Longitudinal Assessment of Cognitive Changes Associated With Adjuvant Treatment for Breast Cancer: Impact of Age and Cognitive Reserve

Ahles, Tim A.; Saykin, Andrew J.; McDonald, Brenna C.; Li, Yuelin; Furstenberg, Charlotte T.; Hanscom, Brett; Mulrooney, Tamsin J.; Schwartz, Gary N.; Kaufman, Peter A.

doi:10.1200/jco.2009.27.0827

Cited by 469 publications

(435 citation statements)

References 29 publications

Supporting

Mentioning

383

Contrasting

Unclassified

Order By: Relevance

“…There is a growing body of evidence that cancer and its systemic treatments can have adverse effects on cognition in some, but not all, survivors of breast cancer 5, 6, 7. Older survivors may be especially vulnerable to cancer‐related decrements in cognitive function due to decreases in reserve 5.…”

Section: Introductionmentioning

confidence: 99%

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Mandelblatt

Clapp

Luta

et al. 2016

Cancer

Self Cite

138

View full text Add to dashboard Cite

BACKGROUNDThe number of survivors of breast cancer aged ≥65 years (“older”) is growing, but to the authors' knowledge, little is known regarding the cognitive outcomes of these individuals.METHODSA cohort of cognitively intact older survivors with nonmetastatic, invasive breast cancer was recruited from 78 sites from 2004 through 2011; approximately 83.7% of the survivors (1280 survivors) completed baseline assessments. Follow‐up data were collected at 6 months and annually for up to 7 years (median, 4.1 years). Cognitive function was self‐reported using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30); scores ranged from 0 to 100, with a higher score indicating better function. Group‐based trajectory modeling determined trajectories; women were assigned to a trajectory group based on the highest predicted probability of membership. Multinomial logistic regression evaluated the association between receipt of chemotherapy (with or without hormonal treatment) and trajectory group.RESULTSSurvivors were aged 65 to 91 years; approximately 41% received chemotherapy. There were 3 cognitive trajectories: “maintained high” (42.3% of survivors); “phase shift” (50.1% of survivors), with scores slightly below but parallel to maintained high; and “accelerated decline” (7.6% of survivors), with the lowest baseline scores and greatest decline (from 71.7 [standard deviation, 19.8] to 58.3 [standard deviation, 21.9]). The adjusted odds of being in the accelerated decline group (vs the maintained high group) were 2.1 times higher (95% confidence interval, 1.3‐3.5) for survivors who received chemotherapy (with or without hormonal therapy) versus those treated with hormonal therapy alone. Greater comorbidity and frailty also were found to be associated with accelerated decline.CONCLUSIONSTrajectory group analysis demonstrated that the majority of older survivors maintained good long‐term self‐reported cognitive function, and that only a small subset who were exposed to chemotherapy manifested accelerated cognitive decline. Future research is needed to determine factors that place some older survivors at risk of experiencing cognitive decline. Cancer 2016;122:3555–3563. © 2016 American Cancer Society

show abstract

Section: Introductionmentioning

confidence: 99%

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Mandelblatt

Clapp

Luta

et al. 2016

Cancer

Self Cite

138

View full text Add to dashboard Cite

show abstract

“…A growing body of evidence demonstrates that a subgroup of patients with BC have pretreatment cognitive deficits, [1][2][3][4][5] suggesting that aspects of cancer pathogenesis or host factors (potentially including variables related to BC surgery) cause cognitive changes or that there are common risk factors for the development of cancer and cognitive changes. 6 Prospective studies have shown cognitive changes differentially attributable to chemotherapy, radiation, and antiestrogen treatment, [7][8][9][10][11] highlighting the need for better understanding of potentially additive and dissociable effects of cancer treatments and the disease process on cognition in vulnerable individuals. 12 Structural and functional neuroimaging allow examination of the neural substrates of cancer-and treatment-related cognitive changes, which currently are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Alterations in Brain Activation During Working Memory Processing Associated With Breast Cancer and Treatment: A Prospective Functional Magnetic Resonance Imaging Study

