Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave. South, Nashville, TN, 37212, USA.
Department of Medicine, Vanderbilt University Medical Center/Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
J Cancer Surviv. 2022 Jun;16(3):614-623. doi: 10.1007/s11764-021-01055-1. Epub 2021 May 11.
Persistent chemotherapy-related cognitive impairment (CRCI) is commonly reported following cancer treatment and negatively affects quality of life. While past research has focused on potential pathophysiological mechanisms underlying this relationship, the role of psychological factors, such as mood, stress, and anxiety, in the development of persistent CRCI has received less attention. As an additional analysis of data from a trial investigating the effects of transdermal nicotine patches on cognitive performance in patients with persistent CRCI, we examined whether change in mood was associated with changes in subjective and objective cognitive functioning.
Participants were randomized to either placebo (n = 11) or transdermal nicotine (n = 11) for 6 weeks, followed by 2 weeks of treatment withdrawal for a total of 8 weeks. Participants were assessed using behavioral, subjective, and objective measures of cognitive functioning and mood at five visits before, during, and after treatment.
Although we did not detect an effect of treatment assignment on mood, over the course of the study, we observed a significant improvement on measures of mood that correlated with improvement in subjective and objective cognitive performance.
We observed improvement in objective and subjective cognitive performance measures. These changes were associated with improvement in subsyndromal mood symptoms, likely resulting from participation in the trial itself.
These results suggest that women with persistent CRCI may benefit from support and validation of their cognitive complaints, cognitive rehabilitation/therapies into their post-cancer care.
The study was registered with clinicaltrials.gov (trial registration: NCT02312943).
癌症治疗后常报道持续性化疗相关认知障碍（CRCI），并对生活质量产生负面影响。尽管过去的研究集中于潜在的病理生理学机制，但心理因素（如情绪、压力和焦虑）在持续性 CRCI 发展中的作用却较少受到关注。作为一项对研究经皮尼古丁贴片对持续性 CRCI 患者认知表现影响的试验数据的额外分析，我们检查了情绪变化是否与主观和客观认知功能的变化相关。
参与者随机分为安慰剂组（n = 11）或经皮尼古丁组（n = 11），接受 6 周治疗，随后进行 2 周的治疗停药期，总疗程为 8 周。在治疗前、治疗期间和治疗后，参与者使用行为、主观和客观认知功能以及情绪评估进行了五次评估。
尽管我们未检测到治疗分配对情绪的影响，但在研究过程中，我们观察到情绪的显著改善，与主观和客观认知表现的改善相关。
我们观察到客观和主观认知表现测量的改善。这些变化与亚综合征情绪症状的改善相关，可能是由于参与试验本身所致。
这些结果表明，持续性 CRCI 的女性可能受益于对其认知主诉的支持和确认，以及将认知康复/疗法纳入其癌症后护理中。
该研究在 clinicaltrials.gov 上注册（试验注册号：NCT02312943）。
