Cognitive Training for Improving Executive Function in Chemotherapy-Treated Breast Cancer Survivors

Abstract

Difficulties with thinking and problem solving are very common among breast cancer survivors. We tested a computerized cognitive training program for 41 breast cancer survivors. The training program was associated with significant improvements in thinking and problem-solving skills. Our findings demonstrate potential for our online, home-based cognitive training program to improve cognitive difficulties among breast cancer survivors. Background A majority of breast cancer (BC) survivors, particularly those treated with chemotherapy, experience long-term cognitive deficits that significantly reduce quality of life. Among the cognitive domains most commonly affected include executive functions (EF), such as working memory, cognitive flexibility, multitasking, planning, and attention. Previous studies in other populations have shown that cognitive training, a behavioral method for treating cognitive deficits, can result in significant improvements in a number of cognitive skills, including EF. Materials and Methods In this study, we conducted a randomized controlled trial to investigate the feasibility and preliminary effectiveness of a novel, online EF training program in long-term BC survivors. A total of 41 BC survivors (21 active, 20 wait list) completed the 48 session training program over 12 weeks. The participants were, on average, 6 years after therapy. Results Cognitive training led to significant improvements in cognitive flexibility, verbal fluency and processing speed, with marginally significant downstream improvements in verbal memory as assessed via standardized measures. Self-ratings of EF skills, including planning, organizing, and task monitoring, also were improved in the active group compared with the wait list group. Conclusions Our findings suggest that EF skills may be improved even in long-term survivors by using a computerized, home-based intervention program. These improvements may potentially include subjective EF skills, which suggest a transfer of the training program to real-world behaviors.

Shining the Light of Research on Lumosity

“…One of these studies trained executive function in 41 women receiving chemotherapy for breast cancer, in 48 sessions spread over 12 weeks, using Lumosity games (Kesler et al 2013). Twenty of these participants served as the inactive control group in the form of a waitlist that eventually received training.…”

“…A composite view of the literature suggests that brain-training games may be more effective in cognitively impaired populations (Klingberg et al 2005;Kesler et al 2013;Finn and McDonald 2011). This suggests that there may be a ceiling effect preventing cognitively healthy people from improving their performance any more.…”

Evaluation of a Web-Based Cognitive Rehabilitation Program in Cancer Survivors Reporting Cognitive Symptoms After Chemotherapy

“…A wait-list randomized controlled trial (RCT) by Kesler et al 9 of an online cognitive training program in 41 patients with breast cancer an average of 6 years after treatment suggested efficacy of cognitive training with improvement in cognitive flexibility, verbal fluency, and processing speed. There were also improvements in self-reported planning, organization, and task monitoring.…”

Cognitive Deficits in Cancer Patients with Haematological Malignancies

“…[41]. Práve cielený kognitívny tré -n ing môže napomôcť zlepšeniu kognitív-nej flexibility, rýchlosti spracovania informácií či verbálnej fluencie [43]. Výzvou budúceho výskumu je tiež voľba vhodných meracích nástrojov a referenčných skupín.…”