Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305-5795, USA.
Clin Breast Cancer. 2013 Aug;13(4):299-306. doi: 10.1016/j.clbc.2013.02.004. Epub 2013 May 4.
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.
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.
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.
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.
大多数乳腺癌（BC）幸存者，尤其是接受化疗治疗的患者，会出现长期认知缺陷，从而显著降低生活质量。受影响的认知领域包括执行功能（EF），如工作记忆、认知灵活性、多任务处理、计划和注意力等。其他人群的先前研究表明，认知训练是一种治疗认知缺陷的行为方法，可以显著提高多项认知技能，包括 EF。
本研究采用随机对照试验，旨在调查一种新的在线 EF 训练方案在长期 BC 幸存者中的可行性和初步疗效。共有 41 名 BC 幸存者（21 名主动训练，20 名候补名单）在 12 周内完成了 48 次训练课程。参与者平均在治疗后 6 年。
认知训练导致认知灵活性、语言流畅性和处理速度显著提高，标准化测量评估的言语记忆也有略微显著的下游改善。主动组的 EF 技能自我评估，包括计划、组织和任务监测，也比候补名单组有所提高。
我们的研究结果表明，即使是长期幸存者，也可以通过使用计算机化、基于家庭的干预方案来改善 EF 技能。这些改善可能包括主观的 EF 技能，这表明训练方案已转移到现实世界的行为中。
