EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL University, Normandie Univ, UNICAEN, Caen, France.
Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.
Brain Behav. 2020 Apr;10(4):e01545. doi: 10.1002/brb3.1545. Epub 2020 Mar 10.
Although cancer patients frequently report cognitive disturbances, it is commonly asserted a lack of association between cognitive complaints and neuropsychological test performances. Our goal was to better understand the relationships between subjective and objective cognitive scores through a metamemory monitoring assessment.
Sixty cancer patients currently treated by chemotherapy and/or targeted therapy, and 30 healthy controls (HC) were included. Cognitive complaint was assessed by FACT-cog, QAM and DEX questionnaires. One or more z-scores ≤-1.65 among these three questionnaires defined the presence of cognitive complaints. Objective cognitive performances assessed episodic memory, processing speed and executive functions/working memory (ESR paradigm, TMT, Stroop, n-back). Metamemory was assessed with a Judgment of Learning (JOL) task.
Patients with cognitive complaints had significantly more depressive and anxiety symptoms (ps < .004), and lower performances on several cognitive tests (ps < .05) than both patients without complaints and HC. More specifically, analyses of the metamemory scores revealed that HC gave significantly more overestimations ("Yes" judgment and incorrect recall) than patients with cognitive complaints (p = .036). For these patients, JOL scores correlated positively with executive functioning (ps < .01).
Metamemory monitoring seems to be well-preserved during cancer. What is more, patients make less overestimation than HC, and they do not underestimate their memory. An accurate self-estimation of memory abilities in cancer patients, particularly those with mild cognitive deficits, may play an adaptive function. Our results suggest that the discrepancy frequently reported between cognitive complaints and objective cognitive scores may not be related to metamemory monitoring dysfunction.
尽管癌症患者经常报告认知障碍，但通常认为认知主诉与神经心理学测试表现之间缺乏关联。我们的目标是通过元记忆监测评估更好地理解主观和客观认知评分之间的关系。
纳入 60 名正在接受化疗和/或靶向治疗的癌症患者和 30 名健康对照者（HC）。认知主诉通过 FACT-cog、QAM 和 DEX 问卷评估。这三个问卷中至少有一个 z 分数≤-1.65 定义为存在认知主诉。客观认知表现通过情景记忆、加工速度和执行功能/工作记忆（ESR 范式、TMT、Stroop、n-back）评估。元记忆通过学习判断（JOL）任务进行评估。
有认知主诉的患者与无主诉的患者和 HC 相比，抑郁和焦虑症状明显更多（p <.004），多项认知测试的表现明显更差（p <.05）。具体来说，元记忆评分分析显示，HC 的过度估计（“是”判断和错误回忆）明显多于有认知主诉的患者（p =.036）。对于这些患者，JOL 评分与执行功能呈正相关（p <.01）。
元记忆监测在癌症期间似乎保持良好。更重要的是，患者的过度估计比 HC 少，并且不会低估自己的记忆力。癌症患者，尤其是那些有轻度认知缺陷的患者，对自己的记忆能力进行准确的自我评估可能具有适应性功能。我们的结果表明，认知主诉和客观认知评分之间经常报告的差异可能与元记忆监测功能障碍无关。
