Pediatric Hematology/Oncology, Children's Healthcare of Orange County, Orange, California, USA.
Texas Children's Cancer and Hematology Centers, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA.
J Adolesc Young Adult Oncol. 2022 Jun;11(3):290-296. doi: 10.1089/jayao.2021.0055. Epub 2021 Oct 21.
Computer-based cognitive rehabilitation programs may help adolescent and young adult (AYA) patients with cancer-related cognitive impairment. This pilot study investigated the feasibility of cognitive rehabilitation as a preventive intervention for AYA patients receiving chemotherapy. Explorative objectives included the correlation of cognitive performance with serum brain-derived neurotrophic factor (BDNF). This pilot prospective study included English-speaking patients 12-25 years of age with a fist diagnosis of cancer requiring chemotherapy. Participants enrolled in the intervention arm participated in a computer-based neurocognitive training program for 20-30 minutes daily for 16 weeks. Outcome measures, including engagement with and completion of computerized neurocognitive testing and serum BDNF levels, were obtained within the first month following diagnosis, ∼16 and 24 weeks from enrollment. Fourteen of 18 eligible patients provided consent, with 7 patients assigned to each the intervention arm and nonintervention arm. Seventy-one percent of the patients in the intervention arm completed at least 80% of the required activities. Compared to baseline, patients in the nonintervention arm demonstrated higher prevalence of impairment in four of the six cognitive domains (processing speed, visual attention, attention/working memory, and executive function) at the end of the study period. There was a nonstatistically significant reduction of serum BDNF levels over time, which was observed in both intervention and nonintervention arms. This pilot study provides some evidence that it is feasible for AYAs with new cancer diagnoses to receive standardized cognitive rehabilitation. Patients receiving cognitive activities experienced less impairment in numerous cognitive domains.
基于计算机的认知康复程序可能有助于患有癌症相关认知障碍的青少年和年轻成人(AYA)患者。这项初步研究调查了认知康复作为化疗 AYA 患者预防干预措施的可行性。探索性目标包括认知表现与血清脑源性神经营养因子(BDNF)的相关性。这项初步前瞻性研究纳入了 12-25 岁的英语患者,这些患者均为首次确诊需要化疗的癌症患者。参加干预组的患者每天接受 20-30 分钟的基于计算机的神经认知训练,持续 16 周。在诊断后的第一个月内、入组后约 16 周和 24 周,获得了包括对计算机神经认知测试的参与度和完成度以及血清 BDNF 水平在内的结果指标。18 名符合条件的患者中有 14 名同意参加,其中 7 名患者被分配到干预组和非干预组。干预组中 71%的患者完成了至少 80%的要求活动。与基线相比,在研究结束时,非干预组的患者在六个认知领域中的四个领域(处理速度、视觉注意力、注意力/工作记忆和执行功能)表现出更高的损伤发生率。在干预组和非干预组中均观察到血清 BDNF 水平随时间的非统计学显著降低。这项初步研究提供了一些证据,表明新诊断癌症的 AYA 患者接受标准化认知康复是可行的。接受认知活动的患者在许多认知领域的损伤程度较低。