联合运动与游戏式认知训练干预：乳腺癌女性神经营养和炎症生物标志物的相关性初步研究。
Combined Exercise and Game-Based Cognitive Training Intervention: Correlative Pilot Study of Neurotrophic and Inflammatory Biomarkers for Women With Breast Cancer.
作者信息
Myers Jamie, Pathak Harsh B, He Jianghua, Ghosh Arnab, Puri Rajni V, Asakura Yuki, Miyashita Mika
机构信息
Author Affiliations: University of Kansas School of Nursing (Dr Myers); and Department of Pathology and Laboratory Medicine, University of Kansas Medical Center (Drs Pathak, Ghosh, and Puri); Department of Zoology, Rajiv Gandhi University, Papum Pare, Arunachal Pradesh, India (Dr Ghosh); Department of Biostatistics and Data Science, University of Kansas Medical Center (Dr He); Centura Health-St. Francis Health Services/Parker Adventist Palliative Care (Dr Asakura), Denver, Colorado; and Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (Dr Miyashita).
出版信息
Cancer Nurs. 2022 Dec 1. doi: 10.1097/NCC.0000000000001175.
BACKGROUND
Interventions that increase neuroprotective factors and/or decrease inflammatory biomarkers may be effective in improving cognitive function for cancer survivors. Concurrent investigation of potential mechanism(s) to fully understand and refine effective interventions is needed.
OBJECTIVE
This correlative prospective substudy was conducted to investigate biomarkers related to potential mechanism(s) for a combined exercise and game-based brain training intervention designed to improve cognitive function in breast cancer survivors.
INTERVENTIONS/METHODS: Fingerstick bloodspot samples were collected at 3 time points during the randomized, wait-list controlled interventional parent study. Samples were analyzed for neuroprotective factors and inflammatory biomarker levels.
RESULTS
Insulinlike growth factor 1 (IGF-1) levels significantly increased (P < .01) for the intervention group from baseline to 4 and 16 weeks postintervention. Insulinlike growth factor 1 levels correlated with neurocognitive test performace improvement for Trail Making Test B (r = 0.31, P = .02). This association was not significant in the mixed model. No significant correlation was seen between IGF-1 levels and changes in self-report of cognitive function, activity level, or intervention dose.
CONCLUSIONS
Further investigation of IGF-1 levels is warranted as related to potential mechanisms for the Combined Exercise and Game-based Cognitive Training intervention. Future investigations should involve a larger sample cohort and incorporate objective measures of physical activity and prescribed sampling time in relationship to the most recent performance of the intervention.
IMPLICATIONS FOR PRACTICE
Fingerstick bloodspot sample collection is feasible, acceptable, and effective for conducting biomarker research. This methodology minimizes participant burden and discomfort; increases clinical trial access for home, off-site, or rural settings; and facilitates research efforts during times of pandemic restrictions.
背景
增加神经保护因子和/或降低炎症生物标志物的干预措施可能有助于改善癌症幸存者的认知功能。需要同时研究潜在机制，以充分理解并优化有效的干预措施。
目的
本相关性前瞻性子研究旨在调查与一项旨在改善乳腺癌幸存者认知功能的联合运动和游戏式脑训练干预措施的潜在机制相关的生物标志物。
干预措施/方法：在随机、等待名单对照的干预性母研究的3个时间点采集指尖血样。对样本进行神经保护因子和炎症生物标志物水平分析。
结果
干预组胰岛素样生长因子1（IGF-1）水平从基线到干预后4周和16周显著升高（P <.01）。胰岛素样生长因子1水平与连线测验B的神经认知测试表现改善相关（r = 0.31，P =.02）。在混合模型中，这种关联不显著。IGF-1水平与认知功能自我报告、活动水平或干预剂量的变化之间未发现显著相关性。
结论
有必要进一步研究IGF-1水平与联合运动和游戏式认知训练干预措施的潜在机制之间的关系。未来的研究应纳入更大的样本队列，并结合身体活动的客观测量以及与干预最新表现相关的规定采样时间。
对实践的启示
指尖血样采集对于开展生物标志物研究是可行、可接受且有效的。这种方法可最大限度地减少参与者的负担和不适；增加家庭、场外或农村地区的临床试验机会；并在疫情限制期间促进研究工作。
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