Goedendorp Martine M, Knoop Hans, Gielissen Marieke F M, Verhagen Constans A H H V M, Bleijenberg Gijs
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Pain Symptom Manage. 2014 Jan;47(1):35-44. doi: 10.1016/j.jpainsymman.2013.02.014. Epub 2013 May 23.
After successful cancer treatment, a substantial number of survivors continue to experience fatigue and related concentration and memory problems. Severe fatigue after cancer treatment can be treated effectively with cognitive behavioral therapy (CBT), but it is unclear whether CBT has an effect on cognitive functioning.
We hypothesized that patients would report less cognitive disability after treatment with CBT for cancer-related fatigue. CBT was not expected to affect neuropsychological test performance, as it has been shown that fatigue is not associated with test performance.
Data were used from a randomized controlled trial in which 98 severely fatigued cancer survivors, treated at least one year previously, were assessed at baseline (T1) and six months post-baseline (T2). Patients were randomly assigned to receive CBT (n = 50) or to a waiting list (WL) control condition (n = 48). Self-reported cognitive disability was assessed by the Concentration subscale of the Checklist Individual Strength and the Alertness Behavior subscale of the Sickness Impact Profile. Neuropsychological test performance was measured by the symbol digit modalities task and two reaction time tasks.
Patients who received CBT for post-cancer fatigue reported significantly less cognitive disability compared with those in the WL group. CBT also was associated with a clinically relevant reduction in concentration problems (CBT, 32% vs. WL, 2%). There were no significant differences in neuropsychological test performance between the CBT and WL groups.
CBT for post-cancer fatigue has already been shown to be an effective therapy. The present study demonstrates that CBT also may lead to a decrease in perceived cognitive disability.
癌症治疗成功后，相当数量的幸存者仍会持续经历疲劳以及相关的注意力和记忆力问题。癌症治疗后的严重疲劳可以通过认知行为疗法（CBT）得到有效治疗，但尚不清楚CBT对认知功能是否有影响。
我们假设，接受CBT治疗癌症相关疲劳的患者在治疗后认知障碍会减轻。由于已有研究表明疲劳与测试表现无关，因此预计CBT不会影响神经心理测试表现。
数据来自一项随机对照试验，该试验对98名至少在一年前接受过治疗的严重疲劳癌症幸存者在基线（T1）和基线后六个月（T2）进行了评估。患者被随机分配接受CBT（n = 50）或等待名单（WL）对照条件（n = 48）。通过个人力量清单的注意力子量表和疾病影响概况的警觉行为子量表评估自我报告的认知障碍。通过符号数字模态任务和两个反应时间任务测量神经心理测试表现。
与WL组相比，接受CBT治疗癌症后疲劳的患者报告的认知障碍明显更少。CBT还与注意力问题在临床上的显著减少相关（CBT组为32%，WL组为2%）。CBT组和WL组在神经心理测试表现上没有显著差异。
CBT治疗癌症后疲劳已被证明是一种有效的疗法。本研究表明，CBT也可能导致感知到的认知障碍减少。
