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使用元认知策略训练改善化疗引起认知障碍女性的认知表现和神经连接的可行性

The Feasibility of Using Metacognitive Strategy Training to Improve Cognitive Performance and Neural Connectivity in Women with Chemotherapy-Induced Cognitive Impairment.

作者信息

Wolf Timothy J, Doherty Meghan, Kallogjeri Dorina, Coalson Rebecca S, Nicklaus Joyce, Ma Cynthia X, Schlaggar Bradley L, Piccirillo Jay

机构信息

Department of Occupational Therapy, School of Health Professions, University of Missouri, Columbia, Mo., USA.

出版信息

Oncology. 2016;91(3):143-52. doi: 10.1159/000447744. Epub 2016 Jul 23.

Abstract

OBJECTIVE

To evaluate the feasibility and preliminary effect of metacognitive strategy training (MCST) on cognitive performance and on neural connectivity in the frontoparietal network in women with chemotherapy-induced cognitive impairment (CICI) following treatment for breast cancer.

METHODS

A single-group pre/post study was conducted. After completing the baseline assessment battery and neuroimaging, the participants completed a 12-session MCST intervention. Following the completion of the intervention, the subjects completed the same assessment battery and neuroimaging as was completed at baseline within 4 weeks after the intervention. The key inclusion/exclusion criteria for this study were: completed chemotherapy for treatment of breast cancer, no other neurological or psychiatric diagnoses, self-reported CICI, and no contraindications to the use of MRI.

RESULTS

MCST had a small-to-large positive effect on all primary (cognitive) and secondary (quality of life and psychosocial) behavioral outcome measures (r = -0.12 to -0.88). There was also a positive change in functional connectivity in a frontoparietal cognitive control network connection in 6 of the 10 subjects, which was correlated to changes in the behavioral measures.

CONCLUSIONS

This study found that MCST was associated with a positive effect on cognitive performance and neural connectivity in women with CICI following treatment for breast cancer.

摘要

目的

评估元认知策略训练(MCST)对乳腺癌治疗后出现化疗引起的认知障碍(CICI)的女性的认知表现及额顶叶网络神经连接的可行性和初步效果。

方法

进行单组前后对照研究。在完成基线评估组套和神经影像学检查后,参与者完成了为期12节的MCST干预。干预结束后,受试者在干预后4周内完成了与基线时相同的评估组套和神经影像学检查。本研究的关键纳入/排除标准为:完成乳腺癌化疗、无其他神经或精神疾病诊断、自我报告有CICI且无MRI使用禁忌症。

结果

MCST对所有主要(认知)和次要(生活质量和心理社会)行为结果指标均有小到中等程度的积极影响(r = -0.12至-0.88)。10名受试者中有6名在额顶叶认知控制网络连接中的功能连接也有积极变化,这与行为指标的变化相关。

结论

本研究发现,MCST对乳腺癌治疗后出现CICI的女性的认知表现和神经连接有积极影响。

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