Applied Brain Research Foundation of Ohio, Cleveland OH, USA.
Integr Cancer Ther. 2013 Nov;12(6):475-87. doi: 10.1177/1534735413477192. Epub 2013 Apr 12.
BACKGROUND AND HYPOTHESES: Postcancer cognitive impairment (PCCI) is observed in a substantial number of breast cancer survivors, persisting for as long as 20 years in some subgroups. Although compensatory strategies are frequently suggested, no restorative interventions have yet been identified. This study examined the feasibility of EEG biofeedback ("neurofeedback") and its potential effectiveness in reducing PCCI as well as the fatigue, sleep disturbance, and psychological symptoms that frequently accompany PCCI.
This was a 6-month prospective study with a waitlist control period followed by an active intervention. Participants were female breast cancer survivors (n = 23), 6 to 60 months postchemotherapy, with self-reported cognitive impairment.
Four self-report outcome measures (Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog], Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-Fatigue], Pittsburgh Sleep Quality Index [PSQI], and Brief Symptom Inventory [BSI]-18) were administered 3 times during a 10-week waitlist control period, 3 times during a 10-week (20-session) neurofeedback training regimen, and once at 4 weeks postneurofeedback.
All 23 participants completed the study, demonstrating the feasibility of EEG biofeedback in this population. Initially, the sample demonstrated significant dysfunction on all measures compared with general population norms. Repeated-measures ANOVAs revealed strongly significant improvements (P < .001) on all 4 cognitive measures (perceived cognitive impairment, comments from others, perceived cognitive abilities, and impact on quality of life [QOL]), the fatigue scale, and the 4 psychological scales (somatization, depression, anxiety and global severity index) as well as on 3 of 8 sleep scales (quality, daytime dysfunction, and global). Two of the other sleep scales (latency and disturbance) were significant at P < .01, and 1 (use of medication) at P < .05; 2 were not significant. Improvements were generally linear across the course of training, and were maintained at the follow-up testing. At the follow-up testing, the sample no longer differed significantly from normative populations on 3 of the 4 FACT-Cog measures (impairment, impact on QOL, and comments), FACIT-Fatigue, PSQI sleep quality and habitual efficiency, or any of the BSI-18 measures of psychological disturbance.
Data from this limited study suggest that EEG biofeedback has potential for reducing the negative cognitive and emotional sequelae of cancer treatment as well as improving fatigue and sleep patterns.
在大量乳腺癌幸存者中观察到癌症后认知障碍（PCCI），在某些亚组中可持续长达 20 年。尽管经常提出补偿策略，但尚未确定任何恢复性干预措施。本研究旨在检查 EEG 生物反馈（“神经反馈”）的可行性及其降低 PCCI 以及疲劳、睡眠障碍和经常伴随 PCCI 的心理症状的潜在有效性。
这是一项前瞻性研究，为期 6 个月，包括等待期对照期和随后的主动干预期。参与者为女性乳腺癌幸存者（n = 23），化疗后 6 至 60 个月，自我报告认知障碍。
在为期 10 周的等待期对照期内，共进行了 3 次自我报告的结果测量（癌症治疗认知功能功能性评估-认知功能[FACT-Cog]、慢性疾病治疗疲劳功能性评估-疲劳[FACIT-Fatigue]、匹兹堡睡眠质量指数[PSQI]和简明症状问卷[BSI]-18），在为期 10 周（20 次）的神经反馈训练方案期间进行了 3 次，在神经反馈后 4 周进行了 1 次。
所有 23 名参与者均完成了研究，证明了 EEG 生物反馈在该人群中的可行性。最初，该样本在所有测量中均表现出与一般人群正常值相比明显的功能障碍。重复测量方差分析显示，在所有 4 个认知测量（感知认知障碍、他人评价、感知认知能力和对生活质量的影响）、疲劳量表和 4 个心理量表（躯体化、抑郁、焦虑和全球严重指数）以及 8 个睡眠量表中的 3 个量表（质量、白天功能障碍和整体）上均有显著改善（P<.001）。另外 2 个睡眠量表（潜伏期和干扰）在 P<.01 时有显著差异，1 个（用药）在 P<.05 时有显著差异；另外 2 个没有显著差异。在训练过程中，改善通常呈线性，在随访测试中仍保持。在随访测试中，该样本在 4 个 FACT-Cog 测量（损伤、对生活质量的影响和评论）、FACIT-Fatigue、PSQI 睡眠质量和习惯性效率，或 BSI-18 中任何一个心理障碍测量中不再与正常值显著不同。
这项有限研究的数据表明，EEG 生物反馈有可能降低癌症治疗的负面认知和情绪后遗症，改善疲劳和睡眠模式。