McDonald

Conroy

Ahles

et al. 2012

JCO

Self Cite

257

237

View full text Add to dashboard Cite

A B S T R A C T PurposeTo prospectively examine alterations in working memory (WM) -associated brain activation related to breast cancer and treatment by using functional magnetic resonance imaging. Patients and MethodsPatients treated with chemotherapy (CTxϩ; n ϭ 16) or without chemotherapy (CTxϪ; n ϭ 12) and healthy controls (n ϭ 15) were scanned during an n-back task at baseline (after surgery but before radiation, chemotherapy, and/or antiestrogen treatment), 1 month after completion of chemotherapy (M1), and 1 year later (Y1), or at yoked intervals for CTxϪ and controls. SPM5 was used for all image analyses, which included cross-sectional between-group and group-by-time interaction and longitudinal within-group analyses, all using a statistical threshold of 0.001. ResultsAt baseline, patients with cancer showed increased bifrontal and decreased left parietal activation compared with controls. At M1, both cancer groups showed decreased frontal hyperactivation compared with controls, with increased hyperactivation at Y1. These cross-sectional findings were confirmed by group-by-time interaction analyses, which showed frontal activation decreases from baseline to M1 in patients compared with controls. Within-group analyses showed different patterns of longitudinal activation change by treatment group (CTxϩ or CTxϪ), with prominent alterations in the frontal lobes bilaterally. ConclusionSignificant frontal lobe hyperactivation to support WM was found in patients with breast cancer. Superimposed on this background, patients showed decreased frontal activation at M1, with partial return to the previously abnormal baseline at Y1. These functional changes correspond to frontal lobe regions where we previously reported structural changes in this cohort and provide prospective, longitudinal data that further elucidate mechanisms underlying cognitive effects related to breast cancer and its treatment.

show abstract

“…-Algunos dominios cognitivos pueden tener mayor propensión a sufrir deterioro (ver Tabla 1) (8,(13)(14)(15) -El déficit puede mantener una relación dosis-dependiente, presentando mayor riesgo las mujeres que reciben quimioterapia a dosis altas (16) . -La combinación de tratamientos antineoplásicos, por ejemplo quimioterapia más tamoxifeno, puede provocar alteraciones cognitivas más severas (10) .…”

Section: Estudios Longitudinalesunclassified

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

2012

View full text Add to dashboard Cite

The problem: Some cancer patients have expressed attention, concentration and memory problems, during and after their treatment with chemotherapy, also called chemobrain. Following these complains, in recent decades, studies about this adverse effect had increased.Development of the topic: this work aims to review and analyze the latest scientific studies investigating the nature and severity of cognitive impairment associated with chemotherapy treatments. Works discussed are drowned from different bibliographical sources, mainly from the PubMed database. Results show that, in recent years, longitudinal studies have increased, chemobrain is being studied above all in samples from women with breast cancer, research in other types of cancer is insufficient. Also, the works include new assessment tools, such as MRI and EEG. Advances are done with animal experiments, in vivo and in vitro. Finally, we found studies on drugs and effective strategies for coping of cognitive impairment. The development of guidelines for its systematic study and recommendations for its approach are still pending.Conclusion: There is not conclusive data on the chemobrain, longitudinal studies should be encouraged, as well as assessing the cognitive impact of certain chemotherapeutic agents in different cancers. The works on cognitive Resumen Planteamiento del problema: Algunos pacientes oncológicos han expresado problemas de atención, concentración y memoria durante y después de los tratamientos con quimioterapia, a los que se ha llamado chemobrain. Como consecuencia de estas manifestaciones, en las últimas décadas los estudios dedicados a indagar este posible efecto adverso se han incrementado.Desarrollo del tema: Este trabajo pretende revisar y analizar los estudios científicos más recientes que investigan la naturaleza y alcance del daño cognitivo asociado a los tratamientos quimioterapéuticos. Los artículos analizados se han extraído de diferentes fuentes bibliográficas, principalmente de la base de datos PubMed. Como resultado de la búsqueda se aprecia que, en los últimos años, se han incremento los estudios de diseño longitudinal; este posible efecto adverso se sigue estudiando sobre todo en muestras de mujeres con cáncer de mama, las investigaciones en otros tipos de cánceres son insuficientes; así mismo, destaca la inclusión de nuevas herramientas de evaluación, como la resonancia magnética y el electroencefalograma, junto con nuevos experimentos realizados con animales, in vivo e in vitro, finalmente se constata la inclusión de algunos estudios sobre fármacos y estrategias eficaces para su afrontamiento. La elaboración de guías para el estudio sistemático y las re-

show abstract

Longitudinal Assessment of Cognitive Changes Associated With Adjuvant Treatment for Breast Cancer: Impact of Age and Cognitive Reserve

Cited by 469 publications

References 29 publications

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Long‐term trajectories of self‐reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance)

Alterations in Brain Activation During Working Memory Processing Associated With Breast Cancer and Treatment: A Prospective Functional Magnetic Resonance Imaging Study

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

Contact Info

Product

Resources

About