Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA,
Brain Imaging Behav. 2013 Dec;7(4):543-53. doi: 10.1007/s11682-013-9237-0.
To assess the feasibility of a cognitive rehabilitation program in breast cancer survivors (BCS) with persistent post-treatment cognitive complaints. BCS with cognitive complaints, 18-months to 5-years post-treatment, were recruited for a once-weekly, five-week, group cognitive training intervention. Outcome measures included self-reported mood and cognitive function, and neurocognitive tests administered at pre-intervention, immediate-, two-month and four-month post-intervention. A sub-study in eight participants evaluated resting state quantitative electroencephalography (qEEG) changes from pre- to immediate post-intervention in relationship to post-intervention changes in cognitive complaints. Twenty-seven BCS completed the protocol and tolerated the intervention well. We observed significant reductions in total and memory-specific cognitive complaints from pre-intervention to immediate post-intervention (p = 0.031 and p = 0.009, respectively) and at four-months post-intervention (p < 0.0001 and p < 0.001, respectively). Significant improvement in neurocognitive tests were found for Symbol Digit, Stroop, and Trails A tests (df = 26, all p's <0.05). Effect sizes for changes from pre-intervention to immediate and to four-month post intervention ranged from 0.429 to 0.607, and from 0.439 to 0.741, respectively. Increase in qEEG absolute alpha power over the course of the intervention was associated with reduced complaints at immediate post-intervention (r = -0.78, p = 0.021), two-months (r range = -0.76 to -0.82, p-value range 0.004 to 0.03), and four-months (r = -0.71, p = 0.048). A five-week group cognitive training intervention is feasible and well tolerated. Cognitive complaints and neurocognitive test performances showed positive changes. qEEG may serve as a potential biomarker for improvement in self-reported complaints. A randomized clinical trial is underway to test the efficacy of the intervention.
评估针对乳腺癌幸存者（BCS）持续治疗后认知问题的认知康复计划的可行性。招募了治疗后 18 个月至 5 年期间存在认知问题的 BCS，参加每周一次、为期五周的小组认知训练干预。评估结果包括自我报告的情绪和认知功能，以及干预前、即刻、两个月和四个月后的神经认知测试。在 8 名参与者中进行了一项亚研究，评估了从干预前到即刻干预期间静息状态定量脑电图（qEEG）的变化与干预后认知抱怨变化之间的关系。27 名 BCS 完成了方案并很好地耐受了干预。我们观察到，从干预前到即刻干预后，总认知和记忆特异性认知抱怨均显著减少（p=0.031 和 p=0.009，分别），且在四个月的干预后也减少（p<0.0001 和 p<0.001，分别）。符号数字、Stroop 和 Trails A 测试的神经认知测试结果显著改善（df=26，所有 p 值均<0.05）。从干预前到即刻和四个月的干预后，变化的效应大小范围分别为 0.429 至 0.607 和 0.439 至 0.741。干预过程中 qEEG 绝对阿尔法功率的增加与即刻干预后抱怨的减少相关（r=-0.78，p=0.021）、两个月时（r 范围=-0.76 至-0.82，p 值范围 0.004 至 0.03）和四个月时（r=-0.71，p=0.048）。为期五周的小组认知训练干预是可行的，且耐受性良好。认知抱怨和神经认知测试表现显示出积极的变化。qEEG 可能成为自我报告抱怨改善的潜在生物标志物。一项随机临床试验正在进行中，以测试干预的疗效。
