Bellens Anne, Roelant Ella, Sabbe Bernard, Peeters Marc, van Dam Peter A
Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, B2650, Edegem, Belgium.
Centre for Oncological Research (CORE), University of Antwerp, B2610, Wilrijk, Belgium.
Support Care Cancer. 2022 Jan;30(1):21-31. doi: 10.1007/s00520-021-06397-1. Epub 2021 Aug 4.
Currently cancer-related cognitive impairment (CRCI) is mainly assessed by means of questionnaires, which is very laborious for the patients and the supervising physician. We evaluated a new online cognitive assessment tool, the MyCognition Quotient (MyCQ, Cambridge) in breast cancer survivors with CRCI, and compared the results with a psychometric test measuring cognitive complaints, depression, and anxiety.
In this prospective study, 46 adult patients between 18 and 70 years old with a diagnosis of BC were studied, all complaining of disturbing cognitive impairment. They participated in a physical cognitive rehabilitation program. The patients had an online cognitive assessment (MyCQ Med by MyCognition) every 4 weeks on their home computer. In addition patients were assessed in the outpatient clinic by the principal investigator at baseline, after 3 and 6 months using the following validated neuro-psychological surveys: the Hospital Anxiety and Depression Scale (HADS), Beck Cognitive Insight Scale (BCIS), and Cognitive Failure Questionnaire (CFQ). MyCQ scores were correlated with the results of these surveys.
Only weak correlations could be found between overall MyCQ or the MyCQ subtests with the psychometric tests (between - 0.43 and 0.458) at baseline and when combining data at time point 0, 3, and 6 months. Linear mixed models showed there was a significant association between Latency Choice Reaction Time and CFQ (continuous; p = 0.026). An AUC of 0.640 and a cut-off of 481.5 ms in Latency Choice Reaction Time were found to distinguish patients with CFQ below 44 to patients with CFQ above 44 (sensitivity 0.63 and specificity 0.73). In Latency Coding an AUC of 0.788 and a cut-off of 1316 ms were found to distinguish non-depressive patients from patients likely to present with depressive symptoms (sensitivity 0.75 and specificity 0.76).
MyCQ cannot replace the various psychometric tests. However, abnormal Latency in cognitive tests, Choice Reaction Time and Coding, seems promising to be used as a screening tool to detect specific aspects of abnormal cognitive functioning in patients with cognitive complaints and depressive symptoms.
目前，癌症相关认知障碍（CRCI）主要通过问卷调查来评估，这对患者和监督医生来说都非常费力。我们评估了一种新的在线认知评估工具——MyCognition商数（MyCQ，剑桥），用于评估患有CRCI的乳腺癌幸存者，并将结果与一项测量认知主诉、抑郁和焦虑的心理测量测试进行比较。
在这项前瞻性研究中，对46名年龄在18至70岁之间、诊断为乳腺癌的成年患者进行了研究，所有患者均抱怨存在令人困扰的认知障碍。他们参加了一项身体认知康复计划。患者每4周在自己家中的电脑上进行一次在线认知评估（MyCognition的MyCQ Med）。此外，主要研究者在基线、3个月和6个月后在门诊对患者进行评估，使用以下经过验证的神经心理学调查：医院焦虑抑郁量表（HADS）、贝克认知洞察量表（BCIS）和认知失误问卷（CFQ）。将MyCQ分数与这些调查的结果进行关联分析。
在基线时以及将时间点0、3和6个月的数据合并时，MyCQ总分或MyCQ子测试与心理测量测试之间仅发现微弱的相关性（-0.43至0.458之间）。线性混合模型显示，潜伏期选择反应时间与CFQ之间存在显著关联（连续变量；p = 0.026）。发现潜伏期选择反应时间的曲线下面积（AUC）为0.640，截断值为481.5毫秒，可区分CFQ低于44的患者和CFQ高于44的患者（敏感性0.63，特异性0.73）。在潜伏期编码方面，发现AUC为0.788，截断值为1316毫秒，可区分非抑郁患者和可能出现抑郁症状的患者（敏感性0.75，特异性0.76）。
MyCQ不能替代各种心理测量测试。然而，认知测试中的异常潜伏期，即选择反应时间和编码，似乎有望用作筛查工具，以检测有认知主诉和抑郁症状患者认知功能异常的特定方面。
