing an expressive writing study in a cancer clinic. Oncologist 13(2):196–204. https://doi.org/10.1634/theoncologist.2007-0147 CrossRefPubMed

17.

Julious SA (2005) Sample size of 12 per group rule of thumb for a pilot study. Pharm Stat 4(4):287–291. https://doi.org/10.1002/pst.185 CrossRef

18.

Gualtieri CT, Johnson LG (2006) Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol 21(7):623–643. https://doi.org/10.1016/j.acn.2006.05.007 CrossRefPubMed

19.

Richardson-Vejlgaard R, Dawes S, Heaton RK, Bell MD (2009) Validity of cognitive complaints in substance-abusing patients and non-clinical controls: the Patient’s Assessment of Own Functioning Inventory (PAOFI). Psychiatry Res 169(1):70–74. https://doi.org/10.1016/j.psychres.2008.06.018 CrossRefPubMedPubMedCentral

20.

Chelune GJ, Heaton RK, Lehman RAW (1986) Neuropsychological and personality correlates of patients’ complaints of disability. In: Goldstein G, Tarter RE (eds) Advances in Clinical Neuropsychology Vol. 3. Plenum Press, New York, pp 95–126CrossRef

21.

Grace J, Malloy PF (2001) Frontal Systems Behavior Scale (FrSBe): professional manual. Psychological Assessment Resources, Lutz

22.

Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C (2012) Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev 38(7):926–934. https://doi.org/10.1016/j.ctrv.2012.05.002 CrossRefPubMed

23.

Suresh K (2011) An overview of randomization techniques: an unbiased assessment of outcome in clinical research. J Hum Reprod Sci 4(1):8–11. https://doi.org/10.4103/0974-1208.82352 CrossRefPubMedPubMedCentral

24.

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):594–603. https://doi.org/10.1111/j.1532-5415.2008.02167.x CrossRefPubMedPubMedCentral

25.

Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M, Morris JN, Rebok GW, Smith DM, Tennstedt SL, Unverzagt FW, Willis SL, ACTIVE Study Group (2002) Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA 288(18):2271–2281. https://doi.org/10.1001/jama.288.18.2271 CrossRefPubMedPubMedCentral

26.

Rebok GW, Ball K, Guey LT, Jones RN, Kim HY, King JW, Marsiske M, Morris JN, Tennstedt SL, Unverzagt FW, Willis SL, ACTIVE Study Group (2014) Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. J Am Geriatr Soc 62(1):16–24. https://doi.org/10.1111/jgs.12607 CrossRef

27.

Wolinsky FD, Vander Weg MW, Howren MB, Jones MP, Dotson MM (2013) A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults. PLoS One 8(5):e61624. https://doi.org/10.1371/journal.pone.0061624 CrossRefPubMedPubMedCentral

28.

Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD (1979) Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann 2(3):197–207. https://doi.org/10.1016/0149-7189(79)90094-6 CrossRefPubMed

29.

Choi J, Mogami T, Medalia A (2010) Intrinsic motivation inventory: an adapted measure for schizophrenia research. Schizophr Bull 36(5):966–976. https://doi.org/10.1093/schbul/sbp030 CrossRefPubMed

30.

Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ (1997) Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument. Urology 50(6):920–928. https://doi.org/10.1016/S0090-4295(97)00459-7 CrossRefPubMed

31.

Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN (2003) The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 49(2):156–163. https://doi.org/10.1002/art.10993 CrossRefPubMed

32.

Farmer ME, Kittner SJ, Rae DS, Bartko JJ, Regier DA (1995) Education and change in cognitive function. The Epidemiologic Catchment Area Study. Ann Epidemiol 5(1):1–7. https://doi.org/10.1016/1047-2797(94)00047-W CrossRefPubMed

33.

Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum Associates, New York

34.

Mahncke HW, Connor 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 U S A 103(33):12523–12528. https://doi.org/10.1073/pnas.0605194103 CrossRefPubMedPubMedCentral

35.

van der Linden D, Frese M, Meijman TF (2003) Mental fatigue and the control of cognitive processes: effects on perseveration and planning. Acta Psychol 113(1):45–65. https://doi.org/10.1016/S0001-6918(02)00150-6 CrossRef

36.

Cook DB, O’Connor PJ, Lange G, Steffener J (2007) Functional neuroimaging correlates of mental fatigue induced by cognition among chronic fatigue syndrome patients and controls. NeuroImage 36(1):108–122. https://doi.org/10.1016/j.neuroimage.2007.02.033 CrossRefPubMed

37.

Northouse LL, Rosset T, Phillips L, Mood D, Schafenacker A, Kershaw T (2006) Research with families facing cancer: the challenges of accrual and retention. Res Nurs Health 29(3):199–211. https://doi.org/10.1002/nur.20128 CrossRefPubMed

38.

Yanez B, McGinty HL, Mohr DC, Begale MJ, Dahn JR, Flury SC, Perry KT, Penedo FJ (2015) Feasibility, acceptability, and preliminary efficacy of a technology-assisted psychosocial intervention for racially diverse men with advanced prostate cancer. Cancer 121(24):4407–4415. https://doi.org/10.1002/cncr.29658 CrossRefPubMedPubMedCentral

Title: Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study
Authors: Lisa M. Wu
Ali Amidi
Molly L. Tanenbaum
Gary Winkel
Wayne A. Gordon
Simon J. Hall
Katrin Bovbjerg
Michael A. Diefenbach
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 6/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-4026-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2018

Sleep disturbance among Chinese breast cancer survivors living in the USA

Digestive toxicities after palliative three-dimensional conformal radiation therapy (3D-CRT) for cervico-thoracic spinal metastases

The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial

Fatigue among patients with renal cell carcinoma receiving adjuvant sunitinib or sorafenib: patient-reported outcomes of ECOG-ACRIN E2805 trial

Associations among physical symptoms, fear of cancer recurrence, and emotional well-being among Chinese American breast cancer survivors: a path model

The views of patients with metastatic prostate cancer towards physical activity: a qualitative exploration

Keynote webinar | Spotlight on antibody–drug conjugates in cancer